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Details Title: health assessment Description: midterm Total Flash Cards: 147 Created: 10/21/2006 09:00:56	To study from this set of flash cards, or to create your own your own study flash cards, register HERE. If you are already a registered user, CLICK HERE.
Cards Term nocturia Definition Nocturia (derived from Latin nox, night, and Greek [τα] ούρα, urine), also called nycturia (Greek νυκτουρία), is the need to get up during the night in order to urinate, thus interrupting sleep. Its occurrence is more frequent in the elderly. Nocturia could result simply from too much liquid intake before going to bed, or it could be a symptom of a larger problem, such as urinary incontinence, Interstitial Cystitis, diabetes, benign prostatic hyperplasia or prostate cancer. Term claudication Definition "limping" Claudication refers to cramplike pains in the calves caused by poor circulation of the blood to the leg muscles. Term thrombophlebitis Definition Thrombophlebitis is phlebitis (vein inflammation) related to a blood clot or thrombus. When it occurs repeatedly in different locations, it is known as "Thrombophlebitis migrans" Term oliguria Definition Oliguria and anuria are the decreased or absent production of urine, respectively. The decreased production of urine may be a sign of dehydration, renal failure or urinary obstruction/urinary retention. Term dysuria Definition dysuria refers to any difficulty in urination. It is sometimes accompanied by pain. It is most often a result of an infection of the urinary tract. Term polyuria Definition excessive fluid output in given amount of time Term monorrhagia Definition Menorrhagia is an abnormally heavy and prolonged menstrual period. Causes may be due to abnormal blood clotting, disruption of normal hormonal regulation of periods or disorders of the endometrial lining of the womb. Depending upon the cause, it may be associated with abnormally painful periods (dysmenorrhoea). Term dysmenorrhea Definition Primary dysmenorrhea refers to menstrual pain that occurs in otherwise healthy women (Wright et al. 2003). This type of pain is not related to any specific problems with the uterus or other pelvic organs. Secondary dysmenorrhea is menstrual pain that is attributed to some underlying disease process or structural abnormality either within or outside the uterus Term dyspareunia Definition painful sexual intercourse, due to medical or psychological causes. Term paresthesia Definition sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect Term polydipsia Definition abnormally large (poly-) intake of fluids by mouth. Term polyphagia Definition excessive hunger and abnormally large (poly-) intake of solids by mouth Term functional assessment Definition ADLs, lifestyle, environment: self-esteem, activity, sleep/rest, nutrition/elimination, interpersonal relationships/resources, spiritual resource, coping and stress management, personal habits, alcohol, street drugs, environment/hazards, intimate partner violence, occupational health Term health history: children and young adults Definition 1.biographic data 2. source of history 3. reason for seeking care 4. present health or history of present illness. 5. past health; childhood illnesses, serious accidents, chronic illnesses, serious illnesses, operations or hospitalizations, immunizations, allergies, medications. 6. developmental history 7. nutritional hisotry 8. Family hisotry 9. review of systems Term review of systems: young adult and children Definition 1. general; wt loss/gain, colds, ear infections, illnesses, energy level, behavior change. 2. skin; birthmarks, skin disease, pigment change, moles, rash 3. head; headache, head injury, dizziness. 4. eyes; strabismus, diplopia, pain, redness, discharge 5. ears 6. nose and sinuses 7. mouth and throat 8. neck 9. breast 10. respiratory system 11. cardiovascular system; cyanosis, limitation of activity, dyspnea on exertions, palpitations, High BP 12. Gastrointestinal system 13. Urinary system 14. genital system 15. sexual health 16. musculoskeletal system 17. neurological: numbness, tingling 18. hematoogica: excessive bruising, lymph node swelling, exposure to toxic agents/radiation. 19. endocrine system: history of diabetes or thyroid disease, excessive hunger, thirty or urination, abnormal hair distribution, precocious or delayed puberty. Term endocrine system Definition Endocrine glands secrete their products immediately into the blood or interstitial fluid, without storage of the chemical. Typical endocrine glands are pituitary, thyroid, and adrenal glands Diseases of the endocrine system are common, such as diabetes mellitus and thyroid disease. Term strabismus Definition also known as "heterotropia", "squint", "crossed eye", "cockeyed', "wandering eye", or "wall eyed", is a condition in which the eyes are not properly aligned with each Term diplopia Definition double vision Term mental disorder Definition a significant behavioral or psychological pattern associated with distress (painful symptom) or disability and has a significan risk of pain, disability, or death, or a loss of freedom Term organic disorder Definition mental disorder: due ot brain disease of known specific organic cause: delirium, dementia, intoxication, withdrawal Term psychiatric mental illness Definition no organic etiology has yet been established, anxiety disorder or schizophrenia Term consciousness Definition being aware of one's own existence, feelings, and thoughts and aware of environment. Term mood and affect Definition affect is a temporary expression of feelins or state of mind. mood is more durable, a prolonged display of feelings that color the whole emotional life. Term mental status exam Definition systematic check of emotional adn cognitive functioning: four main headings: appearance, behavior, cognition, thought processes or A,B,C,T Term aphasia Definition impairment of language secondary to brain damage. a mental status exam asseses language dysfunction as well as any emotional problems associated with it, such as depression or agitation. Term mental status exam: objective data APPEARANCE Definition Posture Body movements Dress Grooming and hygiene Term mental status exam: objective data BEHAVIOR Definition Level of consciousness Facial expression Speech Mood and Affect Term mental status exam: objective data COGNITIVE FUNCTIONS Definition Orientation Attention span Recent Memory Remote memory New learning: THE FOUR UNRELATED WORDS TEST. Term mental status exam: objective data THOUGHT PROCESSES AN DPERCEPTIONS Definition Thought process Thought content Perceptions: aware of reality Screen for suicidal thoughts Term assessment techniques: ORDER Definition 1. inspection 2. Palpation 3. Percussion 4. Auscultation Term fingertips Definition best for fine tactile dicrimination, as of skin texture, swelling, pulsation, lumps. Term dorsa Definition backs of hands and gingers, best for determining temperature because the skin is thinner Term base of fingers Definition or ulnar surface of hand--best for vibration Term percussion Definition -mapping out the location and size of organ -signaling the density (air, fluid, solid) of a structure -detecting an abnormal mass -eliciting pain if inflamed (sinus or kidney) -eliciting a deep tendon reflex using percussion hammer Term Resonant percussion notes Definition AMPLITUDE: medium-loud PITCH: low(vibrations) QUALITY: clean, hollow DURATION: moderate EX: over normal lung tissue Term hyperresonant percussion notes Definition AMPLITUDE: louder PITCH: lower QUALITY: booming DURATION: longer EX: normal is child's lung, abnormal in adult, over lungs w/ increased amount of air, as in emphysems. Term tympany percussion notes Definition AMPLITUDE: loud PITCH: high QUALITY: musical and drum like DURATION: sustained longest EX: over air-filled viscus, e.g. the stomach and intestine Term dull percussion notes Definition AMPLITUDE: soft PITCH: high QUALITY: muffled thud DURATION: short EX: relatively dense organ, as liver or spleen Term flat percussion notes Definition AMPLITUDE: very soft PITCH: high QUALITY: dead stop of sound DURATION: very short EX: when no air is present, over thigh muscles, bone, or over tumor Term otoscope Definition funnels light into the ear canal and onto the tympanic membrane Term ophthalmoscope Definition illuminates the internal eye structures. enables you to look through the pupil at th fundus (background) of the eye. Term normal body temps Definition oral is 37C or 98.6F with range of 25.8C-37.3C or 96.4-99.1F in older adults, temp is usually lower Term normal range of puse rate Definition 60-100. more rapid in infancy and childhood. rate also varies with gender: after puberty, females ahve slightly faster rate than males. <60=bradycardia, well-trained athlete >100=anxiety or increased exercise. Term Pulse Definition 1-rate 2-rhythm 3-force 5-elasticity Term sinus arrhythmia Definition common irregularity in pulse rhythm for children and young adults. heart rate varies with respiratory cycle, speeding up at teh peak of inspirationa dn slowing to normal with expiration. ++if any other irregularities are felt, auscultate heart sounds for a core complete assessment Term pulse: force Definition shows the strength of the heart's stroke volume. a "weak, thready" puse reflects a decreased stroke volume (hemorrhagic shock) a "full, bounding" pulse denotes an increased stroke volume, as with anxiety, exercise. 3+ full bounding 2+ normal 1+ weak, thready 0 Absent. Term normal range for respiration Definition adult: 10-20 18yr: 12-20 16yr: 16-20 14yr: 18-22 Term Blood pressure is.... Definition force of the blood pushing against the vessel wall. Term systolic pressure Definition the maximum pressure felt on teh artery during left ventricular contraction or systole. Term diastolic pressure Definition the elastic recoil, or resting, pressure that ht eblood exerts constantly between each contraction Term pulse pressure Definition the difference between the systolic and diastolic and reflects the stroke volume Term mean arterial pressure Definition pressure focing blood into the tissures, averagesd over the cardiac cycle. diastole lasts longer. it is a value closer to teh diastolic pressure plus one third the pulse pressure. Term average BP Definition 120/80 mm Hg Term normal factors that vary BP Definition age sex race diurnal rhythm (BP clims to a high in late afternoon and early evening and then declines weight exercise emotions stress Term 5 factors that determine BP Definition 1. cardiac output 2. peripheral vascular resistance 3. volume of circulation blood 4. viscosity 5. elasticity of vessel walls Term auscultatory gap Definition period when Korotkoff's sounds disappear during auscultation. occurs in about 5% of people, most often in HPT due to noncompliant arterial system Term when to record three readins in BP Definition when a variance greater than 10-12 mm Hg exists between phases IV and V. IV: abrupt muffling, sound mutes ot a low-pitched, cushioned murmur. V: silence Term orthostatic hypotension Definition a drop in systolic pressure of more than 20mm Hg and/or orthostatic puse increases of 20bpm or more, occurs iwth a quick change to a standing position. Orthostatic changes also occur w/ prolonged bedrest, older age, hypovolemia, and some drugs. Term symptoms of hypotension Definition -increased pulse -dizziness -diaphoresis-excessive sweating -confusion -blurred vision -skin feels cool and clammy Term hypertension Definition prehypertension: 120-139/80-89 stage 1: 140-159/90-99. stage 2: <160/>100 Term causes of hypertension Definition -smoking -dyslipidemia-disruption is amount of lipids in blood. -diabetes mellitus -age >60 -sex (men and postmenapause women) -family history Heart diseases: -left ventricular hypertrophy -angina or prior myocardial infarction -prior coronary revascularization -heart failure stroke or transient ischemic attack nephropathy peripheral arterial disease retinopathy Term Niciception Definition noxious stimuli are perceived as pain: 1-transduction 2-transmission: from spinal cord to brain 3-perception of pain 4-modulation: neurons from brain stem release NTs that block the pain impulse Term neuropathic pain Definition abnormal processing of the pain message. difficult oassess and treat. -pain is often perceived long after the site of injury heals. -sustained on neurochemical level, cannot be identified by xray, cat scan Term neuropathic pain Definition abnormal processing of the pain message. difficult oassess and treat. -pain is often perceived long after the site of injury heals. -sustained on neurochemical level, cannot be identified by xray, cat scan Term visceral pain Definition originates from larger interior organs. can stem for direct injury to the organ, or from stretching of the organ from tumor, ischemia, distention, or severe contraction. ex: appendicitis, ulcer pain, ureteral colic Term deep somatic pain Definition from blood vessels, joints, tendons, muscles, and bone. injury may result from pressure, trauma, or ischemia Term cutaneous pain Definition from skin surface adn subcutaneous tissues. injury is superficial, with a sharp and/or burning sensation Term referred pain Definition pain that is felt at a particular site but originates from another location. both sites are innervated by the same spinal nerve. can originate from visceral or somatic. Term chronic pain Definition doesn't stop when injury heals. outlasts its protective purpse >6 months originates from abnormal processing of pain fibers from peripheral or central sites. Term atelectasis Definition tate in which the lung, in whole or in part, is collapsed or without air.[1] It is a condition where the alveoli are deflated, as distinct from pulmonary consolidation. Term diaphoretic Definition is the state of perspiring profusely, or something that has the power to cause increased perspiration. Term pruritus Definition itching Term alopecia Definition significant hair loss Term vitiligo Definition complete ambsense of melanin pigment in patchy areas of white or light ksin Term junctional nevus Definition macular only. not raised mole Term compound nevi Definition macular and papular--young adults Term hypothermia Definition general: central circulatory disturbance, such as in shock. Localized occurs in peripheral arterial insufficiency and Raynaud's disease. Term hyperthermia Definition increased metabolic rate, suchas in fever or exercise. Hyperthyroidism has an increased metabolic rate, causing warm moist skin Term unilateraly vs. bilateral edema Definition unilateral is considered a local or peripheral cause. bilateral edema or edema that is generalized over the whole body considered a central problem such as heart failure, or kidney failure Term cherry (senile) angiomas Definition small, smooth, slightly raised bright red dots that commonly appear on the trunk in all adults over 30. Term ecchymosis Definition bruising Term aging adult normal findings: KERATOSES: seborrheic keratosis, actinic (senile) keratosis Definition lesions that are raised, thickened areas of pigmentation that look crusted, scaly, and warty. 1. seborrheic keratosis looks dark, greasy adn stuck on 2. actinic keratosis. less common. red-tan scaly plaques that increase over the years to become raised and roughened. Term acrochordons Definition normal variation in aginig adult. "skin tags" overgrowths of normal skin Term senile lentigines Definition commonly called liver spots and are small, flat brown macules. Term sebaceous hyperplasia Definition normal finding in aging adult. raised yellow papules with a central depression. more in men, over the forehead, nose, or cheeks. have pebbly loook Term macule Definition solely a color change, flat and circumscribed of less than 1cm. ex. freckes, flat nevi, hypopigmentation, petechiae, measles, scarlet fever. Term patch Definition macules that are larger than 1cm. ex: mongolian spot, vitiligo, cafe au lait spot, chloasma, measles rash. Term papule Definition something you can feel. ie. solid, elevated, circumscribed, <1cm diameter. due to superficial thickening in the epidermis. ex: elevated nevus, lichen planus, molluscum, wart. Term plaque Definition papules coalesce to form surface elevation wider than 1cm. a plateaulike disk-shapes lesion ex: psoriasis, lichen planus Term nodule Definition solid, elevated, hard or soft, >1cm. may extend deeper into dermis than papule. ex: xanthoma, fibroma, intradermal nevi. Term tumor Definition larger than a few cms. firm or soft, deeper into the dermis; maybe benign or malignant. ex: lipoma, hemangioma Term urticaria (hives) Definition wheals coalesce to form extensive reaction, intensely pruritic Term wheal Definition superficial, raise, transient, and erythematous; slightly irregular shape due to edema. ex: mosquito bite, allergic reaction, dermographism Term cyst Definition encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevating skin. ex: sebaceous cyst, wen. Term vesicle Definition elevated cavity containing free fluid, up to 1cm. clear serum flows if wall is ruptured. ex:herpes simplex, early varicella, herpes zoster, contact dermatitis Term bulla Definition larger than 1cm; usually single chambered; superficial in epidermis; it is thin walled, so it ruptures easily. ex: friction blister, pemphigus, burns, contact dermatitis Term pustule Definition turbid fluid (pus) in the cavity. circumscribed and elevated. ex: impetigo, acne. Term palpebral fissure Definition eyelid Term purpura Definition Purpura is the appearance of red or purple discolorations on the skin, caused by bleeding underneath the skin. Small spots are called petechiae, while large spots are called ecchymoses. Term vitamin deficiencies on hair/skin Definition petechiae, purpura, hyperkeratosis Term hyperkeratosis Definition Hyperkeratosis results when an excess of proteins called keratins are produced. In humans, the term typically refers to a thickening of the skin Term liver disease, effects on skin/hair Definition jaundice, spider angioma Term snellen test Definition tests CNII-Optic nerve. alphabet chart most commonly used and accurate measure of visual acuity. place chart at eye level; test with glasses or contacts one eye at a time, then both eyes. record using fraction of the distance from chart adn last line read correctly. refer if poorer than 20/30 Term "20/20" means.... Definition normal visual acuity is 20/20. top 20 indicates the distance the person is standing from the chart. while denominator gives the distance at which a normal eye could have read that particular line. Term Jaeger card Definition tests near vision. normal result is 14/14 in each eye, read w/o hesitancy and w/0 moving hte card closer or farther away. Term confrontation test Definition measure of peripheral vision. compares the person's peripheral vision with your own. Term corneal light reflex (hirschberg test) Definition parallel alignment of the eye by shining a light toward the person's eyes. note reflection of the light on the corneas: it should be in exactly teh same spot on each eye. Term diagnostics positions test Definition CNIII, IV, VI assesses for muscle weakness during movement. EOM's: extra ocular movements. ask pt to hold head steady and follow movement of yr finger as moves in 6 cardinal positions, holding and returning to center. observe for parallel tracking and presence of nystagmus only in extreme lateral gaze. note placement of upper eyelid which should overlap superior part of eye lid. Term nystagmus Definition shifting of eyes when stressed. Term arcus senilis Definition normal finding in elderly, doesn't alter vision. gray-white arc or circle around the limbus; it is due to deposition of lipid material. Term lacrimal apparatus Definition (a) the lacrimal gland, which secretes the tears, and its excretory ducts, which convey the fluid to the surface of the eye; (b) the lacrimal canaliculi, the lacrimal sac, and the nasolacrimal duct, by which the fluid is conveyed into the cavity of the nose. Term anisocoria Definition small number of people 5% normally have pupils of two different sizes. Term pupillary light reflex Definition darken room and ask pt to gaze into distance. advance light from side toward 1 eye and note response of pupil. normal response is contriction of pupil that eye (direct light reflex) AND simultaneous constriction of pupil in other eye (consensual light reflex) Term testing for accomodation Definition distant obj then to finger 3'' from face. normal response: 1-pupillary constriction 2-convergence of the axes of the eyes Term PERRLA Definition pupils: equal round react to light and accomodation Term ocular structure change in elderly Definition -atrophy of orbital fat, sunken eyes -lacrimal apparatus may decrease tear production -cornea may look coudy: arcus senilis -pupils are small in old age, and the pupillary light reflex may be slowed. -lens loses transparancy and looks opaque. Term presbyopia Definition lens changes in elderly harder to accommodate for near vision. Term cataracts Definition yellowing and thickening of lens by age 70 Term cataracts Definition yellowing and thickening of lens by age 70 Term glaucoma Definition increased ocular pressure--gradual loss of peripheral vision. incidence increases with age, affecting men and blacks Term macular degeneration Definition in elderly. loss of central vision, the area of clearest vision, is the most common cause of blindness. more women than men. unable to read fine print, sew, or do fine work and may have diff distinguishing faces. peripheral vision is not affected, so person can manage self-care. Term elderly: vision Definition -visual acuity may diminish gradulally after 50yrs, even more after 70. -near vision is commonly affected due to decreased power of accommodation int eh lens (presbyopia) -as early as 4th decade, blurred vision and diff. reading. -decreased adaption to darkness Term test of CN XI Definition ROM-- controlled movement, strength against resistance, head back and side-to-side, shoulder shrug Term test for CNVII Definition expression, affect, symmetry and movement. smile. Term test for CNV Definition facial response to sharp and dull touch. movement and sensory. Term CN VIII Definition acoustic nerve. tests: voice test tuning fork test Term hearing loss Definition anything that obstructs transmission of sound. Term conductive hearing loss Definition mechanical dysfunction that blocks ex: impacted cerumen, otoscerosis Term sensorineural hearing loss Definition pathology of CN VIII, inner ear, or ototoxic drugs. Term otosclerosis Definition common cause of conductive hearing loss in young adults between ages 20-40. gradual hardening impedes the transmission of sound and causing progressive deafness. Term elderly: hearing loss Definition cilia lining the ear canal bcms coarse and stiff; this may cause decreased hearing, since it impedes sound waves. also causes cerumen to accumulate and oxidize, reduces hearing. -life history of frequent ear infections may result in scarring on the drum. Term otitis media Definition middle ear infection. one of the most common illnesses in children. incidence and severity increased in native americas, alaskan, canadians, and hispanics. also in premature babies, down syndrome, and in babies fed by bottle in a supine position. Term tinnitus Definition ringing in the ear Term weber test Definition for bone conduction. tuning fork in midline of skull and ask if equally heard. hearing loss--not equal Term rinne test Definition comparing AC and BC normal is AC>BC Term CN I Definition smell Term stensen's duct Definition in buccal mucosa: opening of the parotid salivary gland. it looks like a small dimple opposite the upper second molar. Term leukoedema Definition larger patch in buccal mucosa. a benign grayish opaque area, more common in blacks and east indians. when mild; patch disappears as you stretch the cheeks. Term Fordyce's granules Definition small, isolated white or yellow papules on teh mucosa of cheek, tongue, and lips. painless and not significant. Term torus palatinus Definition nodular bony ridge down middle of hard palate, more commonly seen in native americans and asians. Term CN X Definition vagus nerve. when person says "ahhh" and the soft palate and uvula rise in the midline. gag reflex Term CN XII Definition hypoglossal nerve, having person stick out the tongue. should protrude in the midline. Term elderly: mouth Definition -tongue may be smoother, buccal mucosa maybe shinier -teeth may have yellowed, missing or replaced, gums may recede -nose may appear more prominent Term orem's self-care model Definition focus is self-care. focus on the abilities and limitations of the individual for self-care. if you can do ADL's you're still relatively healthy Term leninger's transcultural model Definition focus on factors that influence care and health problems focus is cultural diversity Term roy's adaptation model Definition focus on individual's adaption to stimuli in the environment. Term nursing process (6) Definition 1. assessment. 2. diagnosis. 3. outcome identification. 4. planning. 5. implementation. 6. evaluation