NR304 Assessment ESE Study Guide

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1. Muscle mass difference: periods of __________ can result in decreased muscle tone.
a) _________ interferes with bone growth and muscle tone.
b) By the age of 80, about _____ of muscle mass is lost.
2. Musculoskeletal
a) Inspection/palpation: How would you perform the musculoskeletal assessment?
b) ROM: When assessing for ROM, do not ___________?
c) What tool do you use to assess ROM?
d) Strength: How is muscle strength rated?

3. Muscle atrophy: Name a s/s that you would see in someone with atrophy of the abdominal muscles.
a) What may a pt have if they are unable to perform abduction of the shoulders, has pain, tenderness, & muscle atrophy?
4. Muscle weakness: What test is used to assess muscle weakness in children?
a) Muscle weakness is common as a person _________, especially with __________.
b) __________ can also cause muscle weakness.
5. Hip dysfunction: Before testing for ROM of the hips you should know…?
a) Decrease abduction common in aging
b) Congenital (ortoloni’s,
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Thought: Listen to the client’s statements. Statements should be logical and relevant. The client should complete his or her thoughts.

Orientation: Determine the client’s orientation to date, time, place as well as the need for physical assessment. Grade the lever of alertness on a scale from full alertness to coma. Memory status: Ask the client’s date of birth, names and ages of any children or grandchildren, educational history with dates and events, work history with dates (remote). Ask the client what they had for breakfast or last meal. (recent)

2. Level of consciousness/response to pain: pg. 744-45

3. Abnormal speech patterns: Note the client’s rate of speech, ability to pronounce words, tone of voice, loudness or softness of voice, and ability to speak smoothly and clearly. * Changes in speech could reflect anxiety, Parkinson’s disease, depression, or various forms of aphasia(inability to communicate)

4. Inability to express themselves

5. Inability to make meaningful speech

6. Inability to express themselves nor understand messages

7. Inability to understand messages/ comprehend

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