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Study Guide Exam 1

by: Kiara Scheuer

Study Guide Exam 1 Nurs 20263

Kiara Scheuer

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Includes everything you need to know for Exam 1
Health assessment:concepts
Study Guide
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This 4 page Study Guide was uploaded by Kiara Scheuer on Friday September 9, 2016. The Study Guide belongs to Nurs 20263 at Texas Christian University taught by Young in Fall 2016. Since its upload, it has received 3 views. For similar materials see Health assessment:concepts in NURSING at Texas Christian University.


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Date Created: 09/09/16
Study Guide Exam I February 15, 2016 1. Concept of health a. Assessment: collection of data about an individual’s health state b. A clear idea of health is important because it determines assessment data to be collected 2. Evidence-based nursing practice a. Current and best clinical practice based on research standards focused on systematic reviews of randomized clinical traits (RCTs) b. Utilizing evidence based practice (EBP) in conjunction with provider experience will lead to better health outcomes for patients c. Fostering a “culture of EBP” at both the undergraduate and graduate levels with assist health educators to make EBP the “gold standard” of practice 3. Subjective a. Subjective data is what a patient says about himself of herself during history taking 4. Objective a. Objective data is what is observed when inspecting, percussing, palpating, and auscultating patient during physical examination 5. Cultural care nursing a. Provision of health care across cultural boundaries in consideration of context 6. Culturally competent a. Understanding and attending to total context of patient’s situation, including the following: i. Immigration status ii. Stress and social factors iii. Cultural similarities and differences b. Congruent behaviors, attitudes, and policies that come together in a system among professionals that enables work in cross-cultural situations c. Culturally sensitive: possessing basic knowledge of, and constructive attitudes toward, diverse cultural populations d. Culturally appropriate: applying underlying background knowledge necessary to provide the best possible health care 7. Empathy a. Recognizes a feeling and puts it into words b. Names the feeling and allows expression of it i. Patient feels accepted and can deal with feeling openly 8. An open-ended question a. Ask for narrative responses b. State topic only in general terms c. Use them in the following situations: i. To begin interview ii. To introduce a new section of questions iii. Whenever the patient introduces a new topic 9. A reflective question a. Echoes patients words, repeating what person has just said, focuses further attention on a specific phrase and helps person continue in his or her way 10.A closed question a. Ask for specific information b. Elicit short one or two word answers, a yes or no answer, or a forced choice c. Use them in the following situations: i. After opening narrative to fill in details person may have left out ii. When you need many specific facts about past health problems or during review of systems iii. To move the interview along 11.Interview a. Subjective data collection, patient (or parent) tells info. Can’t verify information, first step in therapeutic relationship b. Goal of interview: identifying health strengths and problems as a bridge to physical examination 12.Personal space 13.Clarification a. Use when person’s words are ambiguous or confusing i. Used to summarize person’s words and to simplify them to make them clearer b. You are asking for agreement, and the person can then confirm or deny your understanding 14.Genogram a. Family tree b. Age and health, cause of death of relatives c. Family history of various conditions and diseases 15.Part of the hand is best for detecting vibration a. Does not magnify sound, but blocks out extraneous sounds b. Personal instrument 16.Palpation a. Second b. Applies sense of touch to assess: texture, temperature, moisture, organ location and size, swelling, vibration, pulsation, rigidity/spasticity, crepitation, presence of lumps or masses, presence of tenderness or pain c. Sequence: start with light palpation, then deeper when needed. Avoid deep if painful. 17.Percussion a. Third (except in abdomen- comes after percussion) b. Tapping a person’s skin with short, sharp strokes to assess underlying structures c. Uses: mapping location and size of organs, density of structures, detecting superficial abnormal masses (percussion vibrations penetrate about 5cm deep), eliciting pain if structure is inflamed, deep tendon reflex using percussion hammer d. Methods: i. Direct (immediate) the striking hand contacts the body wall ii. Indirect (mediate) using both hands, striking hand contacts stationary hand fixed on person’s skin 18.Auscultation a. Fourth (except in abdomen – comes before percussion) b. Listening to sounds produced by body c. Most body sounds are soft and must be channeled through stethoscope 19.Wong-Baker scale a. Scale to rate pain on, 0-10, even numbers and faces b. Test with back of hand (thin skin) 20.Skin turgor a. Sign used to assess fluid loss or dehydration b. Skin pulled up and should return to normal quickly. If it doesn’t, probably dehydrated c. Shows capillary refill (should be 1-3 seconds) 21.Lichenification a. An area of thickened epidermis induced by scratching b. Skin lines are accentuated so that the surface looks like a washboard 22.Plaque a. A circumscribed, elevated, superficial, solid lesion. MOER THAN .5 cm IN DIAMETER b. Often formed by the confluence of papules 23.Atrophy a. A depression in the skin resulting from thinning of the epidermis or dermis 24.Keloid a. A raised scar after an injury has healed 25.Linear lesion a. Straight line as in a scratch or streak 26.Clustered lesion a. Zosteriform configuration, linear lesions clustered along a nerve route 27.Annular lesion a. Circular lesions 28.Melanoma a. Skin cancer (malignant tumors) b. Moles that are asymmetrical, jagged borders, multicolored, large diameter, and evolving 29.Herpes zoster a. Shingles b. Reactivation of varicella-zoster virus (VZV) c. Severe irritation and lesions along a nerve 30.Thyroid gland a. An important endocrine gland, straddles trachea in middle of the neck b. Synthesizes and secretes thyroxine (T4) and triiodothyronine (T3), which are hormones that stimulate rate of cellular metabolism c. 2 lobes, connected in middle by thin isthmus and above that by the cricoid cartilage or upper tracheal ring (palpable notch: Adam’s apple in males) 31.Lymph nodes a. Greatest supply of nodes in head and neck, small oval clusters of lymphatic tissue that filter lymph and engulf pathogens b. Drain with gravity c. Normal nodes feel movable, discrete, soft, no tenderness d. Preauricular, in front of ear; Posterior auricular (mastoid), superficial to mastoid process; Occipital, at base of skull; Submental, midline, behind tip of mandible; Submandibular, halfway between angle and tip of mandible; Jugulodigastric, under angle of mandible; Superficial cervical, overlying sternomastoid muscle; Deep cervical, deep under sternomastoid muscle; Posterior cervical, in posterial triangle along edge of trapezius muscle; Supraclavicular, just above and behind clavicle, at sternomastoid muscle


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