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NURS 1130 (LSUE) Test 2
Test 2 Lecture (Units 2.1, 3.1, 3.2)
400
Nursing
09/10/2011
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Term
What are the factors affecting growth and development?
 Definition
1. Genetic heredity
2. Prenatal, individual, and caregiver factors
3. Environment & Nutrition
Term
The study of the structure and interactions of all the genes in the human body, including their interactions with each other as well as the environment.
Definition
Genomics
Term
The first trend, with the head and brain developing first, followed by the trunk, legs, and feet.
Definition
Cephalocaudal development
Term
Growth progresses from gross motor movements (such as learning to lift one’s head) to fine motor movements (such as learning to pick up a toy with the fingers).
Definition
Proximodistal development
Term
Both sides of the body developing equally
 Definition
Symmetric development
Term
What trends does growth development occur in?
 Definition
1. Cephalocaudal development
2. Proximodistal development
3. Symmetric development
Term
What are the principles of growth and development?
 Definition
1. Growth and development are orderly and sequential as well as continuous and complex.
2. Growth and development follow regular and predictable trends.
3. Growth and development are both differentiated and integrated.
4. Different aspects of growth and development occur atdifferent stages and at different rates, and can be modified.
5. The pace of growth and development is specific for each person.
Term
Freud identified the underlying stimulus for human behavior as sexuality, which he called __________.
 Definition
Libido
Term
General pleasure-seeking instincts rather than purely genital gratification.
 Definition
Libido
Term
What are the major components of Freud’s theory?
Definition
•the unconscious mind
•the id
•the ego
•the superego
Term
Contains memories, motives, fantasies, and fears that are not accessible to recall but that directly affect behavior.
Definition
Unconscious mind
Term
Part of the mind concerned with self-gratification by the easiest and quickest available means.
 Definition
The id
Term
______________ are a means of unconscious coping to reduce stress in the conscious mind when the id’s impulses cannot be satisfied.
Definition
Defense mechanisms
Term
Conscious part of the mind that serves as a mediator between the desires of the id and the constraints of reality so that one might live effectively within one’s social, physical, and psychological environment.
 Definition
The ego
Term
Includes one’s intelligence, memory, problem solving, separation of reality from fantasy, and incorporation of experiences and learning into future behavior.
Definition
The ego
Term
Development of ________ allows the infant, by 6 months of age, to view self as separate from others and to begin to alter behaviors in response to cues.
Definition
the ego
Term
Part of the mind that represents one’s conscience.
 Definition
The superego
Term
Represents the internalization of rules and values so that socially acceptable behavior is practiced.
 Definition
The superego
Term
What are Freud's stages of development?
 Definition
Oral Stage (Ages 0 to 18 Months)
Anal Stage (Ages 8 Months to 4 years)
Phallic Stage (Ages 3 to 7 Years)
Latency Stage (Ages 7 to 12 years)
Genital Stage (Ages 12 to 20 Years)
Term
Theory stating that learning occurs as a result of the internal organization of an event,forming a mental schema (plan) and serving as a base for further schemata as one grows and develops.
Definition
Piaget's Theory of Cognitive Development
Term
Process of integrating new experiences into existing schemata.
 Definition
Assimilation
Term
An alteration of existing thought processes (schemata) to manage more complex information.
Definition
Accommodation
Term
What are the stages of Piaget's Theory of Cognitive Development?
 Definition
1. Sensorimotor Stage (Birth to 24 Months)
2. Preoperational Stage (Ages 2 to 7 Years)
3. Concrete Operational Stage (Ages 7 to 11 Years)
4. Formal Operational Stage (Age 11 Years or Older)
Term
This stage is characterized by the beginning use of symbols,through increased language skills and pictures, to represent the preschooler’s world.
 Definition
Preoperational Stage (Ages 2 to 7 Years)
Term
in this stage, children learn by manipulating concrete or tangible objects and can classify articles according to two or more characteristics.
 Definition
Concrete Operational Stage (Ages 7 to 11 Years
Term
This stage is characterized by the use of abstract thinking and deductive reasoning.
Definition
Formal Operational Stage (Age 11 Years or Older
Term
Erikson's psychosocial theory is based on what major organizing concepts?
 Definition
1.Stages of development
2.Developmental goals or tasks
3.Psychosocial crises
4.The process of coping
Term
The preoperational stage of Piaget's theory is divided into what parts?
 Definition
1. Preconceptual stage (ages 2 to 4 years)
2. Intuitive stage (ages 4 to 7 years)
Term
In this stage of Piaget's theory, logical thinking is developing, with an understanding of reversibility, relations between numbers,and loss of egocentricity, in addition to the ability to incorporate another’s perspective.
 Definition
Concrete Operational Stage (Ages 7 to 11 Years)
Term
What are the stages of Erikson's Theories of Psychosocial Development?
Definition
1. Trust versus Mistrust (Infancy)
2. Autonomy versus Shame and Doubt (Toddler)
3. Initiative versus Guilt (Preschool)
4. Industry versus Inferiority (School-Aged Children)
5. Identity versus Role Confusion (Adolescence)
6. Intimacy versus Isolation (Young Adulthood)
7. Generativity versus Stagnation (Middle Adulthood)
8. Ego Integrity versus Despair (Later Adulthood)
Term
In what stage of Erikson's theory does the infant learns to rely on caregivers to meet basic needsof warmth, food, and comfort?
 Definition
Trust versus Mistrust (Infancy)
Term
In what stage of Erikson's theory does the toddler (ages 1 to 3 years) learn from the environment and gain independence through encouragement from caregivers to feed, dress, and toilet self.
Definition
Autonomy versus Shame and Doubt
Term
In what stage of Erikson's theory is confidence gained as a caregiver allows the preschooler (ages 4 to 6 years) to take the initiative in learning, so that the child actively seeks out new experiences and explores the how and why of activities.
Definition
Initiative versus Guilt (Preschool)
Term
In what stage of Erikson's theory does the school-aged child gain pleasure from finishing projects and receiving recognition for accomplishments?
 Definition
Industry versus Inferiority (School-Aged Children)
Term
In what stage of Erikson's theory does many physical changes occur with the adolescent in transition from childhood to adulthood.
Definition
Identity versus Role Confusion (Adolescence)
Term
In what stage of Erikson's theory does many physical changes occur with the adolescent in transition from childhood to adulthood.
Definition
Identity versus Role Confusion (Adolescence)
Term
In what stage of Erikson's theory does the young adult unite self-identity with identities of friends and make commitments to others.
Definition
Intimacy versus Isolation (Young Adulthood)
Term
In what stage of Erikson's theory is there is a desire to make a contribution to the world?
 Definition
Generativity versus Stagnation (Middle Adulthood)
Term
In what stage of Erikson's theory does one reminiscence about life events which provides a sense of fulfillment and purpose.
 Definition
Ego Integrity versus Despair (Later Adulthood)
Term
Who described learned behaviors as
developmental tasks that occur at certain periods in life?
 Definition
Robert J. Havighurst
Term
What are Havighurst's developmental tasks?
 Definition
Infancy and Early Childhood
Middle Childhood
Adolescence
Young Adulthood
Middle Adulthood
Later Maturity
Term
__________ studied men and women between the ages of16 and 60 years, labeling the central theme for the adult years as “transformation,” with specific beliefs and developmental phases.
 Definition
Roger Gould
Term
____________ based their theory on the organizing concept of “individual life structure.”
Definition
Daniel Levinson and Associates
Term
Daniel Levinson and Associates' theory centered around the belief that the pattern of life at any point in time is formed by the interaction of what components?
 Definition
1. The self (values, motives)
2. The social and cultural aspects of one’s life (family, career, religion, ethnic background)
3. The particular set of roles in which one participates (husband, father,friend, student)
Term
According to Levinson and associates, what are the major phases in young and middle adult life?
 Definition
•Early adult transition (18-22)
•Entering the adult world (22-28)
•Settling down (30-40)
•Midlife transition (40-45)
•Pay-off years (45-65)
Term
________________ developed a theory of
moral development.
 Definition
Lawrence Kohlberg
Term
What are Lawrence Kohlberg's levels of moral development?
 Definition
Preconventional Level
Conventional Level
Postconventional Level
Term
In Kohlberg's moral development model, the __________ level is based on external control as the child learns to conform to rules imposed by authority figures.
 Definition
Preconventional Level
Term
In Kohlberg's moral development model, what are the stages in the Preconventional Level?
 Definition
1. Stage 1 - punishment and obedience orientation (the motivation for choices of action is fear of physical consequences of authority’s disapproval).
2. Stage 2 - instrumental relativist orientation (the thought of receiving areward overcomes fear of punishment, so actions that satisfythis desire are selected).
Term
In Kohlberg's moral development model, this level involves identifying with significant others and conforming to their expectations.
Definition
Conventional Level
Term
In Kohlberg's moral development model, what are the stages in the conventional level?
 Definition
1. Stage 3 - “good boy–good girl” orientation (the person strives for approval in an attempt to be viewed as “good.”)
2. Stage 4 - “law and order” orientation (behavior follows social or religious rules from a respect for authority).
Term
In Kohlberg's moral development model, what level involves moral judgment that is rational and internalized into one’s standards or values?
 Definition
Postconventional Level
Term
In Kohlberg's moral development model, what are the stages in the postconventional level?
 Definition
1. Stage 5 - social contract and utilitarian orientation (correct behavior is defined in terms of society’s laws).
2. Stage 6 - universal ethical principle orientation (represents the person’s concern for equality for all human beings, guided by personal values and standards, regardless of those set by society or laws).
Term
__________ theory of development views females as developing a morality of response and care, and males as developing a morality of justice.
 Definition
Carol Gilligan's
Term
What are Carol Gilligan's developmental levels?
 Definition
Level 1—Selfishness
Level 2—Goodness
Level 3—Nonviolence
Term
In what level of Carol Gilligan's theory is moral judgment is based on shared norms and expectations, and societal values are adopted.
Definition
Level 2—Goodness
Term
In what level of Carol Gilligan's theory does a changed understanding of self and a redefinition of morality allow reconciliation of selfishness and responsibility.
Definition
Level 3—Nonviolence
Term
___________ postulated a developmental theory of the spiritual identity of humans.
 Definition
James Fowler
Term
What are the stages in James Fowler's Theory of Faith Development?
 Definition
Stage 1 — Intuitive–Projective Faith
Stage 2 — Mythical–Literal Faith
Stage 3 — Synthetic–Conventional Faith
Stage 4 — Individuative–Reflective Faith
Stage 5 — Conjunctive Faith
Stage 6 — Universalizing Faith
Term
In James Fowler's Theory of Faith Development, in what stage do children imitate religious gestures and behaviorsof others, primarily their parents?
 Definition
Stage 1 — Intuitive–Projective Faith
Term
In James Fowler's Theory of Faith Development, in what stage does the child accept the existence
of a deity?
 Definition
Stage 2 — Mythical–Literal Faith
Term
In James Fowler's Theory of Faith Development, in what stage does the person begins to question life-guiding values or religious practices in an attempt to stabilize his or her own identity.
 Definition
Stage 3 — Synthetic–Conventional Faith
Term
In James Fowler's Theory of Faith Development, what stage is crucial for older adolescents and young adults because they become responsible for their own commitments, beliefs, and attitudes?
 Definition
Stage 4 — Individuative–Reflective Faith
Term
In James Fowler's Theory of Faith Development, what stage integrates other viewpoints about faith into one’s understanding of truth.
Definition
Stage 5 — Conjunctive Faith
Term
In James Fowler's Theory of Faith Development, what stage involves making tangible the values of absolute love and justice for humankind?
 Definition
Stage 6 — Universalizing Faith
Term
What are the growth and development stages of the fetus?
 Definition
Preembryonic Stage (conception-3 weeks)
Embryonic Stage (4-8 weeks)
Fetal Stage (9 weeks-birth)
Term
What are the germ layers?
 Definition
1. The endoderm (inner layer) becomes the respiratory system, the digestive system, the liver, and the pancreas.
2. The mesoderm (middle layer) becomes the skeleton, connective tissue, cartilage, muscles, and the circulatory, lymphoid, reproductive, and urinary systems.
3. The ectoderm (outer layer)becomes the brain, spinal cord, nervous system, and outer body parts (skin, hair, and nails).
Term
By the end of this stage, all basic organs have been established, the bones have begun to ossify, and some human features are recognizable.
 Definition
Embryonic Stage (4-8 weeks)
Term
Because this is a period of such rapid growth and change, the fetus is especially vulnerable to any factor that might cause congenital anomalies n this stage (such as maternal use of alcohol, nicotine, over-the-counter medications, or drugs).
 Definition
Embryonic Stage (4-8 weeks)
Term
In this stage of prenatal development all body organs and systems continue to grow and develop.
 Definition
Fetal Stage (9 weeks to birth)
Term
___________ can result in fetal megaloblastic anemia and neural tube defects.
 Definition
Folic acid deficiency
Term
____________ can result in inadequate fetal bone calcification.
 Definition
Vitamin D and calcium deficits
Term
__________ can result in fetal hypothyroidism.
 Definition
Iodine deficiency
Term
A developmental stage from birth to 28 days.
 Definition
Neonate
Term
The neonate is assessed immediately after birth using what?
 Definition
The Apgar rating scale
Term
What reflexes are a physical characteristic of neonates?
 Definition
Moro reflex
the stepping reflex
grasp reflex
hand-to-mouth activity
sucking
swallowing
blinking
sneezing
yawning
Term
A developmental stage from 1 month to 1 year.
 Definition
Infant
Term
What are the physical characteristics of the infant?
 Definition
•Brain grows to about half the adult size.
•Body temperature stabilizes.
•Motor abilities develop, allowing using building blocks,attempting to feed self, crawling, and walking.
•Eyes begin to focus and fixate.
•Heart doubles in weight, heart rate slows, and blood pres-sure rises.
•Deciduous teeth begin to erupt at 4 to 6 months.
•Birthweight usually triples by 1 year, when the averagemale infant weighs 22 lb (10 kg) and the average femaleinfant weighs 21 lb (9.5 kg). Length increases by 50%
Term
An active, affectionate, reciprocal relationship between two people.
 Definition
Attachment
Term
Occurs during a sensitive period in the first few hours after birth and is necessary for later attachment. Might be considered the emotional linkage of two people.
 Definition
Bonding
Term
The two dimensions of play are _________ and ______________.
Definition
Social play
Cognitive play
Term
________ is primarily inborn, although it is influenced by environment.
Definition
Temperament
Term
___________ is uncontrollable, extended crying in an otherwise healthy and well-fed baby.
Definition
Colic
Term
_____________ is a condition of inadequate growth in height and weight resulting from the infant’s inability to obtain or use calories needed for growth.
Definition
Failure to thrive (FTT)
Term
Infants with FTT have signs of ____________ and _____________.
 Definition
malnutrition
delayed development
Term
____________ is the sudden death of an infant under the age of 1 year, unexpected in light of the infant’s history.
 Definition
Sudden infant death syndrome
(SIDS)
Term
A developmental stage from 1 to 3 years.
Definition
Toddler
Term
A developmental stage from 3 to 6 years.
Definition
Preschooler
Term
The physical characteristics of the preschooler include what?
 Definition
•Head is close to adult size by 6 years of age.
•The body is less chubby and becomes leaner and more coordinated.
•Motor abilities include skipping, throwing and catching a ball, copying figures, and printing letters and numbers.
•Full set of 20 deciduous teeth is present; baby teeth begin to fall out and are replaced by permanent teeth.
•Average weight at 5 to 6 years of age is 45 lb (20.4 kg), with boys being slightly heavier than girls.
Term
Growth and developmental highlights of the toddler include what?
 Definition
•Has rapid brain growth; increase in length of long bones of the arms and legs; growth of muscles
•Uses fingers to pick up small objects
•Walks forward and backward, runs, kicks, climbs stairs, and rides a tricycle
•Drinks from a cup and uses a spoon
•At 2 years of age, the toddler is typically four times the birth-weight, averaging 30 to 35 lb (13.6 to 15.9 kg) and 23 to37 inches (58.4 to 94 cm) in height.•Has bladder control during the day and sometimes during the night (2.5–3 years of age)
•Turns pages in a book, and by 3 years of age, draws stick people
Term
A developmental stage from 6 to 12 years.
 Definition
School-aged child
Term
Physiologic development of school-aged children includes what characteristics?
 Definition
•The brain reaches 90% to 95% of adult size; by 12 years of age, the nervous system is almost completely matured, resulting in coordinated body movements.
•Motor abilities progress from the ability to hold a pencil and print words at 6 years of age to the ability to write in script and in sentences at 12 years of age.
•Sexual organs grow but are dormant until late in this period, when hormonal changes begin.
•All permanent teeth are present, except for the second and third molars, by 12 years of age.
•Height increases 2 to 3 inches (5.1 to 7.6 cm) and weight increases 3 to 6 lb (1.4 to 2.7 kg) a year.
Term
Cognitive development of school-aged children includes what characteristics?
 Definition
•Thinks logically and develops concepts of mass, volume,weight, and measurement
•Deals best with actual objects and people, but can relate concepts and compare events
•Uses inductive reasoning to solve new problems
•Generalizes about people, places, and things
•Develops classification systems
•Develops an awareness and understanding of other people’s feelings and points of view
•Understands reversal of events
Term
Cognitive development of the preschooler includes what characteristics?
 Definition
•Egocentrism decreases as socialization with other children increases, and the ability to express self verbally improves.
•Play is more related to real-life events (rather than fantasy).
•Basic curiosity results in constant questions and improved reasoning ability
Term
___________ is diagnosed when a child is at least 5 years of age and is still having involuntary urination, usually at night.
 Definition
Enuresis
Term
___________ begins with puberty and extends from 12 to 20 years of age; the ____________ period is considered to be the 20s and 30s.
Definition
Adolescence
Young Adult
Term
Physiologic development of adolescents include what characteristics?
 Definition
•The feet, hands, and long bones grow rapidly, accompanied by an increase in muscle mass (especially in boys).
•Primary and secondary sexual development occurs, with maturation of the genitalia; presence of body hair; breast development and menstruation in girls; facial hair growth,voice changes, and spermatogenesis in boys.
•Puberty (the time when the ability to reproduce begins)begins at 9 to 13 years of age in girls (with menstruation usually beginning between 10 and 14 years of age) and at 11 or 14 years of age in boys.
•Sebaceous and axillary sweat glands become active.
•Full adult size is reached, although some young men might continue to grow in their 20s
Term
Puberty can be divided into what stages?
 Definition
•Prepubescence: Secondary sex characteristics begin to develop, but the reproductive organs do not yet function.
•Pubescence: Secondary sex characteristics continue to develop, and ova and sperm begin to be produced by their productive organs.
•Postpubescence: Reproductive functioning and the development of secondary sex characteristics reach adult maturity.
Term
Often, ___________ or __________ temporarily abandon traditional religious practices.
 Definition
adolescents
young adults
Term
_____________ are the leading cause of death for adolescents and young adults.
 Definition
Injuries
Term
_________ is the third leading cause of death of adolescents and young adults.
 Definition
Suicide
Term
______________ are the second leading cause of injury and death in adolescents.
Definition
Firearm-related homicides
Term
A gradual process, characterized by continued development and maturation.
Definition
Aging
Term
Theory of aging stating that life span depends to a great extent on genetic factors.
Definition
Genetic Theory of Aging
Term
Theory of aging stating that the immune response declines steadily after younger adulthood as the thymus loses size and function.
 Definition
Immunity Theory of Aging
Term
A chemical reaction that produces damage to the DNA and cell death.
Definition
Cross-linkage
Term
A theory of aging that states As one ages, cross-links accumulate, leading to essential molecules in the cell binding together and interfering with normal cell function.
 Definition
Cross-Linkage Theory
Term
Molecules with separated high-energy electrons, which can have adverse effects on adjacent molecules.
Definition
Free Radicals
Term
Theory of aging that states lipids, found in cell membranes, as well as proteins and cell organelles, are affected. Over time, irreversible damage results from the accumulated effects of this damage
 Definition
Free Radical Theory
Term
Generally considered to be ages 40 to 65.
Definition
Middle Adult
Term
Gradual decrease in ovarian function, with subsequent depletion of estrogen and progesterone.
Definition
Menopause
Term
The loss of estrogen also increases the risk for __________ and __________.
Definition
osteoporosis
heart disease
Term
Androgen levels diminish slowly; the man may have some loss of sexual potency but is still capable of reproduction.
 Definition
Andropause
Term
What are the physical changes in the middle adult?
 Definition
•Fatty tissue is redistributed; men tend to develop abdominal fat, women thicken through the middle.
•The skin is drier.
•Wrinkle lines appear on the face.
•Gray hair appears, and men may lose hair on the head.
•Cardiac output begins to decrease.
•Muscle mass, strength, and agility gradually decrease.
•There is a loss of calcium from bones, especially in perimenopausal women.
•Fatigue increases.
•Visual acuity diminishes, especially for near vision(presbyopia).
•Hearing acuity diminishes, especially for high-pitched sounds.
•Hormone production decreases, resulting in menopause or andropause
Term
What are the leading causes of death in the middle adult years?
 Definition
motor vehicle crashes
occupational accidents
suicide
chronic diseases
Term
One older than 65 years of age.
 Definition
Older Adult
Term
The older adult period is often further divided into what categories?
Definition
The young-old (ages 60 to 74 years)
The middle-old (ages 75 to 84 years) The old-old (ages 85 years and older)
Term
Older women outnumber older men by a ratio of ______.
Definition
3:2
Term
Maintained that older adults often withdraw from usual roles and become more introspective and self-focused.
Definition
Disengagement Theory (now thought of as incorrect)
Term
Theory stating that successful aging involves the ability to maintain high levels of activity and functioning.
 Definition
Activity Theory
Term
Theory that assumes that healthy aging is related to the older adult’s ability to continue similar patterns of behavior from young and middle adulthood.
 Definition
Identity-continuity Theory
Term
A way for an older adult to relive and restructure life experiences and is part of achieving ego integrity.
Definition
Life Review (Reminiscence)
Term
Refers to various organic disorders that progressively affect cognitive functioning.
Definition
Dementia
Term
Of the dementias that affect older adults, _____________ is the most common degenerative neurologic illness and the most common cause of cognitive impairment.
 Definition
Alzheimer’s disease (AD)
Term
An older adult habitually becomes confused, restless, and agitated after dark.
 Definition
Sundowning syndrome
Term
A temporary state of confusion that is an acute illness which can last from hours to weeks and resolves with treatment.
Definition
Delirium
Term
Interventions to redirect the patient’s attention to what is real in the environment.
Definition
reality orientation
Term
The rate of suicide in older adults is highest in ____________.
Definition
white males
Term
Elder abuse most commonly occurs in ______ who are older than ____ years of age.
Definition
women
80
Term
Neglect accounts for _______% of all elder mistreatment reports made to adult protective service agencies.
 Definition
60 to 70
Term
The scientific and behavioral study of all aspects of aging and its consequences.
Definition
Gerontology
Term
The ability to carry out usual and desired daily activities.
 Definition
functional health
Term
Combines the basic knowledge and skills of nursing with a specialized knowledge of aging in both illness and health.
 Definition
Gerontologic nursing
Term
What is included in vital signs?
 Definition
Temperature
Pulse
Respiration
Blood pressure
Oxygen Saturation
Pain
Term
Vital signs are assessed at least every 4 hours in hospitalized patients with what conditions?
Definition
1. High or low blood pressures
2. with changes in pulse rate or rhythm 3. with respiratory difficulty
4. patients who are taking medications that affect cardiovascular or respiratory function
5. patients who have had surgery
Term
If a patient has abnormal or unusual physical symptoms (eg, chest pain or dizziness) or has unexpected changes in vital signs, the nurse should do what?
 Definition
double-check the findings and further assess the patient.
Term
Nurses take vital signs as often as _______________.
 Definition
a patient’s condition requires such assessment.
Term
Core body temperature is normally maintained within a range of _____________.
 Definition
36.0°C (97.0°F) to 37.5°C (99.5°F)
Term
core body temperatures are the lowest in the _________ and highest in the ___________.
 Definition
early morning
late afternoon
Term
Core temperatures are measured at _____________ sites.
 Definition
tympanic or rectal
Term
The thermoregulatory center is located in the __________.
 Definition
hypothalamus
Term
Epinephrine and norepinephrine ____________ (increase/decrease) body temperature.
Definition
increase
Term
Thyroid hormone __________ (increases/decreases) metabolism and heat production.
 Definition
increases
Term
____________ reduces the size of the skin surface to minimize heat loss.
Definition
piloerection
Term
Small connections between the arterioles and the venules that lie directly below the skin surface.
Definition
Arteriovenous shunts
Term
The _______________ controls the opening and closing of the arteriovenous shunts in response to changes in core body temperature and in environmental temperature.
 Definition
sympathetic nervous system
Term
What are the factors that affect body temperature.
 Definition
circadian rhythms
age
gender
stress
environmental temperatures
Term
A person with a normal body temperature is referred to as ___________.
 Definition
afebrile
Term
An increase above normal (considered to be 37°C or 98.6°F) in body temperature in response to trauma or illness.
Definition
Fever (pyrexia)
Term
A person with a fever is said to be
________.
 Definition
febrile
Term
The diffusion or dissemination of heat by electromagnetic waves (Ex. the body gives off waves of heat from uncovered surfaces).
 Definition
Radiation
Term
The dissemination of heat by motion between areas of unequal density (ex. an oscillating fan blowscurrents of cool air acrossthe surface of a warm body).
 Definition
Convection
Term
The conversion of a liquid to a vapor (ex. body fluid in the form of perspiration and insensible loss is vaporized from the skin).
Definition
Evaporation
Term
The transfer of heat to another object during direct contact (ex. the body transfers heat to an ice pack, causing the ice to melt).
 Definition
Conduction
Term
When the thermal set point is increased, the hypothalamus initiates _______________.
Definition
shivering and vasoconstriction
Term
Hyperthermia differs from fever in that _________________________.
 Definition
the hypothalamic setpoint is not changed
Term
Neurogenic fever is usually the result of damage to the hypothalamus from ____________________.
 Definition
intracranial trauma, intracranial bleeding, or increased intracranial pressure
Term
Hyperpyrexia is a high fever, usually above ______________.
 Definition
41°C (105.8°F)
Term
Pyrexia is a fever usually between ______________.
 Definition
38°C (100.4°F) - 40°C (104.0°F)
Term
Hypothermia is usually at or below ______________.
 Definition
35°C (95.0°F)
Term
A normal temperature is usually between ______________.
 Definition
36°C (97.0°F) - 37°C (98.6°F)
Term
Aspirin also should not be given to children and teenagers with _____________ because of a possible association with Reye’s syndrome.
 Definition
chickenpox or influenza
Term
The body temperature alternates regularly between a period of fever and a period of normal or subnormal temperature.
 Definition
Intermittent
Term
The body temperature fluctuates several degrees more than 2°C (3.6°F) above normal but does not reach normal between fluctuations.
 Definition
Remittent
Term
The body temperature remains consistently elevated and fluctuates less than 2°C (3.6°F).
 Definition
Constant
Term
The body temperature returns to normal for at least a day, but then the fever recurs.
 Definition
Relapsing
Term
The fever returns to normal suddenly.
 Definition
Crisis
Term
The fever returns to normal gradually.
 Definition
Lysis
Term
Death may occur when the temperature falls below about __________.
Definition
34°C (93.2°F)
Term
Non-mercury thermometers may be either ___________ or ___________.
Definition
spirit-filled
alcohol-based
Term
Most commonly, a _________ is found on glass thermometers used to take oral temperatures, and a __________ is found on glass thermometers used to take rectal temperatures.
 Definition
long, thin bulb
blunt bulb
Term
Low white blood cell counts
 Definition
neutropenic
Term
________ results as a wave of blood is pumped into the arterial circulation by the contraction of the left ventricle.
 Definition
pulse
Term
Characteristics of the pulse, include ____________________________.
 Definition
rate
quality
rhythm
stroke volume
Term
What is the pulse regulated by?
 Definition
autonomic nervous system through the cardiac sinoatrial (SA) node
Term
____________ stimulation of the SA node via the vagus nerve decreases the heart rate.
 Definition
Parasympathetic
Term
____________ stimulation of the SA node increases the heart rate and force of contraction.
Definition
Sympathetic
Term
A rapid rate (tachycardia) ________ (increases/decreases) cardiac filling time, which, in turn, ________________________.
Definition
decreases
decreases stroke volume and cardiac output
Term
An adult has tachycardia when the pulse rate is ________ beats/min.
 Definition
100 to 180
Term
A pulse rate below 60 beats/min in an adult.
 Definition
Bradycardia
Term
Heart pain
 Definition
Angina
Term
Describes the quality of the pulse in terms of its fullness and reflects the strength of left ventricular contraction.
Definition
Pulse Amplitude
Term
Pattern of the pulsations and the pauses between them.
Definition
Pulse Rhythm
Term
An irregular pattern of heartbeats.
Definition
dysrhythmia
Term
What are the pulse amplitude categories?
 Definition
0 Absent pulse - no pulsation is felt despite extreme pressure.
1+Thready pulse - Pulsation is not easily felt, and slight pressure causes it to disappear.
2+Weak pulse - Stronger than a thready pulse; light pressure causes it to disappear.
3+Normal pulse - Pulsation is easily felt,takes moderate pressure to cause it to disappear.
4+Bounding pulse - The pulsation is strong and does not disappear with moderate pressure.
Term
The diaphragm is more useful for hearing __________ sounds.
 Definition
high-frequency
Term
The bell is more useful for hearing _________ sounds.
 Definition
low-frequency
Term
This device has an ear-piece connected to an audio unit with an ultrasound transducer.
 Definition
Doppler Ultrasound Stethoscope
Term
What are the pulse sites?
 Definition
Temporal
Carotid
Brachial
Radial
Femoral
Popliteal
Dorsalis pedis
Posterior tibial
Term
The ________ pulse site is used for infants who have had a cardiac arrest
 Definition
brachial
Term
The _______ pulse is assessed when giving medications that alter heart rate and rhythm.
Definition
apical
Term
A difference between the apical and radial pulse rates is called the
___________.
 Definition
pulse deficit
Term
Movement of air in and out of the lungs.
 Definition
Pulmonary ventilation (or breathing)
Term
______________ is the act of breathing in.
 Definition
Inspiration (or inhalation)
Term
______________ is the act of breathing out.
Definition
Expiration (or exhalation)
Term
Respirations are controlled by ______________.
 Definition
respiratory centers in the medulla and pons
Term
The respiratory centers in the medulla and pons are activated by what?
 Definition
1. chemoreceptors located in the aortic arch and carotid arteries
2. stretch and irritantreceptors in the lungs
3. receptors in muscles and joints
Term
An _________________ is the most powerful respiratory stimulant.
 Definition
increase in carbon dioxide
Term
Normal respiration is called ________.
 Definition
eupnea
Term
An increased respiratory rate
 Definition
Tachypnea
Term
a decrease in respiratory rate
 Definition
Bradypnea
Term
A/An _________ (increase/decrease) in intracranial pressure depresses the respiratory center, resulting in irregular or shallow breathing, slow breathing, or both.
 Definition
increase
Term
Certain drugs, such as __________________, depress the respiratory rate.
 Definition
narcotics (eg, morphine, meperidine [Demerol])
Term
________ refers to periods during which there is no breathing.
Definition
Apnea
Term
________ is difficult or labored breathing.
Definition
Dyspnea
Term
Dyspneic people can often breathe more easily in an upright position, a condition known as __________.
 Definition
orthopnea
Term
__________ refers to the force of the blood against arterial walls.
Definition
Blood pressure
Term
The difference between systolic and diastolic pressure is called the
_______________.
 Definition
pulse pressure
Term
Decreased blood flow.
 Definition
ischemia
Term
The ______________________ system controls vasoconstriction to increase peripheral vascular resistance and also increases sodium and water retention by the kidneys to increase circulatory fluid volume and thus increase blood pressure.
Definition
renin-angiotensin-aldosterone
Term
___________ is released from the posterior pituitary when stimulated by decreased blood volume and blood pressure, or by an increased osmolarity of the blood.
 Definition
Antidiuretic hormone (ADH, vasopressin)
Term
The quantity of blood forced out of the left ventricle with each contraction is called the ______________.
Definition
stroke volume (SV)
Term
The ______________ is the amount of blood pumped per minute.
 Definition
cardiac output (CO)
Term
cardiac output (CO) averages from ______________ in a healthy adult.
Definition
3.5 L/min to 8.0 L/min
Term
Cardiac Output = ___________.
 Definition
Stroke Volume × Heart Rate
Term
A rise or fall of ___________ mm Hg in a person’s blood pressure is significant, even if it is within the generally accepted normal range.
 Definition
20 to 30
Term
It is one of the most common health problems in adults and the leading cause of cardiovascular disorders.
 Definition
Hypertension
Term
___________ hypertension is hypertension without a known cause.
Definition
Primary (also called essential)
Term
When the hypertension is caused by a known pathology, it is called _________ hypertension.
 Definition
secondary
Term
Overactivation of both angiotensin and aldosterone result in an _________ (increase/decrease) in blood pressure.
 Definition
increase
Term
The categories of antihypertensive medications include ____________ (to decrease fluid volume), ______________ (to block sympathetic stimulation anddecrease cardiac output), _______________ (to relax smooth muscles of arterioles and decrease peripheral vascular resistance), and ____________ (to prevent vasoconstriction by angiotensin II and decrease circulatory fluid volume by reducing aldosterone production).
 Definition
diuretics
beta-adrenergic blockers
vasodilators and calcium channelblockers
ACE inhibitors
Term
___________ is below-normal blood pressure.
 Definition
Hypotension
Term
____________ is a low blood pressure associated with weakness or fainting when one rises to an erect position (either supine to sitting, supine to standing, or sitting to standing).
 Definition
Orthostatic hypotension
(postural hypotension)
Term
It is the result of peripheral vasodilation without a compensatory rise in cardiac output.
Definition
Orthostatic hypotension
(postural hypotension)
Term
The series of sounds for which the nurse listens when assessing the blood pressure are called ______________.
 Definition
Korotkoff sounds
Term
The disappearance of the sound during the latter part of phase I and during phase II is called the
____________.
 Definition
auscultatory gap
Term
The width of the BP cuff should be about ___% of the circumference of the limb to be used.
Definition
40
Term
The systolic pressure is normally 10 to 40 mm Hg higher at this site, although the diastolic pressure is the same.
Definition
Popliteal
Term
_______________ involves collecting, validating,and analyzing data about the patient’s health.
Definition
Health assessment
Term
A ___________________ with a health history and complete physical examination is usually conducted when a patient first enters a healthcare setting, with information providing a baseline for comparing later assessment.
 Definition
comprehensive assessment
Term
An ______________________ is one that is conducted at regular intervals (eg, at the beginning of each home health visit or each hospital shift) during care of the patient.
Definition
ongoing partial assessment
Term
This type of assessment concentrates on identified health problems to monitor positive or negative changes and evaluate the effectiveness of interventions.
Definition
ongoing partial assessment
Term
A _________________ is conducted to assess a specific problem.
 Definition
focused assessment
Term
An ___________________ is a type of rapid focused assessment conducted to determine potentially fatalsituations
 Definition
emergency assessment
Term
A ______________ is a collection of subjective data that provides a detailed profile of the patient’s health status.
 Definition
health history
Term
What are the components of a health history?
 Definition
Biographical Data
Reason for Seeking Health Care
History of Present Health Concern
Medical History
Family History
Lifestyle
Term
A _____________ is the systematic collection of objective information.
 Definition
physical assessment
Term
An _______________ is a lighted instrument used to visualize the interior structures of the eye.
Definition
ophthalmoscope
Term
near-sighted
Definition
myopic
Term
far-sighted
Definition
hyperopic
Term
An __________ is a lighted instrument used to examine the external ear canal and the tympanic membrane
 Definition
otoscope
Term
The _____________, used as a screening test for distant vision,consists of characters in 11 lines of different-sized type; the line of largest characters is at the top of the chart and the line of smallest characters is at the bottom.
 Definition
Snellen chart
Term
A ____________ is used to visualize the lower and middle turbinates of the nose.
Definition
nasal speculum
Term
A ____________ is a two-bladed instrument used to examine the vaginal canal and cervix.
Definition
vaginal speculum
Term
_________ is the process of performing deliberate, purposeful observations in a systematic manner.
Definition
Inspection
Term
The _____________ surfaces of the hand and fingers are used for gross measure of temperature.
 Definition
dorsum (back)
Term
The _____________ surfaces of the fingers and finger pads are used to assess texture, shape, fluid, size, consistency, and pulsation.
Definition
palmar (front)
Term
Vibration is palpated best with the _______ of the hand.
 Definition
palm
Term
For light palpation, apply light pressure with the fingers together depressing the skin and underlying structures less than ________.
Definition
1 cm (0.5″)
Term
Moderate palpation is conducted by depressing the skin surface ______________.
 Definition
1 to 2 cm (0.5″ to 0.75″)
Term
For deep palpation, press inward about __________.
Definition
2 cm (1″)
Term
Applying _______________ to a specific area allows assessment of surface characteristics and underlying structures.
Definition
intermittent pressure
Term
What is assessed in general survey?
 Definition
• Observe general appearance, hygiene, posture, gait, thought processes, speech patterns.
• Evaluate height and weight.
• Take vital signs.
Term
What is assessed in integument?
 Definition
• Skin: Inspect for color and lesions; palpate for temperature, texture, and moisture.
• Hair: Inspect for texture, loss, unusual growth, and infestations.
• Nails: Inspect for color and condition
Term
What is assessed in head & neck?
 Definition
• Skull and face: Inspect for shape and symmetry.
• Neck: Palpate trachea and thyroid gland.
• Lymph nodes: Palpate for size, shape, consistency, and tenderness.
• Eyes: Test visual acuity, extraocular movements, and peripheral vision; inspect for discharge, alignment, and internal structures.
• Ears: Test hearing acuity; inspect position, external ear, tympanic membrane, and for cerumen.
• Nose, mouth, throat: Inspect for color, consistency, condition of teeth, exudate, condition of tonsils; palpate for tenderness
Term
What is assessed in thorax and lungs?
 Definition
• Thorax: Inspect posture and respiratory rate; palpate for crepitus and expansion; percuss for tones; auscultate breath sounds.
• Breasts: Inspect size, shape, symmetry, color, areolas, nipple (discharge), retraction, dimpling; palpate for masses or tenderness.
• Axillary lymph nodes: Palpate for size, shape, consistency, and tenderness.
Term
What is assessed in cardiovascular?
 Definition
• Carotid arteries: Auscultate for bruit; palpate pulse strength.
• Jugular vein: Inspect for pulsations and distention.
• Precordium: Inspect for pulsations; palpate apical impulse, and heart rate and rhythm; auscultate heart sounds and murmurs.
Term
What is assessed in peripheral vascular?
 Definition
• Peripheral pulses: Palpate for symmetry, character, strength, rate, patency.
• Arms and legs: Inspect for color, hair pattern, veins, lesions, and edema; palpate for temperature.
Term
What is assessed in abdomen?
 Definition
• Abdomen: Inspect for size, shape, contour, lesions, distention,and hernia; percuss for tones; palpate for tenderness.
• Bowel sounds: Auscultate for intensity, frequency, and pitch.
• Liver: Percuss and palpate for location and consistency/size; palpate for tenderness.
• Aorta: bruits, pulsation
Term
What is assessed in male genitalia?
 Definition
• Penis: Inspect for inflammation, infestations, rashes, lesions,masses, and discharge. Palpate for masses.
• Scrotum and testes: Inspect for inflammation, edema, and lesions; palpate for masses
Term
What is assessed in female genitalia?
 Definition
• External genitalia: Inspect for inflammation, infestations, rashes,lesions, masses, discharge (color, odor, amount), swelling, and bulging out of vagina.
• Uterus: Palpate for size, position, shape, and consistency.
• Ovaries: Palpate for size, shape, mobility, and tenderness.
Term
___________ is used to assess the location, shape, size, and density of tissues.
 Definition
Percussion
Term
What are the four characteristics of sound that are assessed by auscultation?
 Definition
(1) pitch (ranging from high to low)
(2) loudness (ranging from soft to loud)
(3) quality (eg, gurgling or swishing) (4) duration (short, medium, or long)
Term
What part of assessment includes observing the patient’s overall appearance and behavior, taking vital signs, and measuring height and weight.
 Definition
General survey
Term
Position used to assess the hip joint and the posterior thorax.
 Definition
Prone
Term
The ________ position should not be used for abdominal assessment because it causes contraction of the abdominal muscles.
Definition
Dorsal Recumbent
Term
What is assessed in the anus, rectum, prostate?
 Definition
• Anus: Inspect and palpate for hemorrhoids, lumps, ulcers, fissures.
• Stool: Inspect for color; test for occult blood.
• Prostate: Palpate for size, shape, consistency, and tenderness.
Term
What is assessed in musculoskeletal?
 Definition
• Gait: Inspect gait and posture.
• Joints and muscles: Inspect for size, symmetry, color, and edema;palpate for nodules, crepitus, and strength.
• Joints: Test range of motion
Term
What is assessed in neurologic?
 Definition
• Mental status: Assess level of awareness; level of consciousness;dress, grooming, hygiene; speech; thought processes; and memory and abstract reasoning.
• Cranial nerves: Test ability to smell, see, clench teeth, move eyes,have facial expressions, hear, taste, feel touch, swallow, shrug shoulders against resistance, and protrude tongue.
• Fine motor movement: Test ability to repeatedly touch nose with hand, pat knees with palms and backs of hands, and run heel down opposite shin.
• Sensory: Test ability to distinguish between sharp and dull touch.
• Reflexes: Assess degree of response.
Term
Children to 2 years of age should have their height measured in the _____________________________.
 Definition
recumbent position with the legs fully extended
Term
Infants should be weighed ____________, and children should be weighed ___________.
 Definition
without any clothing
in their underwear
Term
The ______ is a general indicator of the patient’s health status and provides information that might indicate an underlying disease.
 Definition
skin
Term
Changes in skin color include ___________________.
 Definition
erythema
cyanosis
jaundice
pallor
Term
__________(redness of the skin) is more often seen in the face and the neck.
 Definition
Erythema
Term
__________ is a bluish or grayish discoloration of the skin in response to inadequate oxygenation.
Definition
Cyanosis
Term
Cyanosis is assessed as a _______ in patients with white skin and as _________ in patients with dark skin.
 Definition
blue tinge
dullness
Term
_________ is a yellow color of the skin resulting from liver and gallbladder disease, some types of anemia, and hemolysis.
 Definition
Jaundice
Term
Jaundice usually develops first in the _________ and then in _______ and lastly in the ____________.
 Definition
sclera of the eyes
the skin
mucous membranes
Term
_________, or paleness of the skin, often results from an inadequate amount of circulating blood or hemoglobin, causing inadequate oxygenation of the body tissues.
 Definition
Pallor
Term
Pallor in dark-skinned people is seen as an ____________________.
 Definition
ashen gray or yellow ting
Term
___________ is a collection of blood in the subcutaneous tissues, causing purplish discoloration.
Definition
Ecchymosis
Term
_________ are small hemorrhagic spots caused by capillary bleeding.
 Definition
Petechiae
Term
Areas of diseased or injured tissue.
Definition
lesions
Term
Lesions are categorized as ________, which may arise from previously normal skin, and _________, which result from changes in original lesions.
 Definition
primary
secondary
Term
breaks in the continuity of the skin
 Definition
wounds
Term
Assess wounds (breaks in the continuity of the skin) for _____________________.
 Definition
size
shape
depth
location
presence of drainage or odor
Term
Assess rashes for ________________.
 Definition
type
size
elevation
coloring
presence of drainage or itching
Term
An excessive amount of perspiration, such as when the entire skin is moist, is called ____________.
 Definition
diaphoresis
Term
__________ is the fullness or elasticity of the skin and is usually assessed on the sternum or under the clavicle.
Definition
Turgor
Term
Difficulty in lifting a skin fold may indicate _________________.
Definition
edema (excess fluid in the tissues)
Term
Edema is characterized by _________________.
Definition
swelling, with taut and shiny skin over the edematous area
Term
If the area of edema is palpated with the fingers, an indentation may remain after the pressure is released; this is called ___________.
Definition
pitting edema
Term
Edema may be graded as what?
 Definition
0 (none)
+1 (trace, 2 mm)
+2 (moderate, 4 mm)
+3 (deep, 6 mm)
+4 (very deep, 8 mm)
Term
The nails are inspected for ________________.
 Definition
shape, angle, texture, and color.
Term
The angle between the nail and its base in the finger should be about _____ degrees.
Definition
160
Term
Indentations in the nail.
 Definition
Beau's lines
Term
Painless separation of the nail plate from the nailbed.
Definition
onycholysis
Term
Assess the hair for _________________.
 Definition
color, texture, and distribution
Term
balding
Definition
alopecia
Term
excessive amounts of hair on the face and body.
 Definition
hirsutism
Term
Inspect the scalp for ______________.
Definition
color, dryness,scaliness, lumps, lesions, or lice.
Term
What are the common skin variations in newborns and children?
 Definition
•Jaundice and milia (whiteheads) in newborns
•Fine downy hair (lanugo) for the first 2 weeks of life
•Smooth, thin skin at birth
•Pubic hair development at the onset of puberty
Term
What are the common skin variations in the older adults?
 Definition
•Wrinkles, dryness, scaling, decreased turgor
•Raised dark areas (senile keratosis)
•Flat brown age spots (senile lentigines)
•Small round red spots (cherry angioma)
•Fine, brittle gray or white hair
•Hair loss
•Coarse facial hair in women, decreased body hair in men and women
•Thick, yellow toenails
Term
Circumscribed, flat, nonpalpable change in skin color ≤ 1 cm.
 Definition
Macule (Ex. Petechiae, freckle)
Term
Circumscribed, flat, nonpalpable change in skin color > 1 cm.
 Definition
Patch (Ex. Vitiligo)
Term
Palpable, elevated solid mass ≤ 0.5 cm.
 Definition
Papule (Ex. mole)
Term
Palpable, elevated solid mass > 0.5 cm.
 Definition
Plaque
Term
Palpable, elevated solid mass 0.5 - 2cm firmer than a papule.
 Definition
Nodule (Ex. Nevus [wart])
Term
Palpable, elevated solid mass > 2 cm.
 Definition
Tumor
Term
Palpable, elevated solid mass that is irregular, superficial area of localized sin edema.
Definition
Wheal (Ex. Hives, mosquito bite
Term
Circumscribed, superficial skin elevation filled with serous fluid, ≤
0.5 cm.
Definition
Vesicle (Ex. Herpes simplex)
Term
Circumscribed, superficial skin elevation filled with serous fluid, >
0.5 cm.
Definition
Bulla (Ex. 2nd-degree burn)
Term
Circumscribed, superficial skin elevation filled pus.
Definition
Pustule (Ex. acne, impetigo)
Term
Loss of superficial epidermis, moist, nonbleeding surface.
Definition
Erosion
Term
Loss of epidermis and dermis, may bleed and scar
 Definition
Ulcer
Term
Deep linear crack, extends into dermis
 Definition
Fissure
Term
Dried residue of serum, pus, or blood
 Definition
crust
Term
Dried residue of serum, pus, or blood
 Definition
crust
Term
Thin flake of exfoliated dermis
 Definition
Scale
Term
Thickened and roughened epidermis, with increased visibility of skin furrows
 Definition
Lichenification
Term
Thinning of the skin, loss of skin furrows, shiny appearance
 Definition
Atrophy
Term
Scratch of the epidermis
 Definition
Excoriation
Term
Fibrous tissue replaces tissue in the dermis or subcutaneous layer
 Definition
Scar
Term
Hypertrophied scar
 Definition
Keloid
Term
Plugged opening of a sebaceous gland, a hallmark of acne
 Definition
Comedo (Blackheads)
Term
Small, dilated, red or bluish surface vessels; may be part of a basal cell carcinoma or skin injury from radiation
 Definition
Telangiectasia
Term
Inspect and palpate the skull for ________.
 Definition
size and shape
Term
Edema of the face, especially around the eye.
 Definition
periorbital edema
Term
Inspect the face for ___________.
 Definition
color, symmetry, and distribution of facial hair
Term
Assessments of the eye include _______________.
 Definition
external and internal eye structures, visual acuity, extraocular movements, and peripheral vision
Term
Inspect the eyes, eyebrows, eyelids, eyelashes, lacrimal glands, pupils, and iris for _______________.
 Definition
position and alignment
Term
drooping of the upper lids.
 Definition
ptosis
Term
Inward turning of the lower lid.
 Definition
entropion
Term
outward turning of the lower lid.
 Definition
ectropion
Term
Inspect and palpate the lacrimal glands for ____________.
 Definition
edema and pain
Term
A dilation of the pupil due to disease, trauma or the use of drugs.
 Definition
mydriasis
Term
Constriction of the pupil of the eye, resulting from a normal response to an increase in light or caused by certain drugs or pathological conditions.
 Definition
Miosis
Term
The ____________ in visual acuity represents the distance from which a person with normal vision (recorded as 20/20) can read the letters.
Definition
numerator
Term
The larger the __________ in visual acuity, the poorer the vision.
Definition
denominator
Term
Visual acuity is recorded as the smallest line of letters that can be read accurately with no more than ____ inaccurate readings.
Definition
two
Term
Inspect the external ear for ______________.
 Definition
shape, size, and lesions
Term
Palpate the external ear gently for ___________________.
 Definition
pain, edema, or presence of lesions
Term
Pain when manipulating the pinna is a symptom of __________________.
 Definition
an infection of the external ear
Term
The tympanic membrane should be _________________.
 Definition
intact, translucent, shiny, and gray
Term
The result of a problem with the transmission of sound waves through the outer and middle ear.
 Definition
Conductive hearing loss
Term
Hearing loss from inner ear damage.
 Definition
Sensorineural hearing loss
Term
Normally, in the _________, the sound is heard in both ears or is localized at the center of the head.
Definition
Weber’s test
Term
In the Weber's test, patients with ________ hearing loss hear the sound better in the affected ear, whereas if the sound is heard better in the ear without a problem, it indicates ____________.
Definition
conductive
sensorineural hearing loss
Term
Normally, in the Rinne test, air-conducted hearing is _________ (<,>) than bone-conducted hearing.
 Definition
greater than
Term
If the hearing loss is conductive, bone conduction will be ____________ air conduction.
 Definition
the same or greater than
Term
Assess the nose by examining the _________________.
Definition
external nose, the nares, and the turbinates
Term
Test the nose for _________ by occluding one nostril at a time and asking the patient to inhale and exhale through the nose.
Definition
patency
Term
Examine the mucous membranes of the nose for ______________________.
Definition
color and the presence of lesions, exudate, or growths
Term
Inspect the nasal septum for _________________.
 Definition
intactness and deviation
Term
Palpate the frontal and maxillary sinuses for _____________.
 Definition
pain and edema
Term
Assess the mouth and pharynx by inspecting the ______________________.
 Definition
lips, gums and teeth, tongue, and hard and soft palates
Term
Assess the neck for _______________.
 Definition
range of motion and venous distention
Term
The trachea, normally midline at the suprasternal notch, is palpated for _______________.
 Definition
alignment and position
Term
Palpate the lymph nodes with the pads of thefingers for _______________.
 Definition
enlargement, tenderness, and mobility
Term
Enlarged lymph nodes.
 Definition
lymphadenopathy
Term
Palpate the thyroid gland for _____________________.
Definition
size, shape, symmetry, tenderness, and presence of any nodules
Term
What are the common head and neck variations in newborns and children?
 Definition
•Closing of posterior fontanel at 8 weeks of age; soft anterior fontanel at about 18 months of age
•Gazing at and following bright objects by 1 month of age
•Focusing with both eyes by 6 months of age
•Pupils at the inner folds (pseudostrabismus)
•Startle reflex in newborns
Term
What are the common head and neck variations in the older adult?
 Definition
•Impaired near vision (presbyopia)
•Decreased color vision and peripheral vision
•Decreased adaptation to light and dark
•A white ring around the cornea (arcus senilis)
•Entropion and ectropion
•Hearing loss (presbycusis)
•Impaired conductive hearing
•Elongated ear lobes
•Prominent ear landmarks
•Decreased neck range of motion
•Nodular thyroid gland
•Smaller, more easily palpated lymph glands
Term
The thorax comprises the ________________.
Definition
lungs, rib cage, cartilage, and intercostal muscles
Term
Begin inspection of the thorax by observing the patient’s chest for __________________________.
Definition
color,shape or contour, breathing patterns, and muscle development
Term
The chest should be symmetric, with the transverse diameter ________ (greater/lesser) than the anteroposterior diameter.
 Definition
greater
Term
Palpation of the thorax is used to detect areas of __________________.
Definition
sensitivity, chest expansion during respirations, and vibrations (fremitus)
Term
_________ is a symmetric vibration of the chest wall that occurs with speaking.
Definition
Fremitus
Term
When percussing the thorax note the _______________ of sounds produced.
 Definition
intensity, pitch, duration, and quality
Term
When a normal air-filled lung is percussed, the sound is _____________________.
 Definition
hollow, loud, low in pitch, and of long duration
Term
A __________ tone is heard over bony or well-developed muscle tissue.
 Definition
flat
Term
___________ heard over the trachea are high-pitched, harsh sounds, with expiration being ________ inspiration.
Definition
Bronchial sounds
longer than
Term
__________________ are heard over the mainstem bronchus and are moderate “blowing”sounds, with inspiration _______ expiration.
Definition
Bronchovesicular sounds
equal to
Term
________________ are soft, low-pitched sounds, heard best over the base of the lungs during inspiration, which is ________ expiration.
Definition
Vesicular breath sounds
longer than
Term
_______________ are not normally heard in the lungs but, if present, may be auscultated along with normal breath sounds.
 Definition
Adventitious breath sounds
Term
_________ breathing is a general term used to refer to noisy, strenuous respirations.
 Definition
Stertorous
Term
_________ is a harsh, high-pitched sound heard on inspiration when there is a narrowing of the upper airway, such as the larynx or trachea.
Definition
Stridor
Term
________ are fine to course crackling sounds made as air moves through wet secretions; they are most often heard on inspiration.
 Definition
Crackles
Term
Crackles are described as ______ when they are made by air passing through moisture in small air passages and alveoli and as _______ when they are made by air passing through moisture in the bronchioles, bronchi, and trachea.
Definition
fine
coarse
Term
Coarse crackles can also be documented as ___________.
 Definition
rhonchi
Term
________ are continuous sounds that originate in small air passages that are narrowed by secretions, swelling, or tumors.
Definition
Wheezes
Term
Lung sounds that may be inspiratory or expiratory and are high-pitched sounds.
 Definition
Wheezes
Term
Sputum should be assessed for ______________.
 Definition
color,consistency, and amount
Term
What are the common thorax and lung variations in newborns and children?
 Definition
•Louder breath sounds on auscultation
•More rapid respiratory rate (until 8 to 10 years of age)
•Use of abdominal muscles during respiration
Term
What are the common thorax and lung variations in older adults?
 Definition
•Increased anteroposterior chest diameter
•Increase in the dorsal spinal curve (kyphosis)
•Decreased thoracic expansion
•Use of accessory muscles to exhale
Term
Peripheral vascular assessment includes _____________________.
Definition
measuring the blood pressure and assessing peripheral pulses and perfusion
Term
The aortic, pulmonic, tricuspid, and apical areas, and Erb’s point
 Definition
precordium
Term
The apical impulse is located at about the ___________________.
Definition
fourth or fifth intercostal space at the left midclavicular line
Term
Use systematic auscultation with heart sounds, from the __________________.
Definition
aortic area to the pulmonic area to Erb’s point to the tricuspid area and finally to the mitral area
Term
What are the characteristics of a sibilant wheeze?
 Definition
• Musical or squeaking
• High-pitched, continuous sounds
• Auscultated during inspiration and expiration
• Occurs in small air passages
Term
What are the characteristics of a sonorous wheeze?
 Definition
• Sonorous or course
• Low-pitched, continuous sounds
• Auscultated during inspiration and expiration
• Coughing may clear the sound
Term
What are the characteristics of crackles?
 Definition
• Bubbling, crackling, popping
• Low- to high-pitched, discontinuous sounds
• Auscultated during inspiration
• Occurs in small air passages, alveoli, bronchioles, bronchi, and trachea
Term
What are the characteristics of friction rub?
 Definition
• Rubbing or grating
• Loudest over lower lateral anterior surface
• Auscultated during inspiration and expiration
Term
Inflammation of a vein.
 Definition
Phlebitis
Term
What are the common cardiovascular and peripheral vascular variations in newborns and children?
Definition
•Visible pulsation if the chest wall is thin
•Sinus dysrhythmia (the rate increases with inspiration and decreases with expiration)
•Presence of S3(in about one third of all children)
•More rapid heart rate (until about 8 years of age)
Term
What are the common cardiovascular and peripheral vascular variations in older adults?
 Definition
•Difficult-to-palpate apical pulse
•Difficult-to-palpate distal arteries
•Dilated proximal arteries
•More prominent and tortuous blood vessels; varicosities common
•Increased systolic and diastolic blood pressure
•Widening pulse pressure
Term
_______ are abnormal “swooshing” sounds similar to murmurs and are heard over major blood vessels.
Definition
Bruits
Term
Inspect the breasts for ________________.
Definition
size, shape, symmetry, color, texture,and skin lesions
Term
Sebaceous glands on the areolae of the breasts.
 Definition
Montgomery’s tubercles
Term
The breast is assessed in _________.
Definition
four quadrants