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21 Cards in this Set
- Front
- Back
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Why should you use a physical assessment
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to gather baseline data
to supplement, confirm, or refute data obtained in the RN history to Confirm and ID RN diagnoses to make clinical judgments about a client's changing health status and management to evaluate the physiological outcomes of care |
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What is idiosyncrasies
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one's wants, fears ect. with an RN need to know there wanting to be liked, fear of harming the client , or catching a disease
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That are some common areas for palpation (p. 675)
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Skin
Organs Glands Blood vessels Thorax |
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what should an RN be looking for when palpating
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sensitive, resistance, resilience, roughness, texture, and mobility
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How can an RN decrease abdominal rigidity
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placing the Pts arms along the side of the body
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How should an RN palpate the abdominal cavity
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depress about 1 cm (1/2 inch). save tender areas for last, if pt is ok deeper palpation can go 2 to 4 cm (1 to 2 inch) can be done bimanually
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where is the best place for an RN (RN part of the body most sensitive to temp) to feel for temp
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dorsum part of the hand
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How does the RN preform percussion?
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placing the middle finger of the pleximeter hand firmly against the body surface using the plxor strikes the base of the distal joint of teh pleximeter.
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What are the five types of percussion sounds
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Tympany, resonance, hyperresonance, dullness, and flatness (p 677)
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what is auscultation in the RN scope
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listening to sounds produced by the body
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what part of the stethoscope is general used for what sounds
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Bell is best for low-pitched sounds such as vascular and certain heart sounds, diaphragm is best for high pitched sounds such as bowel and lung sounds
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What auscultation should a RN note.
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Frequency
loudness quality duration |
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What is the Lub sound made by
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first heart sound caused by the closure of the mitral valve
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What is olfaction
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Smell
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What are some of the smells an RN should note/familiar with
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Alcohol
Ammonia Body odor Feces Foul-smelling stools in infant halitosis Sweet, fruity ketones Stale urine sweet, heavy thick odor Musty odor Fetid, sweet odor P. 678 |
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Why is hand hygiene so important
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Reduces the transmission of microorganisms
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What is important for examination of a client and environment?
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if possible try to make the client comfortable
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What is important when it come to addressing people by name?
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Children should be called by their first name, parents by Mr. and Mrs.
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When does the general survey of a client begin
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when the RN first meets the client
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What are some of the things the RN looks for in the general survey
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Gender and race, age, signs of distress, body type, posture, gait, body movements, hygiene and grooming, dress, body odor, affect and mood, speech, client abuse, substance abuse
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What is CAGE used for
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CAGE is a set of questions used to determine if someone has a substance abuse problem , if they answer yes to two on more of the following.
Cut down, annoyed, guilty, eye-opner |
