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Health Assessment > Test #1 > Flashcards

Test #1 Flashcards

(39 cards)

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1
Q

Diagnostic Reasoning

A

1) attending to available cues
2) formulating a diagnostic hypothesis
3) gathering data relative to tentative hypothesis
4) evaluating each hypothesis with new data to arrive at the final diagnosis

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2
Q

Priorities

A

1st level - emergent, immediate, life threatening, ABC’s
2nd level - urgent, necessitating prompt interventions, acute pain
3rd level - important, addressed after more urgent problems…teaching, lack of knowledge, resources
Collaborative - involves multiple professions, alcohol abuse, diabetes

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3
Q

Models of Health

A

biomedical model - health is the absence of disease
behavioural model - treatment of disease and preventions
Socioenvironmental Model - sociological and environmental aspects

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4
Q

purpose of the interview

A
  • gather data
  • establish rapport
  • teaching
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5
Q

Implied Contract

A
  • time and place
  • intro and explanation
  • purpose of the interview
  • length of interview
  • what will occur
  • others present
  • confidentiality
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6
Q

Assisting the conversation

A
  • facilitation
  • silence
  • reflection
  • empathy
  • clarification
  • interpretation
  • explanation
  • summary
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7
Q

Ten Traps of Interviewing

A
  • providing false reassurance
  • giving unwanted advice
  • using authority
  • using avoidance language
  • engaging in distancing
  • professional jargon
  • using leading or biased questions
  • talking to much
  • interrupting
  • using “why” questions
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8
Q

Non Verbal Cues

A
  • physical appearance
  • posture
  • gestures
  • facial expressions
  • eye contact
  • voice
  • silence
  • bodily exposure and touch
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9
Q

the complete health history

A
  • biographical data
  • source of history
  • reason for seeking care
  • current health or history of current illness
  • past health
  • family history
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10
Q

Functional Assessment (activities of daily living)

A
  • self esteem
  • activity/exercise
  • sleep/rest
  • nutrition/elimination
  • interpersonal relationships
  • spiritual resources
  • coping and stress management
  • personal habits (tobacco, alcohol)
  • environmental hazards
  • Occupational health
  • intimate partner violence
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11
Q

Assessment Techniques (IPPA)

A

inspection
palpation
percussion
auscultation

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12
Q

Inspection

A

concentrated watching
general survey
compare sides (symmetry)

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13
Q

Palpation

A

can confirm details from inspection

  • touch: texture, temperature, moisture, organ location and size, pain, tenderness, lumps, rigidity, crepitation
  • slow and systemic: warm hands, start away from painful areas
  • light palpation first (1-3cm): work in small concentric circles
  • deep palpation second (5-7cm): avoid digging, intermittent is better than continuous

Fingertips - tactile discrimination
Dorsum - temperature
Base of fingers and ulnar surface - vibrations
bimanual palpation - hand over hand for deep palpation, cupping (duck bill)

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14
Q

Percussion

A 
tapping skin
palpable vibration and characteristic sounds
direct percussion
indirect percussion
characteristics of percussion notes
- resonant: lungs (air filled spaces)
- hyperresonant: hyper inflated lungs
- tympany: stomach (fluid filled spaces)
- dull: solid organs, bones
- flat: bones
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15
Q

Auscultation

A 
diaphragm - high pitched sounds (respiratory, abdominal, cardiac sounds)
Bell - low pitched (vascular sounds)
clean stethoscope
no friction on tubing
never listen through gown/clothing
wet hair to minimize 'noise'
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16
Q

Vital Signs - Normal Ranges (TPRBPSP02)

Study These Flashcards
A 
Temperature 
-oral: 35.8-37.3
-tympanic: 36.5-37.5
Pulse: 60-100 bpm
Respiratory rate: 12-20 respirations per minute
blood pressure: 120/80
oxygen saturation: >95% on room air
pain assessment
17
Q

Temperature

Study These Flashcards
A

oral
tympanic
temporal
rectal (1 degree higher than oral and tympanic, accurate and definitive for kids)
armpit (not accurate, best for kids and babies)
diurnal variance: 1-1.5 degrees (normal change in variance throughout the day)
febrile - above 37.5 C (fever)
rigor - shaking cause cold

18
Q

Pulse

Study These Flashcards
A

rate (30 seconds x 2 or 60 seconds)

  • normal range is 60-100
  • bradycardia = <60
  • tachycardia = >100

Force

  • 0=absent
  • 1=weak
  • 2=normal
  • 3=bounding

Apical Pulse - 5th intercostal space at midclavicular line

pulse deficit - mismatch between apical pulse and peripheral pulse

19
Q

Respiration

Study These Flashcards
A 
normal = 10-20
bradypnea = <10
Tachypnea = >20
20
Q

(oxygen saturation) Sp02

Study These Flashcards
A

measure the amount of oxygen bound to hemoglobin
requires equipment
no nail polish or fake nails
can use on toes and pin of ear

21
Q

Blood Pressure

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A

systolic blood pressure - med surg, measures how much blood is going through the tube, diameter of the tube, flexibility of the tube
diastolic blood pressure - med surg
Mean arterial pressure - ICU, looks at the whole cardiac function

22
Q

blood pressure equipment

Study These Flashcards
A

stethoscope - bell
sphygmomanometer
- aneroid (manual)
- Oscillometric (automatic)
Sizing
- bladder of cuff encircles 80% upper arm circumference
- width of cuff = 40% circumference of upper arm

23
Q

Measuring Blood Pressure

Study These Flashcards
A

Stages

fully compressed = silence (120+)
partially compressed = korotkoffs sounds (80-120)
free flowing = silence (0-80)

stage 1 is where sound starts
stage 5 is where sound ceases

Auscultatory Gap - silence in the middle of korotkoffs sounds, not normal

24
Q

hypertension/hypotension

Study These Flashcards
A 
systolic prehypertension=129
systolic stage 1 hypertension=139
systolic stage 2 hypertension=140+
diastolic hypertension=90
diastolic hypotension=60
25
orthostatic/postural hypotension
A condition in which your blood pressure quickly drops when you stand up from a sitting or lying position You have orthostatic hypotension if your blood pressure drops more than 20 mmHg in systolic pressure and 10 mmHg in diastolic pressure within three minutes of standing up supine x3 minutes >20 mm Hg fall in SBP after 2 min >20 bpm pulse increases after 2 min
26
Geriatric Considerations
temperature less reliable indicator irregular pulse radial pulse may feel stiff, rigid, and tortuous increased respiratory rate increased systolic and diastolic due to hardened arteries
27
Subjective Skin Data
- previous history of skin diseases - changes in colour and pigmentation - changes in a mole - excessive dryness or moisture - pruritus - excessive bruising - rash or lesion - medications - hair loss - change in nails - environmental or occupational hazards - self care behaviours
28
Inspect and Palpate the skin
- colour - temperature - moisture - texture - thickness - edema - mobility and turgor - vascularity and bruising - lesions (colour, elevation, pattern or shape, size, location and distribution, exudate, depth temperature, blanching)
29
Inspection of Musculoskeletal
size and contour of each joint skin and tissue of each joint note swelling and discolouration visual differences between muscle symmetrically
30
Palpation of Musculoskeletal
skin temperature muscles bony articulations joint capsule
31
Temporomandibular joint
``` Inspection Palpation - Open and close mouth Range of motion - Open mouth maximally, test muscle strength - Protrude and retract lower jaw - Side to side/laterally Palpate muscles of mastication ```
32
Cervical Spine
``` Inspection - Alignment of head and neck Palpate - Spinous processes and muscles Motion and expected range - Touch chin to chest - Lift chin - Move each ear to shoulder - Turn chin to each shoulder (REPEAT WITH OPPOSING FORCE) ```
33
Shoulders
``` Inspection - Compare shoulders posteriorly and anteriorly - Pain Palpate - Shoulders and axillae - Palpate bilaterally, comparing side to side - Start at clavicle and work out to shoulder Motion and expected range - Flexion and hyperextension - Abduction and adduction - Internal rotation - External rotation (REPEAT WITH OPPOSING FORCE) ```
34
Elbow
Inspect while flexed and extended Palpate - flex arm 70 degrees and support arm Motion and expected range - flexion and extension - Pronation and supination (REPEAT WITH OPPOSING FORCE - support the joint with one hand and provide opposing force with the other)
35
Wrist and Hand
Inspect - Joints and dorsal and palmar sides - Positioning of wrist and fingers, abnormalities, skin, muscles Palpate - Over each joint in the hand - Support hand - Start at wrist and move toward distal fingers Muscle testing - Flex against resistance: Arm supine on table - Grip strength Special Considerations - Phalen test: Hold hands back to back for 60 seconds. Expected - no symptoms - Tinel’s Sign: Direct percussion at median nerve Expected - no symptoms
36
Hip
``` Inspect - standing and walking - Even and smooth gait - Swing and weight bearing stage Palpate - hip joints - ASIS - Greater trochanter - PSIP Motion and expected range - Raise leg - Bend knee to chest - Flex knee and hip and swing foot out and in - Swing leg laterally and medially (adduction and abduction) - Stand and swing leg back ```
37
Knee
``` Inspect - joint and muscle Palpate - Supine position and relaxed quadriceps muscle - Start proximal (above patella) and move distal Motion and expected range - Bend knee - Extend knee - Watch knee during gait Muscle strength - Flex knee against resistance ```
38
Ankle and Foot
``` Inspect - sitting, standing, and walking Palpate joints - Start proximal and move distal - Support the ankle while palpating Motion and expected range - Point toes down - Turn soles out - Flex and straighten toes Muscle strength - flex and extension against resistance ```
39
Spine
``` Inspect - standing posture Palpate spinous processes Motion and expected range - Stabilize pelvis - Bend sideways, forward, backwards - Twist shoulders to each side ```

Health Assessment (3 decks)

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