NURS 398 Midterm Study Guide PDF

[NURS 398 Midterm Study Guide] **Review:** [ ] [ ] Week 1 Health Promotion and Assessment Basics (9 questions) **Filled out 10/11/2024:** - Differentiate between objective and subjective components of a patient assessment; know what examples of subjective vs objective pieces of patie...

[NURS 398 Midterm Study Guide] **Review:** [ ] [ ] Week 1 Health Promotion and Assessment Basics (9 questions) **Filled out 10/11/2024:** - Differentiate between objective and subjective components of a patient assessment; know what examples of subjective vs objective pieces of patient data are - Recognize the differences between the three levels of prevention (primary, secondary, tertiary) and know examples of each - Demonstrate knowledge of recommended exams/tests/screenings for patients, such as when certain exams/screenings (physical exam, blood sugar, cholesterol, blood pressure, dental, mammogram, colonoscopy, etc.) should be performed - Recognize the types of assessments (basic, system-based, focused, comprehensive) and their intended use; be able to apply this to a clinical scenario - Determine preventative interventions that reduce risk for different types of cancers (breast, prostate, lung and skin) and cardiovascular disease including lifestyle practices, vaccinations, diet and screening - Know the various assessment techniques (palpation, inspection, percussion, auscultation), how to use them and the proper sequence. Week 2 Musculoskeletal (9 questions) - Apply terminology specific to the musculoskeletal system (genu varum, genu normal, genu valgum, effusion, crepitus, atrophy, hypertrophy, etc.) - Note joint and muscle findings and classify as expected vs unexpected findings - Assess gait including identifying components and types - Assess joints and muscles for strength and ROM -- know how to describe the findings of these assessments include strength scale - Acknowledge types of ROM and joint movements appropriate to the intended movement of the joint type (e.g., what movements are appropriate for knee, hip, shoulder, etc.) - Assess spine for curvatures and apply knowledge related to causes/complications of curvatures (what conditions/situations cause or population are more likely to have a particular curvature) and what patients might do to accommodate for the curvature (widening gait, higher center of gravity, etc.) - Identify cranial nerve associated with musculoskeletal system and appropriately test if it is intact - Recognize proper exam sequence for musculoskeletal system (inspection, palpation, ROM, strength) - Know ROM terms and what movements they refer to (circumduction, adduction vs abduction, etc.) Week 3 GI/GU (8 questions) - Identify expected finding/sound (dullness vs. tympany) when percussing in various areas (over organs, air-filled spaces, fluid-filled spaces) - Properly assess (length of time, placement of stethoscope on various shapes of abdomen) bowel sounds noting location and type of bowel sound auscultated (hypoactive, hyperactive, normoactive, absent) - Order of assessment (inspection, auscultation, palpation, percussion) and clinical reasoning of following proper order - Apply assessment findings (valsalva manuver, CVA tenderness, distended abdomen, protruding abdomen, urine color, stool color/consistency) to note usual causes of unexpected findings/abnormalities (appendicitis, constipation, hernia, dehydration, urinary retention, receiving IV fluids, etc.) - Relate assessment findings for color, clarity, amount (polyuria, oliguria, anuria) and odor of urine to the pathological cause (dehydrated, adequately hydrated, hematuria, infection, etc.) - Perform Murphy's punch sign; know how and why we perform this and apply the findings to a disease process Week 4 Eyes Ears Nose Throat and Mouth (8 questions) - Understand terminology relevant to EENT (patency, cerumen, anisocoria, ptosis, enophthalmos, exophthalmos, etc.) - Identify and relate patient complaints/concerns to sensory loss and appropriately identify potential causes and appropriate interventions - Distinguish between the types of hearing loss (sensorineural, conductive) and apply knowledge on potential causes - Acknowledge and document unexpected findings associated with eye shape, pupil size, movement, and vision using proper terminology. Be able to prioritize interventions if applicable. - Perform hearing and vision tests/be able to describe how these tests are performed and what they are testing for (Whisper, Weber, Rinne, Snellen, Rosenbaum & Ishihara) - Assessment of nose including smell and patency, how to assess for these and apply findings (anosmia, deviated septum, patent, etc.) - Assessment of mouth and throat including technique for inspection of the parts of the mouth, cranial nerve tests (for conscious and unconscious patients) and correct documentation. Week 5 Mental Status and Neuro (8 questions) - Identify (number and name) of cranial nerves including how to assess (sensory and motor response) and what is its function - Apply knowledge of cranial nerve damage and proper interventions specific to that cranial nerve (include adjustments to make for patients with cranial nerve damage that accommodate for this damage) - Assess for different reflexes (deep tendon and superficial including plantar reflex) including grading scale, recognize expected vs unexpected findings - Utilize mini mental state examination and Glasgow coma scale to perform assessment of mental status, calculate score of GCS and apply findings; be sure to know the components of each of these assessments i.e. what are you testing for in each (Glasgow-eye opening, verbal and motor responses; MMSE-orientation to time/place, attention and calculation, recognition and recall of objects, long-term memory, language and reading). - Acknowledge all components of a neurological check/recheck (see slide 46) - Identify changes in mental status, their common causes and properly assess/prioritize/intervene to promote safety with patients Week 6 Peripheral Vascular and Lower Lymphatic (8 questions) - Assess edema including types and grading (include both time and depth of edema) and apply patient subjective data to this diagnosis - Assess and identify expected vs unexpected findings for peripheral vascular specific exams (Homan's sign, Allen's sign, Modified Allen's sign); include the disease process that the exam may identify - Demonstrate proper assessment of arteries including technique and location - This also includes what not to do when assessing certain pulse locations (carotids one at a time, not using thumbs, etc.), grading pulses to note their strength (+1, +2, +3, +4, absent) including expected vs unexpected findings, and how to assess pulse points if limited by amputation, surgical wraps, etc. - Assess capillary refill time and note expected vs unexpected findings - Assessment of bruits including expected findings and proper technique - Apply assessment findings of skin to describe peripheral vascular issues - Identify patient risk factors for venous disorders such as deep venous thrombosis/blood clots and who is at highest risk (pregnancy, bedrest, smoking, previous stroke, medication use, etc.) - Assess lower lymphatic system with proper technique, location (epitrochlear, axillary, inguinal) and identification of expected (non-palpable, soft, discrete, small in size, non-tender, movable) vs. unexpected findings (large in size, firm, fixed, tender/painful, clustered/clumped/matted)