Final Exam

Assessment/Technique

Across the lifespan general

Physical appearnace, body structure, mobility, behavior, ht, wt, bmi

BMI

18 and under = underweight

25 -30 overwight

30 and above obese

Underweight can lead to malnutretions, which could be caused by eating disorders

Sound heard over the stomach: tymphany

Bariatric scale is for pts who wt more than 350 lbs

Children under 3 to get a tympanic membrane temperature gently pull the ear down and back

Apical pulse is found at the 5th intercostal

120-180 newborn pulse

60-100 adult pulse

80-140 toddler

Diastolic pressure= pressure in arteries when the heart is at rest

Pulse pressure calculation minues the systolic to the diastolic. Normal range is 30-40.

Types of assessments

Physical assessments

Palpation: pulses, skin temp, turger

Percussion: normal percussion tones, resonant, hyperresonant, tympany, dull, flat

Ausculation: Bell vs diaphragm

Ausculation: Techniques for lungs, heart, and abdomen

Other systems: Inspection, palpation, percussion, auscultation

Abdomen: Inspection, auscultation, percussion, palpation

Precautions/hygiene

Hand hygiene

Univeral precaustion

Cleaning eqipment

Questions/pains

Histroy Taking

	Mnemonic COLDSPA	How would you ask the client?		Mnemonic OPQRSTU	How would you ask the client?
C	haracter	What does it feel like?	O	nset	When did it begin?
O	nset	When did it begin?	P	rovoking	What makes it worse?
L	ocation	Where is it located?	Q	uality	What does it feel like?
D	uration	How long does it last?	R	egion	Where does it spread?
S	everity	What is your pain level from one to ten?	S	everity	What is the pain level from one though ten?
P	attern	What makes it better?	T	ime	When did it begin?
A	dditional associating factors	What do you think is causing this?	U	nderstanding	What do you think is causing this?

Numeric Rating Scale

Wong-baker FACES pain ratting scale

Visual analogue scale

Children development

Infant sitting without support: 9 months

Eriksons theory

Tolder: Autonomy vs. Shame and Doubt

Piaget. 4 y/o is in the preoperational stage

Socratives

Ability to read a number by having it traced on the skin is? Graphestesia

Paralysis of all four extremities? Quadriplegia

What reflex is when the infant sucks on an object that touches the lip? Sucking reflex

What reflex is when the infant turns the head towards the stroked cheek? Rooting reflex

What reflex is when the infant holds onto the finger of the examiner? Plantar grasp

What reflex is when the infant has an upward movement of the big toe when the sole of the foot is stroked? Babinski reflex

Syncops

Paraesthis

Dysarthria

Dysphasia

Receptive aphasia

Expressive aphsia

Romberg test

Stereognosis

Graphesthesia

Ataxia

Hemiplegia

Paraplegia

Tetraplegia

hemiparesis

Presbyopia: normal vision loss by age

Myopia- nearsightness

Hyperopia - farsighntness

Nystagmus: uncontrolled eye movement

Ptosis: Dropping of the eyelids

Epistaxis: Nosebleed

Anosmia: Loss of smell

Miosis: Pinpoint pupils

Mydriasis: Dilation of pupil is different that the other eye

Diplopia - double vision

Photophobia - Sensitivity to light

Tinnitus - ringing noise to ears

Vertigo - feeling of spining

Snellen chart

Reproduction

Functions of the female body

Vaginia: Intercourse, menstruations, childbirth

Cervix: Mucus production, dilates in labor

Fallopian tubes: fertilization site

Ovaries: Produce ova, estrogen, and progesterone

Hormones

FSH: Stimulates follicle development

LH: Triggers ovulation

Estrogen: Regulates cycle

Progesterone: Maintains pregnancy

Breast exam

TSE: Timing (same time each month), shower, examine (in mirror)

Up and down. Left to right

Can be done lying down or standing up

What is concerning during breast exam? Peau' d’orange (contractions/dipling?_

Menarche: Frist menstrual period

Menorrhagia: Heavy period

Dysmenorrhea: painfully period

Amenorrhea: absence of period

HRT: Increases breast cancer and blood clots

Presumptive: Missed period, urinary frequency, breast changes

Probable: Chadwick sign (bluish discoloration of cervix and vagina), Goodell sign (softened cervix), Braxton Hicks contractions, positive pregnancy test

Positive: Fetoscope, doppler, ultrasound

Neurovascular 5 p’s

Penis: Release urine and semen

Testicle: Oval glands to make sperm and produce testosterone

Scrotum: protects testicles and regulate temperature of testicles

Priapism: Prolonged painful erection that lasts four hours or more.

Smegma: A white cheese-like substance that is found between the labia in female neonates, and present at birth. It is also present in male neonates under the foreskin. This is normal.

Cryptorchidism: When a baby one or both testes are not descended into the scrotum. Palpate and can feel the absence of one or both testes in the scrotal sac. this is a birth defect.

Hydrocele:When the baby has fluid surrounding the testes within the scrotum. Scrotum size, symmetry, and palpate to confirm presence of testes. Any discoloration.

Gynecomastia: Enlargement of breast tissue in males usually caused by hormone imbalances of estrogen and testosterone.

Complemention: they are thinking about it but not making a plan

Action:

Maslow’s

Hawthorne Effect: People change their behavior due to them being aware that they are being observed.

Transtheoretical Module: The six stages a patient goes though for behavior change.

Precontemplation: not considering change.

Contemplation: Possibility of change is recognized, but there is ambivalence.

Preparation: commitment to change is made and planning begins.

Action: Steps to changes are made but not stable.

Maintenance: Change is maintained over time.

Termination: change is integrated into lifestyle.

Active immunity: The body has to developd the anitbiodies

Passive immunity: Baby gets immunity from mothers breast milk.

Antigen: Causes a specific immune response when introduced to the body

Antibody: Proteins produced by B lymphocytes in response to antigen, they bin to specific antigens to neutralize them

Pregnant ppl can’t get live vaccine such as NASAL SPRAY flu, varicella, HPV, measles.