- Shuffle
Toggle OnToggle Off
- Alphabetize
Toggle OnToggle Off
- Front First
Toggle OnToggle Off
- Both Sides
Toggle OnToggle Off
Front
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
PLAY BUTTON
PLAY BUTTON
45 Cards in this Set
- Front
- Back
|
Name the four types of assessment
|
Initial comprehensive
ongoing/partial focused/problem-oriented emergency |
|
What is the most common type of assessment performed?
|
ongoing/partial
|
|
Which type of assessment does of Review of Systems?
|
Initial comprehensive
|
|
Name the four steps in the assessment phase
|
collect subjective data
collece objective data validate data document data |
|
What are the four cardinal techniques for physical examination?
|
inspection
percussion palpation auscultation |
|
Define: Interviewing
|
communication process that focuses on clients response
|
|
State the three phases of the interview
|
introducctory
working summary and closure |
|
What do open-emded questions usually begin with?
|
how or what
|
|
what do closed-ended questions usually begin with
|
when or did
|
|
What is the process of validating data for?
|
-verifying that the subjective and objective data is accurate
-preventing errors based on faulty information |
|
When should data be validated
|
-discrepancies between sub and ob data
-discrepancies in history from one time to another -inconcistent findings |
|
How do you validate data?
|
-check own data and repeat assessment
-clarify data with client with more questions -verify data with another professional -comapre ob with sub findings |
|
State the three types of documentation
|
initial
frequent or ongoing focused |
|
Name the types of initial docyumentation
|
-open ended
-cued checklist -integrated cued checklist -minimum nursing data set |
|
State frequent or ongoing assessment form benefits
|
flow charts - vs
progress notes for unusual even ts quick and allow for comparison streamlines documentation |
|
What are key points to cover in hair, skin and nail assessment?
|
-skin color, temp, moisture, texture
-skin integrity -skin lesions -hair loss/unusual growth -nail bed color and capillary refill |
|
What do dark skinned people have on the sclera/nailbeds
|
freckle-like or dark streaks of pigmentation
|
|
What are mongolian spots?
|
bluish, bruise-like marks on back, buttocks, arms, thighs, abdomen
|
|
What race do mongolian spots appear most in?
|
blacks, asians, native americans.
|
|
What is used to palpate texture of the skin
|
palmar surface of three middle fingers
|
|
What is used to palpate thickness of skin?
|
thumb and one finger
|
|
What is used to palpate moisture of the skin?
|
dorsal surface of the hands
|
|
What is used to palpate temper ature of the skin?
|
dorsal/palmar surface of the hands
|
|
Which part of the body is used to check for turgor?
|
skin on sterrnum or under clavicle
|
|
How fast should skin return when checking for turgor?
|
3 seconds
|
|
What does vellus hair cover?
|
entire body except for soles, plams, lips, nipples
|
|
What finding signifies malnutrition in AA children?
|
copper-red hair
|
|
What are Beau's Lines?
|
horizontal ridges on the nails.
|
|
What are Beau's Lines a sign of?
|
acute illness
|
|
What causes nail clubbing?
|
oxygen deficiency
|
|
What stage ulcer shows superficial skin locc involving epidermis alone or also the dermis?
|
state II
|
|
Describe State 3 ulcer
|
-pressure area involved epidermis, dermis and into SQ tissue
-resembles crater -may have tunneling -extends thru all layers of skin and beyond SQ |
|
Describe State 4 lesion
|
-involves epidermis, dermis, SQ, bone and other support tissue
-large crater with hidden areas of damage in adjacent tissue |
|
Describe a macule
|
-<1 cm
-circumscribed border -flat, nonpalpable -brown, red, white, tan, purple EX. - flat moles, freckles |
|
What is the same as a macule except is > 1 cm?
|
patch
|
|
Describe a papule
|
-< 0.5 cm
- elevated, palpable, solid mass -circumscribed border -EX. moles, warts |
|
What is similar to a papule but greater than 0.5 cm
|
plaque
|
|
Describe a nodule
|
0.5 - 2 cm
-elevated, palpable, solid mass -extends deeper into dermis than papule -circumscribed -EX. lipoma, poorly absorbed injection |
|
What is the same as a nodule but >1-2 cm
|
Tumor
|
|
Describe a vesicle
|
-<0.5 cm
-circumscribed, elevated palpable -serous fluid -EX. chicken pox,, poison ivy |
|
What is similar to a vesicle but >0.5 cm
|
Bulla
-EX large blister |
|
Describe a Wheal
|
elevated with transient borders
often irregular size, color varies serous fluid movement into dermis |
|
Describe a Pustule
|
pus filled vesicle or bulla
superficial Ex acne |
|
Describe a cyst
|
encapsulated fluid filled or semisolid mass
located in SQ tissue or dermis circumscribed EX sebaceous cyst |
|
Describe Lichenification
|
-thickening and roughening of skin
accuentated skin markings may be secondary to repeated rubbing, irritation, scratching EX contact dermatitis |
