Health Assessment

Front 1

The protection, promotion and optimization of health and abilities

Back 1

Nursing

Front 2

It is placed on diagnosis and treatment of human responses

Back 2

Emphasis

Front 3

It is the cornerstone of the nursing profession

Back 3

Nursing Process

Front 4

The first and most critical phase of the nursing process

Back 4

Assessment

Front 5

Is collecting, validating, organizing and recording data about the client's health status

Back 5

Assessment

Front 6

It is ongoing and continuous process throughout all the phases of nursing process

Back 6

Assessment

Front 7

This helps to organize information and promotes the collection of holistic data

Back 7

Nursing Framework

Front 8

What are the 4 basic types f HA?

Back 8

ICA

OPA

FPOA

EA

Front 9

Involves collection of subjective data

Back 9

ICA

Front 10

Consists of data collection that occurs after the comprehensive database is established

Back 10

OPA

Front 11

Mini overview of the client's body systems

Back 11

OPA

Front 12

Consists of a thorough assessment of a particular client problem and does not address areas not related to the problem

Back 12

FPOA

Front 13

A very rapid assessment performed in life threatening situations

Back 13

EA

Front 14

What are the steps on HA?

Back 14

S

O

V

D

Front 15

Data that can be elicited and verified only by the client

Back 15

SD

Front 16

What are the four physical examination techniques?

Back 16

IPPA

Front 17

Crucial part of assessment that often occurs along with collection of subjective and objective data

Back 17

VoAD

Front 18

It forms the database for the entire nursing process

Back 18

DD

Front 19

Analysis of data or often called as?

Back 19

Nursing Diagnosis

Front 20

A clinical judgment concerning a human response to health conditions

Back 20

Nursing Diagnosis

Front 21

Physiological complications that nurses monitor to detect their onset or changes in status

Back 21

Collaborative problems

Front 22

"whole"

Back 22

Referrals

Front 23

display poise; focus on the client and the upcoming interview

Back 23

Demeanor

Front 24

Often show what you are truly thinking

Back 24

Facial Expression

Front 25

Wear that ____________?

Back 25

nonjudgmental attitude

Front 26

Allows you and the client to reflect and organize thoughts

Back 26

Silence

Front 27

Most important skill to learn and develop fully to collect complete and valid data from client

Back 27

Listening

Front 28

5 A's of behaviour change

Back 28

Ask

Advise

Assess

Assist

Arrange

Front 29

These cause the client to provide answers that may not be true

Back 29

Biased or Leading questions

Front 30

A type of question that is used to elicit the client's feelings and perceptions

Back 30

Open ended questions

Front 31

Type of question that is used to obtain facts and to focus on specific information

Back 31

Close ended questions

Front 32

Provide the client with a lost if words to choose from in describing symptoms, conditions or feelings

Back 32

Labada list

Front 33

Provides information as questions and concerns arise

Back 33

Providing information

Front 34

Age effects and commonly slows all body systems to varying degrees

Back 34

Gerontologic ViC

Front 35

Nurse can encourage client verbalization by?

Back 35

Well placed phrases

Front 36

Is an excellent way to begin the assessment process because it provides the foundation for identifying nursing problems

Back 36

Health History

Front 37

Focuses on questions related to the clients personal hostory from the earliest beginings to the present

Back 37

Personal health history

Front 38

What are the 8 sections if health history?

Back 38

BD

RfSHC

History

Personal

Family

Ros

Lifestyle

Developmental

Front 39

3 aspects before beginning the examination

Back 39

Physical setting

Yourself

The client

Front 40

Back lying position with knees flexed

Back 40

Dorsal Recumbent

Front 41

Back lying position with legs extended

Back 41

Supine (Horizontal Recumbent)

Front 42

A seated position, back unsupported

Back 42

Sitting position

Front 43

Back lying position with feet supported in stirrups

Back 43

Lithotomy position

Front 44

Side lying position with lowermost arm behind the body

Back 44

Sim's position

Front 45

Lies on abdomen with head turned to the side

Back 45

Prone position

Front 46

Involves using the senses of vision, smell and hearing

Back 46

Inspection

Front 47

Is used from the moment that you meet the client and continues through out the examination

Back 47

Inspection

Front 48

Consists of using parts of the hand to touch and feel

Back 48

Palpation

Front 49

Place your dominant hand lightly on the surface of the structure

Back 49

Light palpation

Front 50

Depress the skin surface 1-2cm with your dominant hand

Back 50

Moderate palpation

Front 51

Place your dominant hand on the skin surface and your non dominant hand on top of your dominant hand to apply pressure

Back 51

Deep palpation

Front 52

Use one hand to apply pressure and the other hand to feel the structure

Back 52

Bimanual palpation

Front 53

Involves tapping body parts to produce sound waves. These sound waves or vibrations enable the examiner to assess what?

Back 53

• Percussion

• Underlying structures

Front 54

What are the different types of percussion

Back 54

Direct

Blunt

Indirect

Front 55

Direct tapping of a body part with one or two fingertips to elicit possible tenderness

Back 55

Direct percussion

Front 56

Used to detect tenderness over organs by placing one hand flat on the body surface and using the fist if the other hand flat on the body surface

Back 56

Blunt percussion

Front 57

The tapping done with this type of percussion produces a sound or tone that varies with the density of underlying structures

Back 57

Indirect percussion

Front 58

A type of assessment technique that requires the use of a stethoscope

Back 58

Auscultation

Front 59

Used because these body sounds are not audible to the human ear

Back 59

Sthetoscope

Front 60

What is the 5th vital sign

Back 60

Pain

Front 61

Reflects the balance between the heat produced and the heat lost from the body

Back 61

Body temp

Front 62

Measured by heat units called _________?

Back 62

Degreees

Front 63

Is the temperature of the deep tissues of the body

Back 63

Core temp

Front 64

The temperature of the skin, subcutaneous tissue and fat

Back 64

Surface temp

Front 65

What is the normal range of temp in babies and children?

Back 65

36.6 - 37.2

Front 66

What is the average temperature of an adult?

Back 66

36.1 - 37.2

Front 67

What is the average temperature of adults over age 65.

Back 67

36.2

Front 68

Body temperature above the usual range

Back 68

Hyperthermia

Front 69

A client who has fever

Back 69

Febrile

Front 70

A client who does not have fever

Back 70

Afebrile

Front 71

Core body temperature below the lower limit of normal

Back 71

Hypothermia

Front 72

Skin that appears flushed and feels warm

Back 72

Defervescence

Front 73

Wave of blood created by contraction of the left ventricle of the heart

Back 73

Pulse

Front 74

A pulse located away from the heart

Back 74

Peripheral

Front 75

It is the central pulse that is located at the apex of the heart

Back 75

Apical

Front 76

The volume of blood pumped into the arteries

Back 76

Cardiac Output

Front 77

Circulation to lower leg

Back 77

Popliteal

Front 78

Circulation to the foot

Back 78

Posterior Tibial

Front 79

Over 100bpm

Back 79

Tachycardia

Front 80

Irregular pulse

Back 80

Arrhythmia

Front 81

Also used to refer to the movement of air in and out of the lungs

Back 81

Ventilation

Front 82

Absence of breathing

Back 82

Apnea

Front 83

Abnormally slow respirations

Back 83

Bradypnea

Front 84

Abnormally fast respirations

Back 84

Tachypnea

Front 85

Breathing that is normal in rate and depth

Back 85

Eupnea

Front 86

Regularity of the expirations and the inspirations

Back 86

Rhythm

Front 87

Aspects of breathing that are different from normal, effortless breathing

Back 87

Quality

Front 88

Normal breathing is silent

Back 88

Sound

Front 89

Difficult and labored breathing

Back 89

Dyspnea

Front 90

Ability to breathe only in upright sitting

Back 90

Orthopnea

Front 91

A shrill, harsh sound heard during inspiration

Back 91

Stridor

Front 92

Snoring or sonorous respiration

Back 92

Stertor

Front 93

Continuous high pitched musical squeak

Back 93

Wheeze

Front 94

Gurgling sounds heard as air passes through moist secretions in the respiratory tract

Back 94

Bubbling

Front 95

Indrawing between the ribs

Back 95

Intercostal

Front 96

Indrawing beneath the breastbone

Back 96

Substernal

Front 97

Indrawing above the clavicles

Back 97

Suprasternal

Front 98

The presence of blood in the sputum

Back 98

Hemoptysis

Front 99

A cough accompanied by expectorated secretions

Back 99

Productive cough

Front 100

A dry, harsh cough without secretions

Back 100

Non productive cough

Front 101

Is a measure of the pressure exerted by the blood as it flows through the arteries

Back 101

Arterial BP

Front 102

Contraction of the ventricles

Back 102

Systolic

Front 103

Ventricles are at rest

Back 103

Diastolic

Front 104

Difference between systolic and diastolic pressures

Back 104

Pulse pressure

Front 105

First faint, clear tapping

Back 105

Phase 1