A-E Assessment in Patient Care

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Questions and Answers

What are the components of the A-E Assessment?

Airway, Breathing, Cardiology, Disability, Exposure

Airway, Bleeding, Circulation, Disability, Exposure

Airway, Breathing, Circulation, Diabetes, Exposure

Airway, Breathing, Circulation, Disability, Exposure (correct)

What is the purpose of repositioning a patient during the A-E assessment?

Repositioning can help open the airway, improve breathing, and increase circulation. It also allows for a more comprehensive assessment of the patient.

What are two examples of advanced airway techniques?

Two examples of advanced airway techniques are the Laryngeal Mask Airway (LMA) and the endotracheal intubation.

Which of the following are included in the 'Disability' section of the A-E assessment?

All of the above Signup and view all the answers

The 'Exposure' section of the A-E assessment involves only checking the patient's skin surface.

False Signup and view all the answers

What is the purpose of performing a head-to-toe assessment?

A head-to-toe assessment is a thorough examination of the entire body to identify any abnormalities or signs of illness or injury. Signup and view all the answers

Which cranial nerve is being assessed when checking a patient’s ability to raise eyebrows, smile, frown, show teeth, puff out cheeks and tightly close eyes?

Cranial Nerve 7 Signup and view all the answers

Which of the following are included in the 'Neck' section of the head-to-toe assessment? (Select all that apply)

Inspect for skin turgor Signup and view all the answers

The acronym PERRLA stands for Pupils Equal, Round, Reactive to Light, & Accommodation

True Signup and view all the answers

Which of the following are included in the 'Chest (Lungs) & Heart' section of the head-to-toe assessment? (Select all that apply)

Auscultate heart sounds Signup and view all the answers

What is the purpose of checking the patient's capillary refill during a head-to-toe assessment?

Checking capillary refill helps assess peripheral circulation, which indicates the effectiveness of blood flow to the extremities. Signup and view all the answers

When assessing the 'Abdomen' section of the head-to-toe assessment, what is the specific term for listening to the sounds produced by the patient's digestive system?

Auscultate for bowel sounds Signup and view all the answers

Checking for 'pitting' edema in the lower extremities involves pressing on the skin and noting whether the indentation remains after releasing the pressure.

True Signup and view all the answers

During a head-to-toe assessment, what does 'joint range of motion' refer to?

Joint range of motion refers to the extent to which a joint can be moved in various directions. It helps assess the flexibility and mobility of the joints. Signup and view all the answers

Study Notes

A-E Assessment

Airway: Ensure patent airway, ask the patient how they are feeling. Consider repositioning (head tilt, chin lift), suction, oropharyngeal adjunct, nasopharyngeal adjunct, advanced airway techniques (LMA).
Breathing: Evaluate respiratory rate, auscultate for normal breath sounds, assess tracheal position, respiratory effort, and oxygen saturation. Reposition the patient if necessary, administer medications (low-flow oxygen via nasal prongs, Hudson mask, non-rebreather mask), and monitor arterial blood gases.
Circulation: Assess skin color, peripheral perfusion (cap refill, skin turgor), cardiac output, blood pressure, and heart rate. Monitor temperature and abdominal assessment. Perform cannulation, venepuncture, ECG, catheterization, control bleeding, and fluid replacement as needed.
Disability: Review medication administered, blood sugar level, and document all patient documentation. Use the Glasgow Coma Scale/AVPU to assess level of consciousness, and review and monitor response to interventions.
Exposure: Examine entire skin surface, establish a thorough clinical history, review medical and laboratory notes, and review laboratory investigations. Perform ISOBAR handover, continue observations, and consider transferring to higher level care if necessary.

Head-to-Toe Assessment

General: Inspect, palpate, percuss, and auscultate. Ensure privacy and ask patient identification and demographic questions.
Vital Signs: Document normal pulse rate (60-100 bpm), blood pressure (120/80 mmHg), oxygen saturation (95-100%), temperature (97.8-99.1°F), and respiratory rate (12-20 breaths per minute).
Orientation: Evaluate patient's orientation to person, place, time, and situation (A&O x4). Ask questions like: "What is your name?", "Do you know where you are?", "What is the current date?"
Head and Face: Inspect head, scalp, and hair. Palpate the head and scalp for symmetry. Assess facial symmetry. Test cranial nerve VII (facial nerve function) by checking eyebrow raising, smiling, frowning, showing teeth, puffing out cheeks, and closing eyes tightly.
Eyes: Inspect external eye structures, pupil size and symmetry, and the reaction of pupils to light (PERRLA).
Neck: Inspect and palpate the neck, including carotid pulse and skin turgor.
Chest (Lungs): Inspect, palpate, percuss, and auscultate the chest for breath sounds. Note any crackles or diminished breath sounds.
Heart: Auscultate heart sounds (A, P, E, T, M) for murmurs and muffled heart sounds.
Spine: Inspect and palpate the spine for curvature and abnormalities.
Abdomen: Inspect, palpate the abdomen, auscultate bowel sounds in all four quadrants, and assesses for abdominal tenderness.
Upper and Lower Extremities: Assess skin for color, contour, lesions, hair distribution, and edema. Check capillary refill and peripheral pulses (radial, post-tibial, and dorsal pedis). Evaluate muscle strength and sensation.

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Description

This quiz focuses on the A-E assessment framework essential for patient care. It covers the critical components of Airway, Breathing, Circulation, and Disability, detailing necessary interventions and evaluations. Test your knowledge on these life-saving techniques and improve your clinical skills.