Physical Assessment Quiz 1

Subjective vs objective

• Subjective: what a person says during history

• Objective: what your observe/do

open ended vs close ended questions

• open ended: narrative information. what beings you here today?

• close ended: asks for specific information (like a yes or a no) where is the pain located?

10 traps of interviewing

1. providing false assurance or reassurance

2. giving unwanted advise

3. using authority

4. using avoidance language

5. distancing

6. using porfessional jargon

7. using leading or biased questions

8. talking to much

9. interrupting

10. using “why” questions

SBAR

• Situation: name, unit, room number

• Background: medical history, what happened, vitals, medications, allergies

• Assessment: labs, assessments (head to toe), imaging

• Recommendation: whats your plan

PQRSTU

• Provocative or palliative

• Quantity or quality

• Region or radiation

• Severity scale (1-10)

• Timing or onset

• Understand (patients preception or problem)

Polyuria

producing abnormal amount of urine

Polydipsia

abrnormal or excessive thirst

Polyphagia

constant hunger

Oliguria

low urine output (passing less than 400 mL/day)

Anuria

Kidneys fail to produce urine (less than 100 mL/day)

HEEADSSS

• Home enviornment

• Education and employment

• Eating

• Activities

• Drugs

• Sexuality

• Suicide

• Safety from injury and violence

ADPIE

• Assessment: physical assessment/medical records

• Diagnosis: clinical findings & clinical judgment to diagnose

• Planning: goals/outcomes

• Implementation : implementing the plan (actually doing)

• Evaluation: did they meet? if not change goals

nonverbal communication vs verbal communication

• verbal = speak lol

• nonverbal: physical apperance, posture, gesture, facial expression, eye contact, touch

ABCT

Appearence

Behavior

Cognition

Thought process

CIWA

• clinical institute

• most sensitive scale for objective measurement of withdrawal

GAD-7

• generalized anxiety disorder scale

• test for anxiety

PHQ-2

Patient Health Questionnaire -2

screens for two types of depressive disorders: depressed mood and anhedonia (lack of intrest)

MMSE

Mini Mental State Exam

• Detects dementia and delirium and to differentiate from psychiatric illnesses

Mini Clog

Reliable & quick instrument to screen for cognitive impairment in healthy adults

tests function, planning, memory, organizing activities

Delirium vs Dementia

• Dementia: chronic progressive loss of cognitive & intellectual functions while concious and perceptive

• Delirium: acute confusional state, agitation, and inattention

Montreal Cognitive Assessment (MoCA)

screens for Sensitive to mild impairments

Three types of Aphasia

• Global Aphasia: most common and severe form. Lesion to posterior & anterior language areas. May only know someone’s name, spontaneous speech/comprehension is absent

• Broca Aphasia: Excessive aphasia, a person can understand language butt cannot use it effectively. Auditory & reading intact. lesion to Broca’s area/motor speech cortex

• Wernicke Aphasia: Receptive aphasia. speech is impaired, lesion to Wernicke area

Blocking

suddenly stops talking/thinking cannot finish thought

Confabulation

makes up memories to fill thought

Neologism

makes up new words that only has meaning to them

Circumlocution

Can’t think of the word, so describes it instead

Circumstantality

Gives so many unnecessary details before getting to point

Loosening associations

jumps from one unrelated topic to another

Flight of ideas

rapidly jumps between topics (still some connection)

Word Salad

words mixed up and make no sense

Perseveration

keeps repeating the same word, phrase or action

Echoalia

repeat what someone says

Clanging

changes word becuase they sound alike

Summary checklist: mental status assessment

Appearance (posture, body movements, dressing, grooming)

Behavior (LOC, facial expression, speech)

Cognitive function ( orientation, attention span, judgement)

Thought process

Preform Mini-Cog, MoCA, Mini mental state examination

CAGE questionnarie

• Identify uncontrolled or excessive drinking

• Cut down

• Annoyed

• Guilty

• Eye opener (do you drink in the am?

SMAST-G

Short Michigan Alcoholism Screening Test

• adults who report social or regular drinking or any amount of alcohol

Abrasion

Wound caused by rubbing of skin or mucous membranes

Avulsion

tearing away of structure or part

Bruise

skin turns blue/purple from bleeding underneath

Contusion

Bruise caused by injury without skin breaking

Cut

see incision

Ecchymosis

large bruise/discolored patch under the skin

Hematoma

collection/pool of blood under skin or in tissues

Hemorrhage

bleeding from broken vessel

Incision

clean cut made my sharp object

Laceration

torn/split wound with irregular edges

Patterned Injury

injury that leaves a specific pattern/shape

Petechiae

Tiny pinpoint red/purple spots from bleeding

Puncture

Small hole made by pointy object

Stab wound

deep penetrating wound (deeper than is wide)

Traumatic alepecia

hair loss from pulling or trauma

Wound Injury

any injury/damage to body

Abnormal findings in child abuse

• adhesive burns

• immersion Injury patterns

• pattern injury burn

• cigarrette burn

• Suspicious bruising

• nasal fractures

• belt bruising

• defensive wounds (hands & forearms)

• thigh bruises

• pressure injuries

Assessment techniques

IPPA

• inspection (look)

• Palpation (touch for pain, lumps, and swelling)

• Percussion (tap to hear)

• Auscultation (listen)

Transmission based precautions

• hand hygeine

• use of gloves, gown, masks, eye protection, face shield

• respiratory hygiene/cough etiquette

• Standard vs Transmission

  • standard are basic precautions take

  • transmission: contact, airborne or droplet

Contact precautions

• Donning

  • hand hygiene

  • put on gown

  • apply clean gloves, pulling gloves over the sleeves of gown

• Doffing

  • remove & dispose of gloves

  • remove gown

  • hand hygiene

Droplet precautions

• Donning

  • hand hygiene

  • put on surgical mask

• Doffing

  • remove surgical mask by touching ties/ear loops