Health Assessment Exam #1 Blueprint PDF

**Health Assessment Exam \#1 Blueprint** Unit 1-3 (Hx and Interviewing, Physical Overview, HEENOT) Questions from study guide:\ **Know the difference between hypertropia, exotropia, esotropia, and**\ **hypotropia.**. (Bickley et al. , 2021, pg 368) - Esotropia (inward deviation) - Exotropi...

**Health Assessment Exam \#1 Blueprint** Unit 1-3 (Hx and Interviewing, Physical Overview, HEENOT) Questions from study guide:\ **Know the difference between hypertropia, exotropia, esotropia, and**\ **hypotropia.**. (Bickley et al. , 2021, pg 368) - Esotropia (inward deviation) - Exotropia (Outward deviation) - Hypertropia (Upward deviation) - Hypotropia (Downward deviation) **Know the difference between Lacrimal gland enlargement, Dryness of the**\ **eyes, Nasolacrimal duct obstruction, and Thyroid eye disease.** (Bickley et al. , 2021, pg 369) ** What is therapeutic communication and special consideration for blind**\ **patients and patients hard of hearing?** [Blind-/Low-Vision:] Shake hands to establish contact and explain your name/role. Present anyone else in the room. Verbally orient to room. Encourage glasses if they wear them. Explain things verbally sing gestures wont be received by patient. (Bickley et al. , 2021, pg 66) [Hearing impairment]: Find out the pt preferred method. Might need ASL interpreter. Encourage use of hearing aids. (Bickley et al. , 2021, pg 65) **How do we establish an effective patient encounter?** **How do you establish rapport with patients with disabilities?** Make eye contact, engage in simple conversations. Avoid talking down to patient or been condescending. (Bickley et al. , 2021, pg 66) **Clues to the Patient's Perspective on Illness** (Bickley et al. , 2021, pg 13) **What information is gathered in a clinical assessment?** - Vitals - General -- Orientation, mood, memory odors, grooming, etc - Eye -Pupils size, accommodation, conjunctiva, sclera, otoscope. Acuity. - HENT- Scalp, hair, face, Ear Canal-otoscope, nose, Mouth (Symmetry, color, moisture, lesions, mucosa, teeth, palate, tongue). Weber test/Rinhe Test. - Nerve I- Olfactory- Not tested. - Nerve II- Optic -Snellen chart - Nerve III- oculomotor-- Extra ocular movement- Follow fingers - Nerve IV -trochlear - Extra ocular movement - Follow fingers - Nerve VI -abducens- Extra ocular movement - Follow fingers - Nerve V -Trigeminal- Motor, sensory and corneal reflex. Clench jaw. Touch skin. - Nerve VII facial -- Raise eyebrows, puff cheeks, smile. - Nerve VIII -vestibulocochlear -- whispering something - Nerve IX glossopharyngeal -- say "Aaaa". Quality of voice. Hoarse? Gag reflex with tongue depressor. - Nerve X -Vagus. - Nerve XI spinal accessory -- trapezius muscles (Shrug shoulders, turn neck side to side). - Nerve XII -- Hypoglossal - Stick out tongue. Symmetry? - Neck- palpate lymph nodes, masses, neck pulsations, trachea midline? Swallow. Check thyroid. - Respiratory. Rate, rhythm depth, Auscultate lungs, under the axilla. - Cardiovascular. Thorax observation of Jugular vein, carotid pulse, listen bruit. Apex with bell. Heart listen x 6 spots. - Gastrointestinal. Listen to Bowel sounds. Palpate light then harder. Percuss the liver. - Musculoskeletal -- Gait. Knee bends. - Integumentary- moist, ulcers, pallor, discolorations, molds. - Neurologic/Psychiatric- Mental, status, cranial nerves, motor system, reflexes. BUE, BLE reflexes. - Genitourinary. General genitalia. Females: Pap smear and bimanual palpation uterus, anorectal fistula. **Explain the Mnemonic FIFE** **Understanding Racism and Bias and Social Determinants of Health** **How to improve patient health and reduce inequities.** Pending answer ** How to address health disparities.** At [pt] level: Ask patient about social challenges, guide to resources to access benefits/support services (MCD, health clinics, etc) At [practice] level: offer culturally safe care, use patient care navigators, "ensure that care is accesible to those most in need" At [community] level: Partening with local organizations/public health agencies. (Bickley et al. , 2021, pg 19) ** Purpose of inspection, palpation, auscultation, and percussion.**  (Bickley et al. , 2021, pg 124) **Causes of fatigue** Fatigue is a common symptom of depression and anxiety. Fatigue es normal response to hard work, sustained stress, grief. Investigate further if fatigue is unrelated to those situations (Bickley et al. , 2021, pg 212) **Assessment of fatigue** Fatigue is a common symptom of depression and anxiety, but consider infectious, endocrine, adrenal, heart failure, COPD/CKD, anemia, electrolyte imbalance, malignancy, nutritional deficits and medications side effects. (Bickley et al. , 2021, pg 212) **Know the difference between hypothyroidism and hyperthyroidism.** S/S (Bickley et al. , 2021, pg 351) ** Alzheimer\'s disease characteristics, diagnostic tests, and treatment plans.** Pending Answer ** Suicide. Who has the highest incidence?** **What screening test will be performed for dementia?** The Montreal Cognitive Assessment (MoCa) (Bickley et al. , 2021, pg 277) **What are common illicit drugs?** ¼ USA Americans reported binge drinking. SUD -- Marijuana, cocaine, psychotherapeutic drugs. (Bickley et al. , 2021, pg 267) **What are common drugs that are overdosed?** Opioids, Fentanyl (Bickley et al. , 2021, pg 267) ** What foods reduce cardiovascular risks?** Enlist **Common causes of breath odor (Halitosis)** Poor oral hygiene, tobacco smoking, plaque retention on teeth, dentures and periodontal disease (Bickley et al. , 2021, pg 267). **Diagnostic tests performed for bacterial throat infection?** Rapid Antigen testing for streptococcal and fusobacterium. (Bickley et al. , 2021, pg 422). **Risk factors for carcinoma of the lip.** - Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others - Fair skin - Excessive sun exposure to your lips - A weakened immune system **What causes angioedema?** Localized subq or submucosal swelling cause by leakage of the intravascular fluid into the interstitial tissue.. Triggered by mast cells. Associates S/S urticaria and pruritus. Usually resolves within 24-48 hrs. Can be LIFE THREATNING if it involves larynx, tongue, upper airway and develops into anaphylaxis (Bickley et al. , 2021, pg 430) **Primary syphilis characteristics, diagnostic tests, and treatment plan.** Characteristics Diagnostics Treatmen Plan **Exudative tonsillitis characteristics, diagnostic tests, and treatment plan**. Streptococcal pharyngitis typically produces white/yellow exudates on the tonsils or posterior pharynx, with red beefy uvula, palatal petechia(Bickley et al. , 2021, pg 430) Test: Rapid antigen strep test. To detect group A streptococcus. Tx Strept throat. (Dynamed) **Foods high in potassium** Enlist **References** Bickley, Lynn et all. (2021) *Bate's Guide to Physical Examination and History Taking*. 13^th^ Edition. Wolker Kluwer.