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UAMS Health Assessment Exam I
History, Interview, General Survey, Vital Signs, Eyes, Ears, Head, Neck, Lymphatics, Skin, Hair, Nails, Lungs, Thorax, Nose, Mouth, Throat
113
Health Care
Undergraduate 3
05/31/2008

Additional Health Care Flashcards

 


 

Cards

Term
What kind of information is given during the interview process?
Definition
Subjective information
Term
What is one very important piece of information to talk about before interviewing a patient that could make the difference between what they tell you and what they don't tell you?
Definition
Confidentiality
Term
What kind of questions should be asked in order to receive the most helpful information?
Definition
Open-ended questions
Term
The nurse asks her patient if they are having any pain and the patient replies "no, I'm fine," yet he is clutching his arm. What kind of communication should the nurse rely on?
Definition
Non-verbal communication
Term
Interpretation
Definition

Based on inference or conclusion

 

"It seems that every time you feel stomach pain, you have a new stressor in your life." 

Term
Facilitation
Definition

Encourages the person to say more.

 

Ex: nodding, "yes, go on," "uh=huh" 

Term
Silence
Definition
'thinking silence' is hard for new nurses, but it is better to let the patient think about what he/she will say, and then allow him/her to talk.
Term
Reflection
Definition

Echoing your patient's words.

 

Ex: P:"My foot hurts" N:"Your foot hurts?" 

Term
Empathy
Definition

Recognizes a feeling and puts it into words.

 

Ex:

P:"Oh great, I own a business, have 20 employees, and now... I can't even make it to the bathroom by myself!"

 N:"It must be hard, having so much responsibility, yet feeling so dependent."

Term
Clarification
Definition

When a persons words are ambiguous.

 

Ex: P:"My blood is tired." N:"Tell me what you mean by 'tired blood'."

 

Summarize your patients words and simplify.

Term
Confrontation
Definition

Your response or feelings toward an observation.

 

Ex: N:"You say it doesn't hurt, but when I touch you here...you grimace." 

 

 

Term
Explanation
Definition

The nurse shares factual or objective information.

 

Ex" N:"You cannot eat anything after midnight due to your scheduled surgery." 

Term
Summary
Definition
Final review of what you think the patient said.
Term
While interviewing your patient, he tells you that he is having pain in his left leg. You respond by asking, "You have pain in your left leg?" This is an example of...
Definition
Reflection
Term
Sally is a 36 year old patient who comes in regularly, complaining of chest pain. You tell her that it seems that each time she comes in for this reason, it is because she has recently been dealing with anxiety about her son Ted who has drug problems. This response is also know as...
Definition
Interpretation.
Term
Harry is a 19 year old male college student who has recently been diagnosed with bone cancer. During your interview, he breaks down and starts sobbing about how he is afraid that he is going to die before he finishes college, and how his grade point will drop if he does not attend class. You respond by saying, "I imagine you must feel very worried about this, especially since you seem to take your studies seriously." Your response is...
Definition
Empathy.
Term
While Tina is explaining to you about her family history of breast cancer, you nod your head and say "continue." This is an example of...
Definition
Facilitation.
Term
Guy is a healthy 90 year old man, just coming in for a regular checkup. After asking him about his family health history, he pauses for a few moments to think. Your response should most likely be...
Definition
Silence.
Term

What are the ten traps of interviewing?

Definition

1. Providing false reassurance

2. Giving unwanted advice

3. Using authority

4. Using avoidance language

5. Engaging in distancing

6. Using professional jargon

7. Using leading or biased questions

8. Talking too much

9. Interrupting

10. Using "why" questions

Term
"You'll be okay! Everything will get better!" is an example of...
Definition
False assurance or reassurance
Term
"Your nurse knows best!" is an example of...
Definition
Using authority
Term
Telling your patient that they had a "myocardial infarction" rather than telling them that they had a "heart attack" is an example of...
Definition
Professional jargon
Term
"If it was me, I would..." is an example of...
Definition
Giving unwanted advice
Term
"You don't have STDs, do you?" is an example of...
Definition
Using leading or biased questions
Term
Telling a parent that their child "went to see the angels" instead of "died" is an example of...
Definition
Using avoidance language
Term
When interviewing a patient, which type of communication (nonverbal or verbal) is usually the true message?
Definition

Nonverbal

Term
Some types of nonverbal communication are...
Definition

- Appearance (grooming, clothing style)

- Posture (crossing arms, slumping, clutching arm)
- Gestures (nodding, yawning, looking at watch)

- Facial Expression (alert, relaxed, angry, pain)

- Eye Contact (shy, bored, cultural)

- Voice (tone, rate, pitch)

- Touch (influenced by culture, age, sex, past experience)

Term

You are interviewing Marcy, a 25 year old caucasian female. When you first walk into her room (having never met her before), would it be best to touch her arm, touch her face, touch her leg, or refrain from touching her?

Definition
Refrain from touching (until you know the person well enough to know how touch will be interpreted).
Term
Social distance is approx. how many feet?
Definition
4-12ft
Term

Which of the following questions would be best to ask when assessing a patient?

 

A. "Do you have a good relationship with your husband?"

B. "Do you and your significant other have a good relationship?"

Definition

B. "Do you and your significant other have a good relationship?"

Term
In general, would a person of Appalachian desent be more likely to expect a close, personal relationship with the nurse, or a friendly, but detached relationship with the nurse?
Definition
A close, personal relationship
Term

Mrs. Slavayotvka only speaks Russian, but her son, Sasha, has come to the hospital with her and speaks both Russian and English. When interviewing her, would it be appropriate to ask her son to interpret what his mother is saying?

Definition
No. It is a confidentiality breach to use a family member, friend, or child to interpret for a patient.
Term
When interviewing someone you are unable to communicate verbally with (because of language or hearing problems), other than using an interpreter, what is another way to communicate with the patient?
Definition
Pantomime
Term
What are some ways of nonverbal cross-cultural communication?
Definition

- Vocal cues (moaning, silence)

- Action cues (posture, expression)

- Object cues (clothes, jewelry)

- Eye contact (downcast, eye=rolling, indirect)

- Use of personal & territorial space

Term

Sam & Elizabeth bring their newborn child into the pediatric clinic for a regular checkup. The baby is sooooo cute and you just want to touch it! It would be better to:

 

A. pat it on the head

B. touch its hand

Definition

B. touch its hand

 

(patting a child on the head is a sign of disrespect or curse in some cultures)

Term

Does health history consist of objective or subjective information?

Definition
Subjective - what the patient says!
Term
If a patient tells you that his "right arm has tingling pain and numbness" at the beginning of the interview, and then says the same thing later in the interview, this infers that the patient is...
Definition

Reliable

 

Reliability - based on if the patient gives same answers later in conversation

Term
Categories of health history include...
Definition

- Biographical data

- Reason for seeking care

- History of present illness

- Past history

- Family history

- Review of systems

- Functional assessment

Term
Biographical data includes...
Definition

- Name

- Phone #

- Address

- Age & birthdate

- Birthplace

- Sex

- Marital status

- Race

- Ethnic origin

- Occupation (now & in past)

Term
Reasons for seeking care include...
Definition

- brief description of reason for visit

- one or two signs or symptoms and their duration

 

- all info is subjective and should be in "quotes"

ex: "chest pain" for over 2 hours

or

"need a physical for work"

Term
History of present illness includes...
Definition

the chronological history of the reason the patient is seeking care

 

(OLDCART or PQRSTU)

Term
Past health includes...
Definition

- Childhood illness

- Accidents or injuries

- Serious or chronic illness

- Hospitalizations

- Operations

- Obstetric History

- Immunizations

- Last exam date for dental, vision, hearing, EKG, chest x-ray

- Allergies

- Current meds

Term
Family history includes...
Definition

Asking questions about:

- Age & health/death of parents, grandparents, siblings & close family members

Term
Review of systems includes...
Definition

- The history of each system from head to toe

 

(everything should be recorded as "present," "absent," or "denies")

Term
Functional assessment includes...
Definition

Measuring a client's self care ability related to:

 

- ADLs

- Activities needed for independent living

- Personal habits (tobacco, alcohol, drugs) 

Term
ADLs (Activities of Daily Living) are...
Definition
bathing, dressing, toileting, eating, walking
Term
When collecting objective data, one must....
Definition

1. Inspect

2. Ausculate

3. Percuss

4. Palpate

 

(IN THIS ORDER!) 

Term
Inspection:
Definition

- is concentrated watching

- always comes first

- begins w/ general survey

- yields surprising amount of data

- compares L & R

- direct & tangential lighting

- draping

- use of instruments 

Term
Ausculation:
Definition

- does not magnify/block extraneous sound (snug fit & quality)

- uses diaphragm (high pitched sounds)

- uses bell (low pitched sounds)

 

Term
Before/during auscalation it is important to do the following:
Definition

- reduce extraneous noise

- keep room & equipment warm

- avoid friction by wetting hair

- never listen through clothing/gown

- avoid touching/rubbing tubing
Term
Palpation:
Definition

Applies touch (texture, temperature, moisture, organ location & size, swelling, etc.)

Term
One can palpate by...
Definition

- using fingertips (tactile discrimination, texture, swelling, pulsation, masses)

- grasping (positon, shape, consistency, attachment to other structures)

- using dorsa or hands & fingers (temperature)

- using ball of hand/base of fingers (vibrations) 

Term
What is the difference between light palpation and deep palpation?
Definition
Light palpation detects surface characteristics & is no deeper than 1".
Term
Percussion:
Definition
Uses tapping/short, sharp strokes.
Term
What are the two types of percussion?
Definition
Direct and indirect.
Term

In the general survey it is important to:

 

A. Look before you touch

B. Touch before you look

C. Palpate before you look

D. Palpate before you ausculate 

Definition
A. Look before you touch
Term
The general survey is...
Definition
A gestalt of the whole person using objective parameters.
Term
The general survey includes:
Definition

- Physical appearance

- Body structure & nutritional status

- Mobility

- Behavior 

Term
Is the general survey subjective or objective?
Definition
Objective
Term
In the general survey, physical appearance includes:
Definition

- Age

- Gender

- Level of consciousness

- Skin color

- Facial features

- No signs of acute distress

Term
In the general survey, body structure includes:
Definition

- Stature

- Nutrition

- Symmetry

- Posture

- Position

- Body build & contour 

Term
In the general survey, behavior includes:
Definition

- Facial expression

- Mood and affect

- Speech

- Dress

- Personal hygiene 

Term

In the general survey, mobility includes: 

Definition

- gait (how they move around)

- range of motion 

Term
Mary weighs Ms. Moore on Tuesday. Ms. Moore weighs 179lbs. Mary weighs Ms. Moore on Wednesday and Ms. Moore weighs 193lbs. What are the two most likely reasons for an increased 14lbs of weight in one day?
Definition

Ms. Moore was not wearing the same outfit on Wednesday as she was wearing on Tuesday and/or the same scale was not used to weigh Ms. Moore both days.

 

Make sure your patients wear the same outfit & use the same scale every time you weigh them! 

Term
Vital signs include:
Definition

- Temperature

- Pulse

- Respiration

- Blood Pressure

 

(usually in this order!) 

Term
When taking vital signs on an infant, the usual proper order is:
Definition

1. Respiration

2. Pulse

3. Temperature

 

Why? If the infant starts to cry it may increase respirations and pulse (least to most invasive)! 

Term
Systolic pressure is...
Definition
maximum on contraction left ventricle; the first sound you should hear when taking BP
Term
Diastolic pressure is...
Definition
resting; last sound you should hear when taking BP
Term
What are some factors that might influence temperature?
Definition

- Diurnal cycle (daily)

- Menstrual cycle (ovulation)

- Exercise

- Age 

Term
Normal resting temperature in °F and C is...
Definition
98.6°F = 37 C
Term
The normal ranges of body temperature in °F and °C are...
Definition

96.4-99.1 °F and 35.8-37.3 °C

 

Low: 96.4 °F (35.8 °C)

High: 99.1 °F (37.3 °C)

Term
To convert Celsius to Farenheit:
Definition

(°C x 9/5) + 32 = °F

 

Celsius times nine-over-five, plus thirty-two equals farenheit.

 

To get the correct answer on the  computer calculator:

1. Divide 9 by 5 (should be 1.8)

2. Multiply 1.8 by °C

3. Add 32

 

TRY THIS OUT ON COMPUTER CALCULATOR BEFORE TEST! 

Term
To convert Farenheit to Celsius:
Definition

(°F - 32) x 5/9 = °C

 

Farenheit minus thirty-two, times five-over-nine equals Celsius.

 

To get the correct answer on the  computer calculator:

1. Subtract 32 from °F

2. Multiply answer by 5/9

 

TRY THIS OUT ON COMPUTER CALCULATOR BEFORE TEST!

Term
You need to orally take your patient's temperature and only glass/mercury thermometers are available. Should you select the thermometer with the short, rounded, red tip or the long bulbed, black tip?
Definition

The long bulbed, black tip is the oral thermometer.

 

(the other is a rectal thermometer) 

Term
You are taking Mr. Robinson's pulse. When he breathes in, his pulse speeds up. When he breathes out, his pulse in normal. Mr. Robinson has...
Definition
sinus arrhythmia
Term
Normally, when taking pulse, one should:
Definition
count pulse for 30 seconds & multiply pulse x 2
Term
If pulse is irregular, one should:
Definition
count pulse for a full minute
Term
Ms. Jones has a pulse of 59. Ms. Jones has:
Definition

Bradycardia 

Term
Mr. Dude has a pulse of 101. Mr. Dude has:
Definition
Tachycardia
Term
A normal pulse rating is:
Definition
+2
Term
Normal respirations for newborns (born vaginally) is:
Definition
30-40 bpm
Term
Normal respiration for adults is:
Definition
10-20 bpm
Term
Normal respiration for C-section born newborns is:
Definition
Up to 80 bpm
Term
Does pulse pressure increase or decrease with age?
Definition
Pulse pressure increases with age.
Term
Normal BP is:
Definition
120/80
Term
Normal BP range is:
Definition
90/60-139/89
Term
Mrs. Redintheface has a BP of 140/90. She suffers from:
Definition
Hypertension
Term
Ms. Overelaxed has a BP of 89/59. She suffers from:
Definition
Hypotension
Term
A patient suffering from orthostatic (or postural) hypotension has an increased risk for:
Definition
falling
Term
What is the "5th vital sign?"
Definition
PAIN!
Term
Mr. White has had pain in left foot for 6 1/2 months. The type of pain he has is:
Definition
chronic
Term
It is important to remember that pain is subjective. Pain is...
Definition
whatever the person says it is!
Term
A numeric rating scale for pain can be introduced to a patient as young as...
Definition
3 or 4 years old
Term
What ratings on a scale from 1-5 are enough to require medication?
Definition
4 or 5
Term
When assessing whether or not an infant is in pain, one must rely on what type of communication?
Definition
Nonverbal
Term
What type of information is "pain?"
Definition
Subjective
Term
What is the key ingredient to health?
Definition
Nutrition
Term
In order for the body to have optimal functioning of cells and systems, defense against disease and environmental toxins, and excretion of environmental toxins, what is essential?
Definition
Proper nutrition
Term
During at least the first year of life, what type of food is best for an infant?
Definition
Breast milk
Term
During late childhood, growth is (fast/slow)?
Definition
Slow
Term
During adolescence growth is (fast/slow)?
Definition
Fast
Term
The critical period for brain growth is:
Definition

the first eight years

 

(50% by age 2, 100% by age 8) 

Term
Extra nutrients are needed when?
Definition
During pregnancy
Term
When does growth stabilize?
Definition
During adulthood
Term
What age is prone to under nutrition?
Definition
Aging adult
Term
Ms. Chu is from China. Today lunch options are either rice or spaghetti. Since Ms. Chu is Chinese, which would she rather have?
Definition
You won't know until you ask. Don't assume that she'd rather have rice just because she is Chinese. Ask her which she'd rather have.
Term
Eating pattern, food allergies or intolerances, medications and nutritional supplements, self-care behaviors, alcohol or illegal drug use, exercise and activity patterns, and family history are all what type of nutritional data?
Definition
Subjective
Term
BMI is measured as:
Definition
weight (in kg) / height (in meters)
Term
What is a normal range for BMI?
Definition
18.5-25
Term

You have just finished listening to Mr. Brown's lungs. The next thing you should do is:

 

A. Observe his breathing

B. Percuss his lung area

C. Palpate his back

D. Look for lesions 

Definition

B. Percuss his lung area

 

(remember the order of assessment: inspect, ausculate, percuss, palpate. Since you just ausculated, you would percuss next.) 

Term
The physical examination is what type of information?
Definition
Objective
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