Exam One Review Chapters 1-6 PDF

Exam One Review Chapters 1 6 Pain Assessment Chapter 6 4 questions Whattypeofquestions can you ask to get the onset of pain Where did the pain begin What were you doing Did the pain begin suddenly or gradually...

Exam One Review Chapters 1 6 Pain Assessment Chapter 6 4 questions Whattypeofquestions can you ask to get the onset of pain Where did the pain begin What were you doing Did the pain begin suddenly or gradually Acute pain has a sudden onset is of short duration Tschemicpain gradually increases in intensity Pertinentchronicpain last longer than 6 months pfytffmtd.PE ent cultures may describe pain using words the nurse is not familiar to the nurse  Health Preventions 3 questions Drag Drop Primary vaccine teachings etc SendaryMost screenings exams Prevention Management Tertiary Data drag drop select all that apply history ask.rti.it also Eajattn symptoms are subjective TiffstEtf percussion ausculation etc s asenfection paptation signs are objective Techniques of Physical Assessment Data for physical assessment are collected w thesetechniques Inspection data obtained by a visual examination of the body including body metettureaslo obtained by smelt  y used throughout entire exam w each body system ex Nurse inspecting lungs respiratory system nurse observes Shape of chest breathing rate depth effort of respiration nailbeds overall color of skinlips Palpation using the hands to feel texture size shape consistency pulsationtlocationof certain parts of pt's body Also used to identify areas the pt reports as being tender or painful nurse'stouch should be gentle hands warm nails short toprevent discomfort or injury to the pt Palmer surfaces of the fingers finger pads are more stensitivetopalpations thanthefingertipsthus theyaremorebetter fordetermining position texture size consistency massestfluid moisturetcrepitus Ulnar surface of the hands extending to the 5ᵗʰ fingerTmostsensitive toVibration Dorsal surface back of hands is more sensitive so to temperaturel Tmersurface Palpation is light or Deep controlled by the amount of pressure applied light Palpationspressing down to a depth of Iom t used to access skin Tenderness Deep Palpations pressingdown to a depth of 4cm w one or two hands used to determine size contour of an organ Percussion to evaluate the size borders consistency of internalorgansidetecttenderness determine the extent of fluid in a body cavity striking a finger or Landdirectly again rPff i Tevaluate used ex sinus of an adult by tapping afinger over the sinus or to elicit tenderness orpain over kidney by striking the costovertebral angle CVA directly w fist requiresboth hands performed depending on which by body area is being assessed ex indirect percussion of the kidney involves placing the nondominant hand palm down w fingerstogether over the CVA gently tapping the back of the hand w the fist of dominant hand AfflEIIthntensitypitchburationauality resonate loud low long Hollow extremely dull Bonetmuscle Flat soft high short viscerative medium borders pop medium meaning none 89 intestines timanic loud high medium Drumlike loud YET Hermtishapling resinate very longer Booming Auscultation listening to sounds w in the body stethostcopeblocks out extraneous sounds that may interferetwith hearing sounds produced by the heart bloodvessels lungs intestines Sound it's characteristics intensity pitch duration quality closing eyes while listening to reduce visual stimuli due to sounds beingtransitory or subtle SelectiveHearing isolation of specific sounds such asair during inspiration or a single heartbeat characteristics offoundshard by Action Instensity is the loudness of the sound described as soft medium orloud Litch isthefrequency or number of sound waves  y generated per second High pitched sound waves have high frequencies Expected high pitch sounds are breath sounds low pitch sounds are cardiac sounds Duration of sound vibrations isshort medium or long layetofsoft tissue dampen the duration of sound from deep organs Quality refers to the description of the sounds hollow dull crackle Positionsforexaminatio s ffhf.fiff.eriortnoraxt I.ta lungs anteriorthorax lungs breasts axilla heart vital signs upper extremities limitations maybeunable to sit physically weakened patient nurse should use supine position w head of bed elevated  Supine Head neck anterior thorax lungs breasts axilla heart abdomen extremities pulses limitations IF pt becomes short of breath the nurse may need to raise the bed lying on back Dorsalrecumbent Head neck anteriorthorax t to breaststxillaheart abdomen limitations Pts w painful disorders are more comfortable w kneesflexed Lithotomy Female genitalia and genital tract Timitations position embarrassing uncomfortable minimize time spent in it kept well draped  Ins Rectum vagina Limitations Joint deformities may hinder the pts ability to blend the hip knee Irone Musculoskeleton system limitations poorly tolerated in pt's respiratory difficulties w flying on stomach Lateral recumbent Heart Titationspositions poorly tolerated in pts respiratory difficulties lying on side  knee chest Rectum Timitations embarrassing uncomfortable minimize time spent kept well draped Anatomical Positions Posterior Back Surface of the Body Anterior Front surface of the body Lateral pertaining to the side away from Inferior Below the head lower Superior Above higher toward the head Medially Superficial distal Phasesofinterviews Introduction Phase Greet the pt introduce self top Establishpurpose of the visit from pt Describe the purpose process of the interview  Discussion Phase Facilitate maintain a patient centereddiscussion Use various communication skills techniques to Collect Data summarize the data wIh xse Allow pt to clarify the data Create ashared understanding of the problems w the pt plan for the next steps end interview IIIfestions TEfatek.iq Vended Y Broadly stated questions that encourage a freeflowing open response responses that are more than 1 or 2 words Pt describes onset of symptoms in their own words own pace Challenge if pt cannot focus on specific topic of question or take excessive time to tell their story Ex How have you been feeling  y g Tell me alittle about yourself What brings you to the clinic today EndedbirectiveQuestionsl.to Closed gain more precise details that requires only a 1 or 2 word response or leads pt to the focus of onset thoughts valuable in collecting data may be used Witha open ended questions be failing to allow pt's to describe their health in their own ordscanleadto inaccurate conclusions Ex Do you become short of breath when walking up the stairs How many days have you been able to not eat Is the pain in your stomach sharp dull or aching Techniques that Enhance the Interview activelisteninglisteningwapurposetothe spoken words noticing nonverbal behaviors Performed by concentrating what pt is saying  y g yg the subtleties of the message being conveyed together w facial expressions body language observed Assumptions can cause a nurse to ask an illogical question Pay full attention to pt's response rather than trying to predict how the will pt respond next Facilitation Phrases used to encourage the pt to continue talking fdfnffdftgffhl.fi flrward Clarification used to obtain more info about conflicting vague or ambiguous statement Pt I was so angry I almost lost it Nurse What did you by Almost lost it mean Reflection used to gain clarification by restating a phrase used by the pt in the form of a question encourages elaboration indicates that the nurse is interested in more info Pt I got out of bed Ijust didn'tfeel right Nurse You didn't feel right Pt Uh huh I was dizzy had to sit back on thebed before I fell over Confrontation used when inconsistencies are noted between what the pt reports observations or other data about the pt Nurses tone of voice is important when using confortation use a tone that communicates confusion or misunderstanding rather than one that is accusatory angry Interpretation uses interpretation to share w the pt the conclusions drawnfrom data given After hearing conclusions the pt can confirm deny or revise the interpretation Summarise condenses orders data obtained during the interview to help clarify a sequence ofevents useful when interviewing pt who rambles on or does not provide sequential data EEfMmlpIhFEcttor for a successfulinterviewis establishing a positive rapport leads to trust that enhances the sharing of personal info  g Factors that affect the rapport are Professional behavior of the nurse effective communication Professional Behaviors make a positive Strongfirst impression First Impression Factors appearance dressing grooming clean appearance modest professional attire t identification badge are imperative being promptknocking before entering a room introducing oneself fully present to the situation Effectivecommunications interpersonal skills are central to effectivecommunication conduct interviews in an efficient calm unhurried manner Actively listen to pts KaltNonverbal Nonverbal behavior Posture gestures eyecontact facial expression project to pt's the nurse's level of interest acceptance understanding of them Avoid reactions based on a pts appearance or the info shared  fieg.it gfrersonalcommunicationslis EE n a IEvio interview conductedin privatequietcomfortable roomfree from environmental distractions Importance of privacy especially when discussing issues that are highly personal cannot be femized Pts should bephysically comfortable during the interview conducted in a quiet setting w out distractions Privacy is best gained by conducting interview in an unoccupied room IF interview is in an occupied roomsemi private or room Draw currents back block out visual distractions Nurse pt should sit at a distance from one another that provides for a comfortable conversationflow Pt's comfortlevel is partly related to personal space amount of space the pt needs is influenced by pt culture previous experiences in similar situations Room temperature set at a comfortablelevel eliminate unnecessary noise  y Remove unnecessary equipment or turnedoff eoarigofData_ helps problems appear more clearly done by body system format cardiovascular musculoskeletal auditory visual or a conceptual by format gas exchange perfusion mobility Aldocumentationshouldbeaccurate ifeng.at PIit toieary Faces individual so pt can see nursesface holding the interview in a quiet room Eachpersonshouldbeconsideredaunique Individual t_ TIER a r  repeat Did they Et understand egze Handwashing When Before After direct contact with a pt 15 20 seconds for both handsanitizer t soap w water BETTIFFITI rectal trauma re rectal temp surgery Colonsotomy cancer treatments GI bleeds Post MI heartattack pts Normalvitals Feature 96.4 F 35.8 C to 99.1 F  37.3 C w average 98 6 F 37 C Heart Rate inf 100 160 Toddler 98 140 School Aged 75 118 Adolescent 60 100 Adult 60 100 Respiratory Rate infant 30 53 Toddler 22 37 SchoolAged 18 25 Adolescent 12 20 Adult 12 20 Bloodpressured infant Systolic 72 104Diastolic 37 56 Toddler Systolic 86 106 Diastolic 42 63 SchoolAged Systolic 97 115 Diastolic 57 76 Adolescent Systolic 110 131 Diastolic 64 83 Adult Systolic 2120 Diastolic 80  What vital signs increase Temperature High Respiratory Rate IF blood Pressure is high in one arm check the other arm What is a ganglion cyst what does it look like A fluid filled bump Lump that usually appears on a joint or tendon sheath often theorist Also occurs in ankles feet Often goes away on it's own doesn't usually require treatment can be removed drained Erm or spongy feeling can occur after injury 1  Ethanatemia Do Not use 0.9 percent solution on pt w high sodium levels Dosagecalculations 5 questions how to round up Lestions 3 68 round to nearest 10ᵗʰ 3.7 3 68 round to nearest whole 4.0 2,68 Medicalerminology 9 questions Basic Word Structure Prefix suffice meaning  Cardiology meaning study of theheart rootword cardio Suffix logy study of hematology study of the blood root hematlo suffix logy study of Gastritis medially distal Lateral Superficial  IE iii a swintnenome Victims Women children men can be victims to Perpetrators mostoften an intimate partner or parent figure Contributingfactors often associated w drug or alcohol use or both questions to Ask Have you been physically injured hit kicked punched by someone in home in the last your year Many women are victims of domestic violence Do you feelsafe in your current relationship w your husband or significantother Are you afraid of an individual w whom you have previously had a relationship