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what are the 4 possible assessments id have to do

1. abdominal

2. cardiac

3. respiratory

4. neuromuscular

What are some possible abdominal chief complaints

1. stomach hurting for two days

2. ive got sharp pain in my lower right side

3. i feel cramping in my lower abdomen

4. Nauseated and vomiting

5. Belly feels bloated

6. Heartburn after meals

What are some possible abdominal pertinent ROS/history questions

1. Have you noticed a change in bowel habits (constipation, diarrhea)

2. Have you noticed any blood in your stool?

3. Where is the pain? 

4. Any nausea or vomiting 

5. How would you describe the duration of the pain? Is it constant, intermittent?

6. Noticed any bloating?

7. Describe the pain? 

8. Abdominal surgeries in past? 

9. Changes in diet?

10. Family history of inflammatory bowel diseases (Chrons diease, ulcerative cholitis)? 

What are some possible abdominal environmental/risk factor questions

1. Have you traveled out of the country recently (risk for eating contaminating foods or contaminated water that can lead to some infection (gastroenteritis, hep A, parasitic)? 

2. Have you eaten undercooked or raw foods (increases risk for foodborne lllnesses, such as salmonella? 

3. Have others around you have similar symptoms (risk for spread of infection or food poisoning if you guys have eaten together?) 

4. Have you been in any contact with animals (can get infections)? 

5. activity

6. Are you prescribed any opioids, such as morphine or oxycodone? (can cause gastritis)

7. Do you drink alcohol? (irritates the gastric muscos) 

What do you do after ROS/History/Risk factor questions?

Vital signs and explain vital signs with therapeutic communication 

What 4 skills do i have to do for abdominal

DRAPE THEN LIFT GOWN

1. inspect ::::::: scaphoid, flat, distention? symmetrical, asymmetrical? Lesions? Rashes? Bruising?

2. auscultate ::::::: 4 quadrants with DIAPHRAGM, vascular sounds with BELL, listening for any bruits/whooshing sounds → abnormal blood flow caused by stenosis or aneurysm

3. percuss :::::::::: 4 quadrants (listen for dullness/tympany

4. light palpation ::::::::::: full abdomen (any tenderness)

ill report this to the _________. do you have any questions for me? we’ll see you again shortly. 

What are some possible cardiac chief complaints?

1. chest pain or discomfort

2. Palpitations

3. Chest tightness or heaviness with exertion/stress

What are some possible cardiac pertinent ROS/history questions

1. Are you experiencing any chest pain?

2. Have you noticed your heart beating abnormally fast or slow?

3. Do you have shortness of breath? Does it happen when lying down, exertion, rest?

4. Any swelling in legs or ankles?

5. Do you feel tired easiy?

6. Any dizziness, lightheadedness 

7. History of hypertension or high cholesterol? 

What are some possible cardiac environmental/risk factor questions

1. Do you smoke or have you smoked in the past? (if so, how long and how often)

2. How often do you exercise? (sedentary = risk for cardiac disease)

3. Do you find your job environment stressful?

What 4 skills do i have to do for cardiac

1. examine upper and lower extremities (color (not pale/blue), temperature, hair_

2. heart sounds (APE to Man) AND carotid, i guess i can palpate carotid 

3. Bilateral peripheral pulses (radial, dorsalis pedis, posterior tibialis) + EDEMA

4. Capillary refill of fingers and toes

What are some possible respiratory chief complaints

1. SOB

2. Wheezing

3. Sputum

4. Frequent respiratory infections

What are some possible respiratory pertinent ROS/history questions

1. experiencing shortness of breath or difficulty breathing

2. any history of chronic lung conditions? asthma, COPD

3. are you coughing? is it dry or productive

4. have you felt any pain while breathing? 

5. do you have trouble sleeping due to breathing?

6. do you have a hard time breathing when laying down? 

7. Noisy breathing? 

What are some possible respiratory environmental/risk factor questions

1. do you smoke or have you smoked in the past? 

2. are you exposed to air pollutants at your work or home environment?

3. has there been anyone around you have respiratory infections? (covid, the flu) 

4. does anyone you live with smoke?

What 4 skills do i have to do for respiratory?

1. inspect anterior and posterior DIAPHRAGM chest expansion (symmetrical, unlabored, refular pattern, no use of accessory muscles)

2. listen to anterior and posterior lung sounds (in and out through mouth as i move stethescope) 

3. tactile fremitus (listen for increased or decreased vibratioons. this can point to either fluid build up or thickened chest wall or any abnormaility that can increase or decrease vibration - FRONT AND BACK

4. posterior chest expansion using hands

possible neuromuscular chief complaints

1. falls, frequent tripping

2. muscle stiffness

3. numbness, tingling

4. diffculty maintain balance

What are some possible neuromuscular pertinent ROS/history questions

1. any recent or past injuries

2. muscle weakness?

1. joint pain or stiffness?

2. describe pain

3. confusion or dizziness?

4. numbness or tingling?

5. muscle spasms, involuntary movmeents

6. changes in balance 

7. history of stroke?

8. trouble with fine motor skills 

What are some possible neuromuscular environmental/risk factor questions

1. How would you describe your activity level? Do you do any weight training? Decrease osteoporosis, when you get older and maintain strength in your muscles and bones

2. do you do heavy lifting? this can put strain on your muscles?

3. Do you use any drugs : can affect neural pathwayys with long term use

4. Do you have history of diabetes? (reduce sensation especially in your peripherals)

what 4 skills do i have to do for focused neuromuscular

1. A&O x4 (tell me your name, what day of the week it is, where are you, and why you’re here today)

2. coordination rapid movements (flippp, thumbs to fingers, go fast, nose to finger

3. upper and lower extremity strength

4. gait (heel toe, walk on heels, walk on toes) + ROMBERG

hand hygiene when

1. enter

2. before physical/touching patient

3. leaving

when i say hi what do i do

1. explain procedure

2. name and dob and CHECK wrist band