Test 2 Flashcards
(167 cards)
1
Q
Postmenopausal bleeding
A
Bleeding after menopause, can mean uterine cancer
2
Q
Atrophic vaginitis
A
Dry vagina
3
Q
Uterine prolapse
A
Lack of pelvic strength, uterus falls through vagina, recommend kegals
4
Q
Permission statement
A
Used for adolescent interview, start with something like “Often boys your age experience…”
5
Q
Ambiguity approach
A
Used for adolescent interview, “When did you…” rather than “Do you…”
6
Q
What percent of infertility is male related
A
20%
7
Q
Fluorescent yellow
A
Excess water- soluble vitamins excreted
8
Q
Cloudy
A
Urinary tract infection
9
Q
Bright orange, blue, green
A
Medication, dyes
10
Q
Red/pink
A
Blood
11
Q
Orange/Tea colored
A
Liver disease/biliary disorder
12
Q
What position do you give genital exam on males
A
Standing up
13
Q
Epispadius
A
Urethra is higher
14
Q
Hypospadius
A
Urethra is lower
15
Q
Infibulation
A
Removing clitoris
16
Q
What do you offer when giving pap smear
A
A mirror
17
Q
What do you ask pt to do when giving pap smear
A
Have patient take deep breaths and bear down to increase comfort
18
Q
When are pap smears given
A
Every 3 years starting at age 21 or becoming sexually active
19
Q
Liver location
A
RUQ
20
Q
Spleen location
A
LUQ, behind stomach
21
Q
Gallbladder location
A
Right below liver
22
Q
Stomach location
A
LUQ behind liver, in front of spleen
23
Q
Small intestine location
A
Part of all quadrants
24
Q
Ascending colon location
A
RUQ
25
Descending colon location
LLQ
26
Appendix location
RLQ
27
Pancreas location
Over aorta, in middle/LUQ
28
Adrenal glands location
Right above kidneys
29
Kidneys location
Right kidney is slightly lower, beside pancreas
30
Epigastric
Upper region of abdomen
31
Umbilical
Middle region of abdomen
32
Hypogastric or suprapubic
Lower region of abdomen
33
Order of physical exam for abdomen
1. Inspection
2. Auscultation
3. Percussion
4. Palpation
34
How to check contour
Slightly elevate head with pillow
35
How should umbilicus look
Midline, no discoloration or drainage
36
Striae
Stretch marks
37
What else should you do when inspecting abdomen
Have pt hold up head, take deep breath, and cough to look for masses
38
Types of contour
1. Flat
2. Concave
3. Rounded
4. Protuberant
39
Causes of abdominal distension
1. Obesity
2. Air/gas
3. Pregnancy
4. Feces
5. Ascites (fluid)
6. Mass
40
Umbilical hernia
Intestines bulging through umbilical
41
Incisional hernia
Incision from surgery has intestines coming through because muscle didn’t heal
42
Diastasis recti
Intestines pushing through split in muscle
43
Where do you start when auscultating for bowel sounds
RLQ
44
How many bowel sounds should you hear in a minute
5-30
45
Hyperactive bowel sounds
More than about 30 in a minute
46
Hypoactive bowel sounds
Less than about 5 in a minute
47
What could hypoactive bowel sounds mean
Postsurgical or have not eaten in a while
48
When can you declare that there are no bowel sounds
After listening for 5 minutes and not hearing any
49
Paralytic ileus
Anesthesia paralyzes the ileus
50
Bruits
Abnormal, can indicate hypertension, usually over blood vessels
51
Friction rub
Grinding sound, usually over vessels
52
Predominant sound in abdomen
Tympany, but dullness over organs
53
How to find liver span
Percuss down from midclavicular line and stop when you go from resonance to dullness and then percuss from abdomen and stop when you go from tympany to dullness
54
What is the normal liver span
6-15 cm
55
Pediatric liver span
5 cm at 5 years old
56
How to find spleen span
Between 9th and 11th intercostal space, just left of the mid axillary line, work your way up until you hear dullness
57
Costovertebral tenderness
First percuss over the kidneys, pain means there is a kidney infection
58
Rectal exam positions
1. Left lateral
2. Standing
3. Lithotomy (females only)
59
Healthy people 2020 goals (skin hair nails)
1. Reduce occupational skin disease
2. Reduce health care associated infection
3. Reduce sun exposure
4. Teaching healthy habits
60
What to look for when inspecting hair
1. Color
2. Odor
3. Texture
4. Distribution
5. Lesions
61
What to look for when inspecting nails
1. Shape and contour
2. Consistency
3. Capillary refill
62
What to look for when inspecting skin
1. Color
2. Odor
3. Temp
4. Moisture
5. Texture
6. Thickness
7. Edema
8. Mobility and turgor
9. Vascularity or bruising
10. Lesions
63
What to look for in temperature of skin
1. Hypothermia
| 2. Hyperthermia
64
Diaphoresis
Excessive sweating
65
Pallor
Paleness
66
Erythema
Reddened skin
67
Cyanosis (skin)
Blue tint
68
Jaundice
Yellow tint
69
Dark skinned variation: pallor
Brown skin may be yellowish brown and dull, black skin appears ashen
70
Dark skin variation: Cyanosis
Dark and lifeless, no warm undertone
71
Dark skin variation: Jaundice
Yellowish in palms and palate, can be seen in sclera
72
Dark skin variation: Erythema
Purple tinge; verify by palpating for warmth
73
Caucasions are more at risk for
Skin cancer
74
African americans are more at risk for
1. Keloids
2. Acanthosis nigrans
3. Mongolian spots
75
Asians are more at risk for
1. Sparse body hair
| 2. Mongolian spots
76
Braden scale measures
1. Sensory perception
2. Moisture
3. Activity
4. Mobility
5. Nutrition
6. Friction and shear
77
Stage 1 pressure ulcer
A defined area of persistent redness, in darker skin tones it may appear with red, blue, or purple.
78
Stage 2 pressure ulcer
Superficial abrasion, blister or shallow crater
79
Stage 3 pressure ulcer
Full thickness skin loss, a deep crater
80
Stage 4 pressure ulcer
Full thickness skin loss with extensive destruction, to muscle, bone, or supporting structures
81
What to inspect with lesions
1. Color
2. Elevation
3. Pattern or shape
4. Size
5. Location and distribution on body
6. Exudate
82
Evaluating lesion using ABCDE
```
A: Asymmetry
B: Border
C: Color
D: Diameter
E: Elevated
```
83
Normal diameter of lesion
1/8-1/4 of an inch
84
Annular or circular/oval
Oval or rounded lesion
85
Gyrate
Squiggle, associated with parasites
86
Target
Bullseye appearance
87
Discrete
Rounded bumps not associated with each other
88
Grouped
Bumps in a group
89
Polycyclic
Bumps that run together, no defined edges
90
Confluent
Run together, not raised, spread across an area
91
Linear
Striae; makes a line
92
Zosteriform
Follows a nerve ending
93
Macule
Flat, distinct, discolored area of skin less than 1 cm wide (freckle)
94
Papule
Small, raised, solid pimple or swelling, often forming part of a rash on the skin and typically inflamed but not producing pus
95
Urticaria
Hives
96
Nodule
Growth of abnormal tissue
97
Wheal
Transient, circumscribed, elevated papules or plaques, often with erythematous borders and pale centers.
98
Pustule
A vesicle filled with pus
99
Fissue
Crack
100
Erosion
Skinned first layer of skin
101
Stasis ulcer
Caused by bad circulation
102
Excoriation
Severe scratching
103
Atrophic scar
Striae
104
Lichenification
A skin condition that occurs in response to excessive itching or rubbing of the skin and results in thick, leathery patches of skin
105
Tail of spence
Area around axilla
106
Sentinel lymph node
The first lymph node(s) to which cancer cells are most likely to spread from a primary tumor
107
Sentinel lymph node biopsy (SLNB)
Can be used to help determine the extent, or stage, of cancer in the body
108
Healthy people 2020 goals (breasts)
1. Reduce breast cancer death rate
2. Reduce # late stage breast cancers
3. Increase # of women who get screening
109
What to look for in breast inspection
1. Appearance
2. Skin
3. Lymphatic drainage areas
4. Nipple
5. Retractions
110
Signs of retraction and inflammation
1. Dimpling
2. Fixation (not moving)
3. Edema (peau d'orange)
4. Deviation in nipple pointing
5. Nipple retraction
111
Breast palpation position
Supine
112
Breast palpation patterns
1. Wedge (start from nipple going out)
2. Circular
3. Verticle strip
113
Male breast
Gynecomastia
114
Precordium
The area of the heart
115
S1
Mitral, tricuspid valves closing
116
S2
Aortic and pulmonic valves closing
117
External and internal carotid artery
Located near the top
118
Internal and external jugular vein
May see pulsations, located near clavicle
119
Cardiovascular non modifiable risk factors
1. Age
2. Male gender
3. Heredity (race, history)
120
Cardiovascular modifiable risk factors
1. Smoking
2. High cholesterol
3. High BP
4. Inactivity
5. Obesity
6. Diabetes
121
Pre hypertension BP
120-139/80-89
122
Stage 1 hypertension BP
140-159/90-99
123
Stage 2 hypertension BP
>160/>100
124
What to inspect in cardio assessment
1. Carotid arteries
| 2. Jugular veins
125
What to assess on carotid arteries
1. Pulsations
2. Palpate
3. Auscultate for bruit
126
What to assess on jugular veins
Inspect for jugular venous pulses
127
What to inspect on chest
1. Pulsations
2. Lifts
3. Heaves
128
Normal heart sounds
1. First heart sound
2. Second heart sound
3. Splitting of second heart sound
129
What happens at the beginning of diastole
S2
130
What happens at end of diastole/beginning of systole
S1
131
Location of heart
Between 2nd-3rd intercostal space on right sternal border to left mid clavicular line
132
What does enlargement of jugular veins show you
If there is something wrong with one side of the heart
133
What heart attack symptoms are unique to women
Indigestion, fatigue
134
Orthopnea
Having to sleep elevated
135
Diaphoresis
Sweating
136
Who is more at risk for heart disease
African Americans
137
Risk for smokers for heart disease is
2-4 times higher
138
What do you do when auscultating neck vessels
Use the bell of the stethoscope
139
Thrill
Seeing chest vibrate
140
PMI
Point of maximum impulse; 5th intercostal space left mid clavicular line; apex of heart
141
What step do you not necessarily have to do
Percuss
142
APE-To-Man
1. Aortic area
2. Pulmonic area
3. Erb's point
4. Tricuspid area
5. Mitral area
143
Aortic area location
Right sternal border 2nd intercostal space
144
Pulmonic area location
Left sternal border 2nd intercostal space
145
Erb's point location
Left sternal border 3rd intercostal space
146
Tricuspid area
Left sternal border 5-6th intercostal space
147
Mitral area
Left mid clavicular line, 5th intercostal space
148
S2 is louder than S1 at
Aortic and pulmonic area
149
S1 = S2
Erb's point
150
S1 is louder than S2 at
Tricuspid and mitral
151
First heart sound
"Lub"; AV valves; heart louder at apex
152
Second heart sound
"Dub"; SL valves; louder at base
153
Splitting heart sound
Splitting of heart sound at inspiration
154
How do you auscultate chest
With diaphragm first, then bell (bell tells if there is murmur)
155
Extra heart sounds
1. Third heart sound
| 2. Fourth heart sound
156
Third heart sound
"Kentucky"; normal in children and young adults (under 30); in older adults it could signifiy fluid overload in ventricle which could lead to heart failure or regurgitation
157
Fourth heart sound
"Grace note" "Tennessee" Normal in adults and children under 30; over 30 could mean stiff ventricle
158
What to inspect on arms and legs
1. Skin
2. Profile skin (clubbing)
3. Capillary refill
4. Symmetry
5. Pules (grade from 0-3+; compare bilaterally)
159
Modified Allen test
Have pt make a fist and release ulnar side and compress radial side, should have normal blood flow
160
What to palpate on extremities
1. Skin
2. Temperature
3. Even hair distribution
4. Venous patterns
5. Capillary refill
6. Profile sign (clubbing)
7. Symmetry
8. Pulses
9. Edema
161
Lower extremity pulses
1. Femoral artery
2. Popliteal
3. Dorsalis pedis (on top of foot)
4. Posterior tibial (medial side of ankle)
162
Pitting edema grades
1+: 2mm
2+: 4mm
3+: 6mm
4+: 8mm
163
Homan's sign
Pull back on feet and raise straight leg, looking for pain
164
Chronic arterial vascular insufficiency signs and symptoms
1. Deep muscle cramps
2. Cool extremities
3. Pale extremities
4. Loss of hair
5. Shiny skin
165
Chronic venous arterial vascular insufficiency signs and symptoms
1. Aching tired full feeling
2. Ulcers
3. Edema
4. Varicose veins
166
Acute arterial vascular insufficiency signs and symptoms
EMERGENT
1. Pain (throbbing)
2. Pallor
3. Pulselessness
4. Poiliothermia (cold)
5. Paralysis
6. Parasthesia (altered sensation)
167
Acute venous vascular insufficiency signs and symptoms
Needs prompt attention
1. Deep muscle tenderness
2. Red warm swollen
3. Pain increases with dorsiflexion (Homan's sign)
