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182 Cards in this Set

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What order do you use to assess the abdomen?
Use different order : inspect, auscultate, palpate
What do you inspect for?
- Contour-flat or slightly rounded
-The abdomen should be flat to round in people of average weight and may be slightly concave in a slender person. It may protrude with obesity, pregnancy, ascites (large accumulation of fluid in the peritoneal cavity), or abdominal distention
-Striae or stretchmarks can be caused by pregnancy, excessive weight gain or ascistes. New striae are pink or blue, old striae are silvery white, in pts. w/ darker skin may be dark brown
-Masses and Nodules
-Respiratory movement
What are the 7 F’s of
Abdominal Distention?
Fat, Fluids, Flatus, Feces, Fetus, Fatal Growth , Fibroid tumor
Where do you auscultate bowel sounds?
In all 4 quadrants (hypoactive, active, hyperactive)
How do you ausculate for BS?
Use the diaphragm of the stethoscope and press lightly. Listen in a systemic progression, such as from RUQ, LUQ, LLQ, RLQ
What is a normal finding?
BS should be noted every 5 to 15 sec. The duration of a single bowel sound may range from 1 to several seconds. Sounds are high-pitched gurgles or clicks
Abnormal BS
Increased BS: Borborygmus or borborygmi, high pitched, tinkles.
-Increased peristalsis (diarrhea, laxative, gastroenteritis, GI bleed, early intestinal obstruction)
-Absent or decreased BS: mechanical obstruction or paralytic ileus, Peritonitis & bowel obstruction
Palpation of abdomen
-Light palpation only: aprox. Depressed 1 cm
-Ask if tenderness is present: palpate involved area last.
-WNL: smooth and consistently soft
Light palpation:
-Light palpation (3/8 to ¾ in. [1-2 cm]
-Tender, muscle tone, surface characteristics
-*Pads of fingertips: all 4 quadrants
-Some muscle resistance expected
-Note tenderness or involuntary resistance that cannot be relaxed on command.
-Superficial masses or local rigidity
rebound tenderness
Where is the liver and gallbladder located?
Right upper quadrant:
Where is the Appendix located?
Right lower quadrant
Assessing abdominal pain:
-Time, location, activity, when pain occurs
-Pain changed locations since started?
-Gallbladder colycystitis
-Certain position relieve the pain?
-Pancreatitis (knee chest)
-Colicky (kidney stone) restless movement
-Appendicitis (lying still)
Elimination Pattern
Change in BMs
-frequency or consistency
-diet or activity
-Rx (meds)
*Warning sign of cancer
Change in Bowel Function
Change in bowel function?
-Increased gas, pain, fever
-N/V/D (nausea, vomiting, diarrhea), abdominal cramps
-Foods that cause gas
-Fever (inflammation or infection)
-Abdominal cramping
-Change in color of stool
-Pain, burning, freq. urination?
Bladder infection (women-risk of cystitis)
-*Fever, chills, back pain-(pyelonephritis)
-Color or urine (blood)
-darker amber
-blood (menstrual period or kidney disease)
-Weight gain, edema, SOB, decreased UO= (AFR) acute renal failure
Normal urinary patterns
-Intake & Loss-1500-3500 ml
-Average 2500 ml per day
-30 cc’s per hr minimum output
-Voiding pattern?
-Bladder palpation/Scan
Older Adults:
-motility of esophagus (dilation lower end)
-altered swallowing/risk of choking
-Gastric acid (sufficient enzymes for digestion)
-*Motor activity (delayed emptying of stomach) moves through large intestine slower: constipation
-Liver decreases in size p/ age 50:altered metabolism of drugs
Older Adult Health History
Abdominal pains?
-degenerative vascular disease-gastric pain
-Fluids & fiber in diet; laxatives?
Incontinence? Sudden-when laugh or sneeze?
Stress incontinence
Urinary incontinence-15-30%
Assess gait
-observe how the patient stands and moves.
-arms should swing naturally at his sides.
-posture should be erect
-each foot, in midswing should clear the floor and pass the other foot.
Assess for range of motion:
Ball and socket: Flexion-move leg forward and up
Flexion, extension, and hyperextension of hand
Lateral flexion:
Tilt head as far as possible toward each shoulder
Raise arms from side position forward to position above head.
Raise arm to side to position above head with palm away from head.
-lower arm sideways and across body as far as possible.
Suppination: turn lower arm and hand so that palm is up.
Pronation: turn lower arm so that palm down
Plantar flexion:
-Move foot so that toes are pointed upward
-move foot so that toes are pointed downward
Assess for muscle strength:
-Assess strength of arms and legs against resistance (use 0-5 scale, where 0 is no movement.
Function Level
0-No evidence of contractility
1-evidence of slight contractility (T)
2-Poor (P)
3-Fair (F)
4-Good (G)
5-Normal (N)
Testing muscle strength
Plantar flexion: Have patient push his foot down against your resistance.
Dorsiflexion: Have the patient pull his foot up as you try and hold it down.
Handgrip strength-face the patient, extend fingers and squeeze
[Response should be bilaterally equal and the grip tight and full flexion]
Risk factors for Musculoskeletal Disorders:
As you conduct a health history related to the musculoskeletal system, it is important to consider common risk factors associated with this system and follow up with additional questions should risk factors exist.
Osteoarthritis (OA)
-gender: occurs in women over age 45 yrs more than in men but it occur in men under 45 years more than in women
-weight: being over weight puts stress on joints (M)
-repeated cartilage damage: overuse of joints increases risk (M)
-Joint injury: injury to the knee or hip increases risk (M)
-physical inactivity: lack of exercise weakens muscles that support joints (M)
-age: bone density decreases at age 35
-gender: woman have less bone tissue and lose it more readily than men
-race: whites and Asians have increased risk
-family history: a family history of osteoporosis increases risk
-Lifestyle: cigarette smoking, excessive alcohol intake, consuming inadequate calcium and performing weight-bearing exercises increase risk (M)
-Medications: such as glucocorticioids, methotrexate, thyroid hormone, antacids, and heparin (M)
-estrogen: deficiency from menopause, surgical removal of ovaries (M)
Age related factors:
Infants-Barlow-Ortolani: Maneuver to detect hip dislocation, adduction/abduction
Older Adults-decreased tone, elasticity, mass & strength
Ethnic & Cultural Variations:
Navajo Indian and Canadian Eskimos are among the cultures with the highest incidence of hip dislocation. In these cultures newborns are tightly wrapped in blankets or strapped to cradle boards. Hip dislocations virtually unknown in cultures where infants are carried on their mothers backs or hips in the widely abducted straddle position such as in the Far East and Africa.
-Structure and function
-Subjective data-Health Hx Questions
-Objective data-the physical data
-abnormal findings
Health Hx Questions
-Headache -Incoordnation
-Head injury -numbness or tingling
-Dizziness/vertigo -difficulty speaking
-seizures -signifigant past hx
-tremors -evironmental/occupational hazards
Health History:
-Preform ADLS?
-Chronic diseases-HTN, Myasthenia Gravis; MS
-Rx or OTC (reason, SE)
-ETOH (amt)
-marijuana, cocaine, barbituates, tranquilizers, mood altering drugs
What should be included in Past Medical Hx?
-Injury/trauma (head or spinal cord)-residual deficits (weakness)
-Stroke (aphasia/hemiparesis)
OR (brain, sp. cord, nerves)
-Seizures (Rx-safety)
-Family Hx (CVA, seizures, tumor
What are risk factors for CVA (Brain Attack)?
-age (>55); (Men>women)
-Heredity (family Hx & race)
-*African Americans (HTN)
-HTN most important risk factory**
-Cigarette smoking-constricts arteries & increases BP
Objective Data
The Physical Exam:
-Equipment needed: penlight, tongue blade, cotton swab/ball, occasionally need: familiar aromatic substances
How do you perform neurological exam?
-Cephalocaudal organization (head to toe)
-compare side to side
-complete neuro exam only when problems are found in history
-mental status
-Glasgow Coma Scale=3-15 (LOC scale)
-Cranial Nerves Intact; CN II, VII, X
-Reflexes/Motor Function/Coordination
-Grips and pushes
Levels of Consciousness (LOC
-Alert & Oriented X 3
-Lethargic: drowsy but can be aroused *earliest sign of deteriorating neuro status
-Stuporous: can be aroused but by vigorous stimulation
-Semi-comatose: unresponsive except to mild painful stimuli
-Comatose: unresponsive to all but painful stimuli
Cranial Nerve II:
Visual acuity and fields
Cranial Nerve VII
Facial: Motor/sensory of face-smile, frown, puff cheeks
Cranial Nerve VIII
Acoustic: Weber and Rinne tests
Cranial Nerve X
Vagus: Tested with IX-overlap in function
Glasgow Coma Scale (3-15)
-able to follow simple commands
-oriented to time, place, and person
-Best verbal response
-Best motor response
-Best Eye Opening
-Perfect score=15
-Coma=7 or less
Eye opening response:
4 :Spontaneously-opens eyes spontaneously
3 :To speech-opens eyes when told to
2:To pain-opens eyes only on painful stimulus
1:None-doesn’t open eyes in response to stimulus
Motor response:
6: Obeys-shows two fingers when asked
5: Localizes-reaches toward painful stimulus and tries to remove it.
4: Withdraws-moves away from painful stimulus
3: Abnormal flexion-Assumes a decorticate posture
2: Abnormal extension-assumes a decerebrate posture
1: None-No response; just lies flaccid, which is an ominous sign
Verbal Response:
5: Oriented-reports current date
4: Confused-Report incorrect year
3: Inappropriate words-replies randomly with incorrect word
2: Incomprehensible-moans or screams
1: None-no response
Assessment of pupils:
PERRLA-Pupils equal, round, reactive to light and accommodation.
Test for direct and consensual response:
Dim the lights, ask client to hold the eyes open and fix his or her gaze on an object across the room. Approach with a penlight beam from the side and shine it directly on the pupil. The illuminated pupil should constrict (direct response) CN-III; the other pupil should constrict simultaneously (consensual response). The optic nerve CN II senses the light, and the oculomotor nerve (CN III) creates the constriction of the iris, which makes the pupil appear smaller. Repeat with other eye.
To test accommodation:
Ask the client to fix his/her gaze on a distant object across the room. The pupils should dilate when visualizing a distant object. Then ask the client to shift his or her gaze to your finger, placed about 6 inches from the clients nose. Normally both eyes should constrict and converge (move inward toward the nose).
Grips & Pushes:
-Instruct the patient to squeeze your hands
-Cross your arms so that your right hand grips their right hand
-Instruct the patient to push against your hands with their feet
-Clients instructed to:
-use own finger to nose, eyes opened then closed
-their nose to your finger
-thumb to fingers, both hands
-heel down shin
-toe tapping
-Assess gait
Sensory Assessment:
-Subjective Assessment:
-Subjective data
-Assess peripherally, distal to proximal, applied to extremities at varied rates
-Light touch: soft stimulus
-Superficial Pain-sharp vs. dull
-Temperature-warm vs. cold vials
Significant Abnormal
Neuro Assessment
-alterations in consciousness
-alterations in pupil consciousness
-alterations in eye movement-Doll eyes
-Alterations in breathing pattern
-Alterations in speech
-Seizures-general, partial (begin locally)
Older Adults:
-Effects of decline gradual-normal
-If abrupt=disease
-Starts at age 30
-conduction velocity of nerve impulses diminishes 10 %
-smell declines
-corneal reflex & taste diminished
-gag reflex-reduced
Achilles tendon 7 abd. Reflexes decrease
-speed & agility reduced (ROM) & neck)
-balance altered (degeration cochlea
Exam of Older Adults:
-ADLs (note personal hygiene, appearance, dress)
-Slowed response
-moves slowly
-decline in function (sense of taste)
Health Promotion:
-Motor vehicle accidents (MVA)
-seat belts
-designated driver (ETOH)
-Traumatic brain injuries (TBI)
-20-30% severe enough –lifelong disability
-young males highest risk
-infants & older adults 2nd highest risk
Sports injuries-14% sp. cord injuries
66%=driving injuries
feet first, first time
Unintentional injuries c/ firearms-guns locked
External Female Genitalia and Rectum
Inspection of male genitalia
-pubic hair, penis, scrotum, testes
-skin should be slightly wrinkled, skin should be pink to light brown in white patients and light brown to dark brown in black patients.
-Check the penile shaft for lesions, swelling, and smegma
-inspect the pubic hair for distribution and general characteristics.
Risk Factors for Testicular Cancer:
-family history
-history of undescended testicle or late descending testicle
-history of mumps and later shrinking of the testicles
-injury to the scrotum
-ethnicity: more common in white than black
Patient teaching: Testicular self-exam
-Have the patient hold his penis out of the way with one hand. Instruct him to roll each testicle between the thumb and first two fingers of his other hand.
-A normal testicle should have no lumps, move freely I the scrotal sac, and feel firm, smooth , and rubbery.
-Both testicles should be the same size, although the left one is usually lower that the right because of the left spermatic cord is longer.
Interview Guide: Female
-Ask about her menstrual cycle
-How old does menstruation cycle
-Age when menstruation began
-Pubic hair & skin
-Labia Major & Minora
-Pigmentation & surface characteristics
Health Promotion:
-Vaginal Examination
-Pap Smear
-Vulvular Self-examination
-Kegal Exercises
Pain Assessment:
JHACO pain standards
(1) Initial assessment and regular reassessment of pain, taking into account personal, cultural, spiritual, and ethnic beliefs
(2) Education of all relevant providers in pain assessment and management
(3) Education of patients and families regarding their roles in managing pain, as well as the potential limitations and side effects of pain treatments
Pain Threshold:
The point at which a stimulus is perceived as pain
Pain tolerance:
-The duration or intensity of pain a person will endure before outwardly responding
-A person’s culture, pain experience, expectations, role behaviors, and physical and emotional health influence pain tolerance.
-decreases with repeated exposure to pain, fatigue, anger, boredom, apprehension, and sleep deprivation.
-increases after alcohol consumption, medications, hypnosis, warmth, distracting activities, and strong faith beliefs.
Acute vs. Chronic pain
Acute pain: Has a recent onset defined as less than 6 months and results from tissue damage, is usually self-limiting, and ends when the tissue heals.
Chronic pain: may be intermittent or continuous pain lasting more than 6 months.
-client reports symptoms of irritability, depression, withdraw, and insomnia.
Types of stimulus
Mechanical: Alteration in body fluids, duct distention.
Chemical: Perforated visceral organ
Thermal: Burn (heat or extreme cold)
Electrical: Burn
Subjective pain assessment: ABCD’s
A- Is affective response, which is the client’s emotional response, such as anger, fear, anxiety, or depression.
B- Is the behavioral response, that is synonymous with alleviating factors and refers to show how clients act when they feel pain, such as slow deep breathing, or distraction techniques.
C- Is the cognitive response, which refers to the meaning of the pain for them, their belief about the purpose of the pain, and their attitude of the pain.
D- Is the description that clients provide of their pain, which includes the usual symptom analysis: location, quality, quantity, chronology, setting, associated manifestations, alleviating factors, and aggravating factors.
-Where is your pain?
-Can you point to the locations
-Can you describe what the pain feels like?
Somatic pain: is usually aching or throbbing in quality
Visceral pain: is aching and well localized if from tumor or intermittent, cramping, and poorly localized if from obstruction.
Pain Quality Descriptors Commonly Used:
-throbbing -tender
-nagging -shooting
-stabbing -intense
-sharp -unbearable
-gnawing -intense
-burning -heavy
-aching -tight
-Observe client for posture and hand movement
-Observe facial expressions
-Listen for sounds the client makes
-Inspect skin for color, temperature, and moisture
Age related variations:
Neonates & Infants
-Pain is evidenced by increased heart rate, hypertension, decreased O2 saturation, pallor, and sweating
Toddlers and preschoolers:
-have difficulty understanding pain and the procedures that cause pain
-they have developed a basic ability to describe pain and its intensity and location
-often respond by crying or with anger.
-children may perceive the pain as a threat to their security or as a punishment
School Age children
-at this age are better able to describe pain location and pattern
Voicing feelings of pain may be considered a weakness, in presence of peers
Older Adults:
-Pain is not an expected aspect of aging
-Pain is frequently under detected because of physical and cognitive impairment of older adults with dementia.
-They may deny the pain because they associate the pain with getting older, or they may use distraction to prevent the pain w/ interfering with their daily activities.
-Indicators of pain may be fatigue, lethargy, or anorexia
Young & Middle Adult Health Promotion:
Young Adult-20-40 yrs
What is the developmental stage of the young adult according to Erickson?
Intimacy vs. Isolation
-self exploration
-develops close relationships with friends and spouse or feels lonely and isolated.
What is the phase of cognitive development according to Piaget?
Formal concrete operations
-uses rational thinking
-reasoning is deductive and futuristic
What are the physical and cognitive tasks?
-establish autonomy as an individual
-planning direction for life, getting an education
-becoming involved in relationships, selecting mate, marriage
-usually a time of maximal physical strength and health “prime of life
Health promotion:
-Hgb & Hct, chol
-Pap smear, testicular exam, Prostate, PSA
-Assess for drug and alcohol abuse
-add folic acid supplements-child bearing women.
Prevent Injury
-smoke detectors
-seat belts
-safe driving practices
-firearm safety
Sexual History
-safe sex practices
-screening for STD’s
Middle Aged Adult
40-65 yr.
What is the developmental task of the middle aged adult according to Erickson?
Generativity vs. Stagnation
-time of production
-maintaing a standard of living
Psychological Tasks:
-assisting children to become independent
-adjusting to aging parents
-accepting physical changes
-developing leisure time activities
Physical Changes:
Signs of ageing begin
-hair thins
-skin turgor and moisture decreases
-visual and hearing changes occur
-Most chronic illness begin at this time
Health Promotion & Prevention
-balance of calories and activities
-vitamin supplements
Physical Exam
-Screening tests
-Cholesterol and triglyceride levels
-Occult stool testing
-sigmoidoscopy/colonoscopy every 5 years beginning at age 50
-Mammograms and pap smears
-TSE and Prostate exams
Elderly Age Related Changes in Health Promotion
Older adulthood begins at about age 65 and continues until death. The degree and rate at which changes occur vary among individuals, systems, and organs as does a person’s ability to compensate
Older Adult-65 & Older
Ego integrity vs. Despair
-sense of satisfaction with life
-acceptance of self
Basic Needs:
Regardless of age, individuals have the same basic needs:
-physiological function
Older adult development:
Cognitive Development
-intelligence remains
-thought processes slower
Physical changes
-although the efficiency of body systems declines with age, the body has reserve and compensatory mechanisms that normally allow an individual to function well in late adulthood
-the older adult experiences age related changes, but the rate and response are individual and require unique care.
Health Promotion & Prevention
-requires fewer calories but same basic nutrition
-BP, TIA’s, stroke
-Functional and cognitive deficits
Screening: hearing, vision/cataracts, glaucoma, skin exams, mammogram and pap spears, PSA and Prostate exams
Safe driving practices
-night driving, know when to quit
Prevention of Injury:
-Assess environment for risk of falls
-seat belts
-smoke detectors
-safe sex practices
Health Care of the Older Adult
Frequently older adults respond to illness by:
-Developing disorientation or delirium
-Weakness and immobility
The development of such changes should be recognized, documented, and reported.
-Medication can be a powerful tool for improving the health of older adults but delicate balance is needed to minimize adverse effects.
-the older adult’s body has decreases ability to handle absorption, transportation, and elimination of the medications
-the nurse must do an assessment of the patient’s ability to take the medication correctly.
Hospitalization, Surgery & Rehabilitation
-the nurse need to be knowledgeable of the influence of aging on the body ability to handle anesthesia & immobility
-the older adult requires longer post-op recovery and convalescent periods
-intervention to prevent complications are even more important because of the body changes due to aging.
Security Concerns:
-older adults spend a greater percentage of their income on health care than younger individuals
-many have fixed incomes from retirement pensions and only limited savings to pay for the rising costs of food, housing, and health care
-housing-older adults prefer to remain independent and have their own homes
Psychosocial Care- Nursing Dx.
-Loss, grief, and depression
-grieving, dysfunctional related to personal, social and economic losses
Health Promotion for the Healthy Aging
-More and more individuals are taking charge of their own health.
-The nurse should caution individuals to investigate the qualification of the provider, research the method being considered, and allow time to identify reactions using only one therapy at a time.
-Encourage older persons to make decisions that affect their lives after getting sufficient information.
Diagnostic Tests & Procedures
The use of scientific and skillful methods establishes cause and nature of a person’s illness.
-History of disease process
-Signs and symptoms present
-Laboratory data
-Special tests; examples-x-rays, bone scans, skin tests, etc.
Nursing Responsibilities:
Related to Diagnostic Tests
-understand the reason for the testing
-educating and preparing the client
-anxiety levels r/t to screening or to r/o a disease
-scheduling the tests
-nursing care before, during, and after the procedure
-proper care and disposition of specimens
Types of Testing:
-Blood studies
-Urine and Fecal studies
Blood studies:
-able to assess multiple body processes
-dietary restrictions
-specific time of day, or during treatments
-Cultures drawn prior to ABX
-Heed special interventions
What are the two basic categories of blood tests?
Hematology: examination of actual blood cells; RBCs, WBCs, platelets
Chemistry: series of test of the chemical composition of plasma, CMP, BMP
Hematology is
Study of blood cells, CBC or ABC
What is the function of a WBC-Leukocytes?
What are the normal values for WBCs?
5,000-10,000 cells per cu mm
What would be an indication of an elevated WBC count?
Bacterial Infection
What would be an indication of a decreased WBC count?
Impaired immune system
-First divided into 2 main groups
-Then subdivided into 6 types
-Values represent % of whole WBC count
Function: to transport O2 from lungs to tissues-using hemoglobin to carry the O2
What are normal values of RBCs?
4.5-6 million cells per cu mm
-slight variations for men and women
Hemoglobin-HGB *
-Protein and iron compound that actually transports O2 and CO2
What are the normal values of Hemoglobin? *
12-16 gm/100 ml
-The concentration of cells in plasma
-Expressed in %
What are the normal values of hematocrits?
-varies with age and gender
Platelets (Thrombocytes)
-smallest cells
Normal values of platelets?
150,000-400,000 cells per cu mm
Types of Coagulation Studies
-PT:Prothrombin time, used with Coumadin therapy
-INR:International Normalized Ratio, compares PT with a control value
-PTT:partial thromboplastin time, used with Heparin Therapy
Chemistry Studies-Electrolytes:
Na, K, Ca, CL, Mg, PO4, plus HCO3
Sodium Na+
Normal value: 135-145 mEq/liter
Potassium K+ *
Normal value: 3.5-5.3 mEq/liter
BUN and Creatine, Albumin
BUN and Creatine reflect kidney function
Increase=altered renal function
Decrease=can show impaired liver function
-0.6-1.3 mg/dl
-increase shows altered glomerular filtration
-Reflects nutritional state and hepatic function
Arterial Blood Gasses-ABGs
Acid/Base balance
pH of arterial blood= 7.35-7.45
HCO3 (bicarb) = 22-26 mEq/L
Respiratory Function:
O2 saturation = 95-100%
PO2 = 75-100 mm Hg
PCO2 = 35-45 mm Hg
Blood Glucose
FBS-fasting blood sugar, normal values 80-120
GTT (glucose tolerance test)
-Blycosylated HGB (HbA1c)- shows glucose levels over a 6-8 week period
-7% or less is desired
SBGM-self monitoring
-capillary glucose testing
Blood Tests for Cholesterol
-total blood cholesterol levels
-high density lipoprotein or HDL (good cholesterol)
-low density lipoprotein or LDL (bad cholesterol)
-test results are reported per deciliter of blood (mg/dl)
Total Cholesterol Levels:
-less than 200 mg/dL: desirable
-200 to 239 mg/dL: borderline to high
-240 mg/dL or higher is dangerous
HDL Levels:
-HDL is actually a cholesterol mopping up lipoprotein. The cholesterol bound to HDL does not get deposited in the arteries. A high HDL is considered to be protective.
-Less than 35 mg/dl low (increased risk of heart disease)
-Greater than 60mg/dL high HDL (reduced risk of heart disease
LDL carries most of the cholesterol in the bloodstream. If the level gets too high, the cholesterol gets deposited in the wall of arteries and causes them to become narrowed.
-Less than 130 mg/dL desirable
-130 to 159 mg/dL borderline to high
-160mg/dL or greater is high
Cholesterol Ratio
For total cholestererol to HDL ratio
-calculated by dividing total cholesterol level by HDL level
-Below 5 to 1 desirable
-3.5 to 1: optimal
-Less than 200 mg/dL normal
-200 to 400mg/dL: borderline to high
-400 to 1000 mg/dl : high
-Greater than 1000mg/dL : very high
Other blood studies
-Liver function
-Cardiac Enzymes-CK and CK-MB, Tropin
Urine Studies:
-Provides data on kidneys, glucose and various hormones, etc..
-Types of samples needed-sterile, routine urinalysis, timed, culture & sensitivity, clean-catch, midstream, catch specimen, 24 hour collections
Fecal Studies
-Used for microbiologic studies, chemical determinations, and parasitic exams
-certain medications effect outcomes
Tetracycline’s, anti-diarrhea meds, and anticoagulants
-Dietary restrictions effect outcomes, NO fish, red, meat, poultry, excessive green leafy vegetables 2 to 3 days prior to test
-Guaic tests (Hemoccult)
-Ova and Parasites
Sputum Studies:
-assesses pulmonary Tuberculosis, Bacterial Pneumonia, Chronic Bronchitis
-Acid-fast bacilli (AFB) to test TB
-Culture & Sensitivity best results with early AM samples
-Throat Cultures use a sterile swab kit, Sputum, not saliva
Imagery Studies:
CXR-Patient concerns
GI Series- UGI, BE, CT scan, MRI, PET
Electrical Imagery
X-Ray Studies
-Provides a picture body structures with B/E’s or IVP’s
-Question clients-recent x-rays, allergies to iodine, die, pregnant?
-Usually bowel cleansing ordered
-Stools may change to white color until al barium is expelled
Many Other Tests:
-Nuclear Scanning
-Ultrasound Studies (Sonogram)
-Lumbar Puncture (LP)
-Toxicology Studies
Alternative/Complimentary Therapies
Complementary Therapy:
Use of alternative therapy with conventional therapy
Alternative Therapy:
Approaches to medical diagnosis and therapy that have not been developed by use of generally accepted scientific methods
Holistic Nursing:
-Holistic nursing programs add training in compassion, self-care, massage, healing or therapeutic touch, intuition, and spirituality.
-Nurses trained in this area may work as part of a larger integrated clinic or, with the proper license, have an independent practice. Many tend to work in the field of women’s health care.
Certification programs are available to nurses or to students enrolled in nursing school. A few independent schools offer this type of training as an alternative to the traditional nursing degree.
What is herbal medicine?
-Many different types of natural medicine use herbs as part of their practice. In the United States, herbal medicines generally refers to a system of medicine that uses European or North American plants.
-In medicine, an herb can be a root, a piece of tree bark, and a mushroom, or anything else which grows naturally and falls into the plant kingdom.
What is an herbalist?
In the United States, an herbalist is a self-defined professional. There is no national or state system of licensure or certification for herbalists. Professional groups may grant certification to members that have reached a certain level of training as an herbalist. Some herbalists concentrate on growing or wildcrafting (picking) herbs. Others manufacture herbal products. Still others teach or counsel people about the use of herbs as medicines.
Can an herbalist practice medicine?
-Legally in the United States, the practices of medicine is restricted to those professionals who have a license. Practice is generally defined as both diagnosis and prescription, with a focus on the treatment of disease (the laws vary from state to state). There are no restrictions, however, on teaching people how to take better care of themselves. Most herbalists define themselves as teachers, healers, or counselors rather than as medical practioners.
How do states regulate the practice of herbal medicine?
-In general the “practice of medicine” is regulated according to the state’s licensing laws. The “scope” of the license dictates how you can use herbal medicine, for example a licensed midwife may be allowed to use herbs in her practice, but only as they relate to a woman’s health, pregnancy or childbirth.
How can a student become certified or recognized as a professional herbalist?
-The American Herbalists Guild (AHG) offers a professional membership. The AHG grants a professional membership following a peer-review by the admissions committee. Licensed practitioners are granted membership upon submitting proof of their training and license as well as a short personal and professional biography and curriculum vitae.
History & Treatments:
-Ancient Asian tradition
-dates back 5,000 years
-US acceptance in the last 30 years
Who does acupuncture treat?
-Elderly and aging who have exhausted traditional methods.
-curbing alcohol and drug addictions
-those in need or pain relief
Implications on traditional medicine:
Acupuncture can be combined with modern therapies to treat:
-carpal tunnel syndrome
-menstrual cramps
-macular degeneration
-peripheral neuropathy
Procedures and treatments:
-360 “channels” on the body
-insertion of tiny needles
-can be twirled for stimulation
-Electro-acupuncture-needles attached to electrical current that in turn produce endorphins
Choosing an Acupuncturist:
-Recognized by the AMA in 1998
-Most states require license
-ACAOM-keeps track of those educated
Potential dangers:
-Hepatitis B
-bacterial infections
Should be avoided by: pregnant women, those who use blood thinners, those who bruise /bleed easily
Is the inhalation and bodily application of essential oils from aromatic plants to relax, balanced rejuvenate, restore, or enhance body, mind, and spirit. Pure essential oils is quite wide, ranging from deep and penetrating therapeutic uses to the extreme subtlety of a unique fragrance.
What are the different types of Aromatherapy?
-cosmetic, massage and olfactory
-Regardless of which type you choose, essential oils should always be diluted in a carrier oil or water.
How does Aromatherapy work?
-when inhaled, essential oil affect our bodies in several ways. The essential oil component molecules enter the nasal passages, stimulates the olfactory nerve & sends messages directly into the limbic system (seat of memory, learning and emotion).
-this inhalation triggers changes within the limbic system which in turn can stimulate physiological responses within the body via the nervous, endocrine or immune systems.
-either stimulation or sedation of body systems or organs may occur.
What laws apply to the practice aromatherapy?
-At this time there’s no specific regulation of Aromatherapists or Aromatherapy. Many practitioners incorporate it into their practice, such as massage therapy, an the laws governing that practice are the ones that apply. An aromatherapist with no other medical training or license generally works as a counselor or teacher and should follow whatever regulations apply to that profession in their area.
What is Biofeedback Training?
-Helps patients improve their health by understanding signal for their own bodies and working consciously to affect change. Generally, biofeedback is used in a clinical setting by licensed health professionals. Because it provides an alternative to drugs for the treatment of stress-induced pain, such as migraines or muscle spasms, it works well in a natural medicine setting.
How is it practiced?
Clinical are trained to use the biofeedback machines to gauge a person’s internal bodily functions to help the patient tune into the activity inside their bodies. Patients then learn to identify the circumstances that trigger their symptoms and are taught some for of relaxation exercise to relieve the symptoms.
What degrees or certificates are available:
Certification for healthcare professionals is available. To qualify for training, trainees must have a bachelor’s degree or higher from a regionally-accredited academic institution in a healthcare field.
What is a Chiropractic?
Chiropractic focuses on the relationship between the spinal column and the nervous system. Through spinal adjustments, chiropractic doctors alleviate problems caused by the misalignment of the vertebrae. DCs do not use surgery or drugs in their practice, but they may also incorporate many other natural therapies besides spinal manipulation, including: craniosacral therapy, visualizations, breathwork, herbal or vitamin supplements, and so on
What does a Chiropractor do?
Chiropractors, also know as doctors of chiropractic (D.C) or chiropractic physicians, diagnose and treat patients whose health problems are associated with the body’s muscular, nervous, and skeletal systems, especially the spine. Chiropractors believe interference with these systems impairs normal function sand lowers resistance to disease. They also hold that spinal or vertebral dysfunction alters many important body functions by affecting the nervous system, and that skeletal imbalance through joint or articular dysfunction, especially in the spine, can cause pain.
-In cases in which difficulties can be traced to involvement of musculoskeletal structures, chiropractors manually manipulate or adjust the spinal column. Many chiropractors also use water, light massage, ultrasound, electric, and heat therapy and may apply supports such as straps, tapes, and braces. They may also counsel patients about wellness concepts such as nutrition, exercise, lifestyle changes, and stress management, but do not prescribe drugs perform surgery.
What are the typical perquisites for chiropractic schools?
-It is recommended that students have earned a baccalaureate degree in the arts or sciences from an accredited college or university, completed with a min. cumulative grade point average of 2.5-4.0
-all 50 states and the District of Columbia in the US regulate the practice of chiropractic and grant licenses to chiropractors who meet educational requirements of the State and pass a State approved board examination.
-for licensure, most state boards recognize either all or part of the four-part test administered by the National Board of Chiropractic Examiners.
Homeopathy is practiced worldwide, especially in Europe, Latin America, and Asia. However, even in the US’s the homeopathic drug market is a multimillion dollar industry.
-homeopathic remedies, which are made from naturally occurring plant, animal, or mineral substances, are recognized and regulated by the FDA and are manufactured by est. pharm. companies under strict guidelines
What is Homeopathy used for?
to treat acute and chronic health problems as well as for disease prevention and health promotion. Recent clin. Trials suggest that homeopathic medicines have a positive effect on allergic rhinitis, fibrositis, and influenza.
Education & Licensure:
-Generally, most practitioners in the U.S hold another medical degree that allows them to diagnose and prescribe such as: MD, DO, DC, ND, nurse practitioner, physicians assistant.
-There is now formal or legal licensing or governmental regulation of homeopathic practitioners in the US or Canada. A few states like Arizona formally state that homeopathy belongs only under the jurisdiction.
What does a naturopathic physician do?
-A licensed naturopathic physician (ND) attends a four year graduate level naturopathic medical school and is educated in all of the same basic sciences as an MD but also studies holistic and nontoxic approaches to therapy with a strong emphasis on disease prevention and optimizing wellness. A naturopathic physician takes rigorous professional board exams so that he or she may be licensed by a state or jurisdiction as a primary care general practice physician
What states license naturopathic physicians?
Alaska, Arizona, Connecticut, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, and Washington