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48 Cards in this Set
- Front
- Back
Physical Examination
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is a systematic, orderly process by which the nurse collects objective data about the client's body, mind and spirit.
It is a critical investigation and evaluation of client's present status. |
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Validation
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Comparing data with another source
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Inspection
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Visual examination, to observe, to look, to smell
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Palpation
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using the sense of touch; to feel, to stroke the surface of an area to detect its characteristics such as temperature, vibration, turgor, texture, masses, etc.
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Auscultation
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listening to sounds produced in the body, usually aided by a stethoscope
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Dyspnea
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difficulty in breathing
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Hemoptysis
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Bloody sputum
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Cyanotic
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blue, blue-gray
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Mottled
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patchy areas of blue
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Pallor
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pale
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Flushed
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reddish hue
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Diaphoretic
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skin moist with perspiration
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Level of Consciousness (LOC)
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the client's awareness of his surroundings
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Complaint
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statement of any symptom or problem
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Adjunct equipment
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includes any medical equipment or devices in use
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Dysphasia
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difficulty with speech or understanding the spoken word
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Jaundice
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yellowish- orange skin, sclera, mm
in darked skin: assess hard palate excess bilirubin; liver or hemolytic disease |
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Erythema
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red
increased blood flow inflammation rashes |
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Senile Lentigo
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brown age spots due to sun exposure
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Diaphoresis
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perspiration
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Edema (Effusion)
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the abnormal presence of fluid in the body
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Periorbital
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edema around the eyes
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Ascites
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edema in the abdominal cavity
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Anasarca
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all over edema
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Lesions
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any abnormal area of the skin
ex.: wound, cyst, rash, boil, tumor |
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Myopia
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nearsightedness
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Hyperopia
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farsightedness
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Presbyopia
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lens is unable to change shape to accommodate close vision
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Ptosis
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drooping of the eyelid
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Arcus senilis
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bilateral gray ring around the iris due to lipid deposits
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Cataracts
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cloudiness of the lens
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PERRLA
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Pupils are equal, round, react to light, and accommodate
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Mydriasis
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dilation for distant
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Miosis
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pinpoint constriction for close
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Cerumen
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ear wax
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Edentulous
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no teeth, or a number of them missing
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FROM
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Full Range of Motion
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Bronchial sounds
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over trachea
harsh, loud duration of I<E |
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Bronchovesicular sounds
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1-2 ICS, SB and posteriorly between the scapulae
I=E |
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Vesicular sounds
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very quiet
I>E |
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Adventitious sounds
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unequal sounds or if the incorrect sound is heard in a location
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Body temperature
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the heat of the body determined by the balance of heat produced and heat lost
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Core temperature
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reflects temperature of the core body tissues (vital organs)
ex.: tympanic and rectal |
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Surface temperature
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temperature varies according to site used
lower than core Oral and axillary |
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Hypothermia
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subnormal, temp less than 96.8 F or 36 C
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Fever (Pyrexia)
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temp is above 100.4 F or 38 C
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pulse pressure
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difference in systolic and diatolic BP
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Respiration
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act of breathing for 1 min.
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