Term
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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. |
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Term
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Definition
"limping"
Claudication refers to cramplike pains in the calves caused by poor circulation of the blood to the leg muscles. |
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Term
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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" |
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Term
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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. |
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Term
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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. |
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Term
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Definition
| excessive fluid output in given amount of time |
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Term
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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). |
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Term
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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 |
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Term
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Definition
| painful sexual intercourse, due to medical or psychological causes. |
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Term
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Definition
| sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect |
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Term
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Definition
| abnormally large (poly-) intake of fluids by mouth. |
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Term
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Definition
| excessive hunger and abnormally large (poly-) intake of solids by mouth |
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Term
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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 |
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Term
| health history: children and young adults |
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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 |
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Term
| review of systems: young adult and children |
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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. |
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Term
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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. |
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Term
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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 |
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Term
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Definition
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Term
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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 |
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Term
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Definition
| mental disorder: due ot brain disease of known specific organic cause: delirium, dementia, intoxication, withdrawal |
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Term
| psychiatric mental illness |
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Definition
| no organic etiology has yet been established, anxiety disorder or schizophrenia |
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Term
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Definition
| being aware of one's own existence, feelings, and thoughts and aware of environment. |
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Term
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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. |
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Term
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Definition
| systematic check of emotional adn cognitive functioning: four main headings: appearance, behavior, cognition, thought processes or A,B,C,T |
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Term
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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. |
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Term
mental status exam:
objective data
APPEARANCE |
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Definition
Posture
Body movements
Dress
Grooming and hygiene |
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Term
mental status exam:
objective data
BEHAVIOR |
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Definition
Level of consciousness
Facial expression
Speech
Mood and Affect |
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Term
mental status exam:
objective data
COGNITIVE FUNCTIONS |
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Definition
Orientation
Attention span
Recent Memory
Remote memory
New learning: THE FOUR UNRELATED WORDS TEST. |
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Term
mental status exam:
objective data
THOUGHT PROCESSES AN DPERCEPTIONS |
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Definition
Thought process
Thought content
Perceptions: aware of reality
Screen for suicidal thoughts |
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Term
| assessment techniques: ORDER |
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Definition
1. inspection
2. Palpation
3. Percussion
4. Auscultation |
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Term
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Definition
| best for fine tactile dicrimination, as of skin texture, swelling, pulsation, lumps. |
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Term
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Definition
| backs of hands and gingers, best for determining temperature because the skin is thinner |
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Term
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Definition
| or ulnar surface of hand--best for vibration |
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Term
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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 |
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Term
| Resonant percussion notes |
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Definition
AMPLITUDE: medium-loud
PITCH: low(vibrations)
QUALITY: clean, hollow
DURATION: moderate
EX: over normal lung tissue |
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Term
| hyperresonant percussion notes |
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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. |
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Term
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Definition
AMPLITUDE: loud
PITCH: high
QUALITY: musical and drum like
DURATION: sustained longest
EX: over air-filled viscus, e.g. the stomach and intestine |
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Term
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Definition
AMPLITUDE: soft
PITCH: high
QUALITY: muffled thud
DURATION: short
EX: relatively dense organ, as liver or spleen |
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Term
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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 |
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Term
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Definition
| funnels light into the ear canal and onto the tympanic membrane |
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Term
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Definition
| illuminates the internal eye structures. enables you to look through the pupil at th fundus (background) of the eye. |
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Term
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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 |
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Term
| normal range of puse rate |
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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. |
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Term
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Definition
1-rate
2-rhythm
3-force
5-elasticity |
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Term
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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 |
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Term
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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. |
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Term
| normal range for respiration |
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Definition
adult: 10-20
18yr: 12-20
16yr: 16-20
14yr: 18-22 |
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Term
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Definition
| force of the blood pushing against the vessel wall. |
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Term
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Definition
| the maximum pressure felt on teh artery during left ventricular contraction or systole. |
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Term
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Definition
| the elastic recoil, or resting, pressure that ht eblood exerts constantly between each contraction |
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Term
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Definition
| the difference between the systolic and diastolic and reflects the stroke volume |
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Term
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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. |
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Term
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Definition
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Term
| normal factors that vary BP |
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Definition
age
sex
race
diurnal rhythm (BP clims to a high in late afternoon and early evening and then declines
weight
exercise
emotions
stress |
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Term
| 5 factors that determine BP |
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Definition
1. cardiac output
2. peripheral vascular resistance
3. volume of circulation blood
4. viscosity
5. elasticity of vessel walls |
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Term
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Definition
period when Korotkoff's sounds disappear during auscultation.
occurs in about 5% of people, most often in HPT due to noncompliant arterial system |
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Term
| when to record three readins in BP |
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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 |
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Term
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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. |
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Term
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Definition
-increased pulse
-dizziness
-diaphoresis-excessive sweating
-confusion
-blurred vision
-skin feels cool and clammy |
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Term
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Definition
prehypertension: 120-139/80-89
stage 1: 140-159/90-99.
stage 2: <160/>100 |
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Term
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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 |
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Term
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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 |
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Term
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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 |
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Term
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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 |
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Term
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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 |
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Term
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Definition
from blood vessels, joints, tendons, muscles, and bone.
injury may result from pressure, trauma, or ischemia |
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Term
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Definition
from skin surface adn subcutaneous tissues.
injury is superficial, with a sharp and/or burning sensation |
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Term
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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. |
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Term
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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. |
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Term
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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. |
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Term
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Definition
| is the state of perspiring profusely, or something that has the power to cause increased perspiration. |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| complete ambsense of melanin pigment in patchy areas of white or light ksin |
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Term
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Definition
| macular only. not raised mole |
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Term
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Definition
| macular and papular--young adults |
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Term
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Definition
| general: central circulatory disturbance, such as in shock. Localized occurs in peripheral arterial insufficiency and Raynaud's disease. |
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Term
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Definition
| increased metabolic rate, suchas in fever or exercise. Hyperthyroidism has an increased metabolic rate, causing warm moist skin |
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Term
| unilateraly vs. bilateral edema |
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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 |
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Term
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Definition
| small, smooth, slightly raised bright red dots that commonly appear on the trunk in all adults over 30. |
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Term
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Definition
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Term
aging adult normal findings:
KERATOSES: seborrheic keratosis, actinic (senile) keratosis |
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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. |
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Term
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Definition
normal variation in aginig adult. "skin tags"
overgrowths of normal skin |
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Term
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Definition
| commonly called liver spots and are small, flat brown macules. |
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Term
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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 |
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Term
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Definition
solely a color change, flat and circumscribed of less than 1cm.
ex. freckes, flat nevi, hypopigmentation, petechiae, measles, scarlet fever. |
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Term
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Definition
macules that are larger than 1cm.
ex: mongolian spot, vitiligo, cafe au lait spot, chloasma, measles rash. |
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Term
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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. |
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Term
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Definition
papules coalesce to form surface elevation wider than 1cm. a plateaulike disk-shapes lesion
ex: psoriasis, lichen planus |
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Term
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Definition
solid, elevated, hard or soft, >1cm. may extend deeper into dermis than papule.
ex: xanthoma, fibroma, intradermal nevi. |
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Term
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Definition
larger than a few cms. firm or soft, deeper into the dermis; maybe benign or malignant.
ex: lipoma, hemangioma |
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Term
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Definition
| wheals coalesce to form extensive reaction, intensely pruritic |
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Term
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Definition
superficial, raise, transient, and erythematous; slightly irregular shape due to edema.
ex: mosquito bite, allergic reaction, dermographism |
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Term
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Definition
encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevating skin.
ex: sebaceous cyst, wen. |
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Term
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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 |
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Term
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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 |
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Term
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Definition
turbid fluid (pus) in the cavity. circumscribed and elevated.
ex: impetigo, acne. |
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Term
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Definition
|
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Term
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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. |
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Term
| vitamin deficiencies on hair/skin |
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Definition
| petechiae, purpura, hyperkeratosis |
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Term
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Definition
| Hyperkeratosis results when an excess of proteins called keratins are produced. In humans, the term typically refers to a thickening of the skin |
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Term
| liver disease, effects on skin/hair |
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Definition
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Term
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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 |
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Term
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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. |
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Term
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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. |
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Term
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Definition
measure of peripheral vision.
compares the person's peripheral vision with your own. |
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Term
| corneal light reflex (hirschberg test) |
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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. |
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Term
| diagnostics positions test |
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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. |
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Term
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Definition
| shifting of eyes when stressed. |
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Term
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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. |
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Term
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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. |
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Term
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Definition
| small number of people 5% normally have pupils of two different sizes. |
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Term
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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) |
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Term
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Definition
distant obj then to finger 3'' from face.
normal response:
1-pupillary constriction
2-convergence of the axes of the eyes |
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Term
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Definition
pupils:
equal
round
react to light and
accomodation |
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Term
| ocular structure change in elderly |
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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. |
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Term
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Definition
lens changes in elderly
harder to accommodate for near vision. |
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Term
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Definition
yellowing and thickening of lens
by age 70 |
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Term
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Definition
yellowing and thickening of lens
by age 70 |
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Term
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Definition
increased ocular pressure--gradual loss of peripheral vision.
incidence increases with age, affecting men and blacks |
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Term
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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. |
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Term
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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 |
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Term
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Definition
| ROM-- controlled movement, strength against resistance, head back and side-to-side, shoulder shrug |
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Term
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Definition
expression, affect, symmetry and movement.
smile. |
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Term
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Definition
facial response to sharp and dull touch.
movement and sensory. |
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Term
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Definition
acoustic nerve.
tests:
voice test
tuning fork test |
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Term
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Definition
| anything that obstructs transmission of sound. |
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Term
|
Definition
mechanical dysfunction that blocks
ex: impacted cerumen, otoscerosis |
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Term
| sensorineural hearing loss |
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Definition
| pathology of CN VIII, inner ear, or ototoxic drugs. |
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Term
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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. |
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Term
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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. |
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Term
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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. |
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Term
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Definition
|
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Term
|
Definition
for bone conduction. tuning fork in midline of skull and ask if equally heard.
hearing loss--not equal |
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Term
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Definition
comparing AC and BC
normal is AC>BC |
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Term
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Definition
|
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Term
|
Definition
in buccal mucosa:
opening of the parotid salivary gland. it looks like a small dimple opposite the upper second molar. |
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Term
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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. |
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Term
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Definition
| small, isolated white or yellow papules on teh mucosa of cheek, tongue, and lips. painless and not significant. |
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Term
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Definition
| nodular bony ridge down middle of hard palate, more commonly seen in native americans and asians. |
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Term
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Definition
vagus nerve. when person says "ahhh" and the soft palate and uvula rise in the midline.
gag reflex |
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Term
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Definition
hypoglossal nerve,
having person stick out the tongue.
should protrude in the midline. |
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Term
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Definition
-tongue may be smoother, buccal mucosa maybe shinier
-teeth may have yellowed, missing or replaced, gums may recede
-nose may appear more prominent |
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Term
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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 |
|
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Term
| leninger's transcultural model |
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Definition
focus on factors that influence care and health problems
focus is cultural diversity |
|
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Term
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Definition
| focus on individual's adaption to stimuli in the environment. |
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Term
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Definition
| 1. assessment. 2. diagnosis. 3. outcome identification. 4. planning. 5. implementation. 6. evaluation |
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