Health Assessment Exam 1 Review Flashcards

Vocabulary flashcards created from Health Assessment Exam 1 Review covering pain assessment, general survey, vital signs, HEENT, safety precautions, documentation, and therapeutic communication.

Pain Health History Characteristics

Essential components of a pain history assessment including location and radiation, quality and severity, timing and setting, and aggravating and alleviating factors.

Signs of Respiratory Distress (General Survey)

Abnormal physical observations during a general survey that indicate increased work of breathing, such as labored breathing with wheezing, labored speech, use of accessory muscles, and diaphoresis.

Pulse Volume Scale (+1/4)

A documentation indicating a weak or thready pulse. On this scale, 0 is absent, +1 is faint/weak, +2 is usually normal, and +4 is bounding.

Heart Rate Elevating Factors

Clinical factors and conditions that can increase heart rate, including hyperthyroidism, fever, pain, and anxiety. Beta-blockers typically lower heart rate.

Orthostatic Hypotension

A condition supported by reports of dizziness or syncope upon standing and a drop in systolic blood pressure greater than $30\,\text{mm Hg}$. Diagnostic criteria typically require a drop of at least $20\,\text{mm Hg}$ systolic or $10\,\text{mm Hg}$ diastolic within $3\,\text{minutes}$ of standing.

Normal Adult Lymph Node Assessment

Expected lymph node findings in a healthy adult where nodes are nonpalpable, or present as small (less than $1\,\text{cm}$), discrete, smooth, nontender, and movable.

Whisper Test Normal Result

Demonstration of normal hearing achieved when a client covers one ear and correctly repeats a two-syllable word whispered into the unblocked ear.

Weber Test Normal Result

A hearing test outcome where sound is heard equally in both ears without lateralizing.

Rinne Test Normal Result

A hearing assessment where air conduction lasts approximately twice as long as bone conduction, demonstrating an approximate $2:1$ ratio.

Normal Nasal Cavity Mucosa

Healthy mucosal findings in the nasal cavity characterized as pink and moist without any lesions.

Expected Head and Neck Assessment Findings

Normal findings in a healthy adult including a midline trachea, a thyroid that rises slightly with swallowing, and nonpalpable or small (less than $1\,\text{cm}$), smooth, nontender lymph nodes.

Neck Injury Precaution

The required safety protocol when a neck injury is suspected, requiring the nurse to stabilize the head and neck in a neutral position to protect the cervical spine and obtain assistance before proceeding.

Subjective Data Documentation

The practice in health history documentation of using quotation marks to record the client's exact words in order to preserve their subjective report.

Joining Stage of Interview

The initial phase of a client interview where trust and respect are best promoted by asking the client what name they prefer to be called.

Prolonged Steroid Use (Eye Health)

A risk factor for glaucoma due to long-term corticosteroid use raising intraocular pressure.

Normal Pupillary Light Reflexes

Demonstration of normal pupillary responses where light directed into one pupil causes both pupils to constrict briskly and equally (direct and consensual light reflexes).

History Taking in Mild Dementia

A communication strategy to obtain a reliable health history from an older adult with mild dementia by including the client and asking their permission for a caregiver to provide supplemental information.

Nontherapeutic Nurse Responses

Communication techniques that shut down client discussion, including false reassurance, asking judgmental "why" questions, giving approval, or telling the client not to worry.