Flashcards in Week 1: Intro to Health Assessment Deck (24)
What are the two types of visits we conduct as FNPs? When would you conduct each?
Comprehensive patient assessment: new patients in the office or hospital, annual well-visit
Focused patient assessment: appropriate for established patients, especially during routine or UC visits
Regardless of visit type, collect the following information: _____ (3)
What are the components of the comprehensive exam and what is generally collected during each? (6)
Initial information: identifying patient info and source/reliability
Chief complaint(s): primary symptom or concern causing the patient to seek care
HPI: amplifies the CC describing the chronology of events as to how each symptom developed; includes patient's thoughts/feelings; pulls relevant portions of ROS
Past medical history: lists adult illnesses with dates for events (medical, surgical, OB/gyn, psych)
Family history: outlines or diagrams age and health or age and cause of death of siblings, parents, grandparents
Personal and social history: history of tobacco, alcohol, recreational drug use, sexual history, educational level, family of origin, current household etc.
What is the difference between subjective and objective data?
Subjective: what the patient is telling you
Objective: measurable data
What is a differential diagnosis and how is it formulated?
List of potential causes for patient's problems - formulated using the data from assessment
What is the HPI?
concise, clear and chronologic description of the problems prompting the patient's visit
What are the 7 attributes of a symptom?
Location: where in/on the body the problem, symptom or pain occur or move to other areas
Quality: an adjective describing the type of problem, symptom or pain
Quantity or severity: patient's nonverbal actions or verbal description as to the degree or extent of the problem, symptom or pain: pain scale, comparison of the current problem, symptom or pain to previous experiences, how bad is it?
Timing: describes when the symptom or pain started
○ Onset: setting in which it occurs, what actions or circumstances cause the problem, symptom or pain to occur worsen or improve
○ Duration: how long the problem, symptom or pain have been present or how long the problem/symptom or pain lasts
○ Frequency: how often it occurs
Remitting or exacerbating factors: actions or activities taken to improve the issue and the outcome
Associated manifestations: other s/sx that occur when the issue occurs
What does OLDCART stand for?
What is a leading question?
Question that elicits a specific response
How should the FNP quantify tobacco use?
Cigarettes are reported in pack-years; calculated by multiplying number of packs of cigarettes smoked per day by the number of years the person has smoked
One pack is 20 cigarettes
What are the validated screening questions for depression?
“Over the past 2 weeks, have you felt down, depressed, or hopeless?”
“Over the past 2 weeks, have you felt little interest or pleasure in doing things?”
What is the acronym for alcohol/drug screening?
C: cutting down
A: Annoyance when criticized
G: Guilty feelings
What question is important to ask regarding drug use?
How many times in the past year have you used an illegal drug or prescription medication for non-clinical reasons?
What is the USPSTF screening recommendation for IPV?
routine screening of all women of childbearing age for intimate partner violence and providing or referring those who screen positive for intervention services
What is the difference between weakness and fatigue?
Weakness denotes a demonstrable loss of muscle power, if localized can be related to neuropathy or myopathy
Fatigue is a nonspecific symptom with many causes - refers to a sense of weariness or loss of energy
When is fatigue an expected finding?
Normal response to hard work, sustained stress or grief, elicit the life circumstances in which it occurs
Will be associated with many chronic/acute diseases/illnesses
How do we define weight loss?
loss of 5% or greater of usual body weight over a 6-month period
How do we define obesity?
BMI > 30
Define validity. What is the gold standard?
Measure whether the test accurately identify whether a patient has a disease
The gold standard: the best measure of whether a patient has disease
What is the difference between sensitivity and specificity?
Sensitivity: probability that a person with the disease has a positive test (true positive rate)
Specificity: probability that a nondiseased person has a negative test (true negative rate)
What type of routine screening do older adults need?
Consider life expectancy, functional status
What geriatric syndromes should the FNP assess for in older adults?
Falls, urinary incontinence, frailty, cognitive impairment
What are some ways to approach a pediatric patient? (6)
Direct questions to child first if possible
When appropriate, review with child the purpose of the visit
Examine child on parents lap
Distract, play, patience
Engage child with questions about their interests
Move from least invasive to most invasive - save ears, mouth, abdomen for last