Health Assessment Midterm #1

Front 1

a _____ refers to health, illness, and the meanings they hold for people shaped by gender, age, ability, and social, cultural, family, historical, and geographical contexts, and how these contexts influence how nurses view, relate, and work with patients and families

Back 1

relational approach

Front 2

_____ is aimed at making similarities and differences more transparent to us to that we can be as responsive as possible to people's varying needs

Back 2

a relational approach

Front 3

a universal phenomenon that shapes the health and wellbeing of every person

Back 3

culture

Front 4

an individual's _____ develops in distinctive and specific ways depending on where they live, family background, SES, languages, spirituality, ancestry and history and an individual and as a member of a group

Back 4

cultural orientation

Front 5

equating culture with ideas about ethnicity or race overlooks most _____ relevant to health

Back 5

sociocultural aspects

Front 6

assuming _____ and making assumptions leads to unsafe health assessment practices

Back 6

stereotypes

Front 7

the process of conceptualizing culture in fairly narrow terms, or assuming that people act in particular ways because of their culture

Back 7

culturalism

Front 8

according to this perspective, culture is a relational aspect of individuals that shifts and changes over time, depending on an individual's history, social context, past experiences, gender, professional identity, etc.

Back 8

critical cultural perspective

Front 9

attributing illness to individual behaviors or factors, and the view that the individual is responsible for getting well, values 'adherence' to medical recommendations such as diagnostics, medicine, and surgery

Back 9

Western dominant healthcare culture

Front 10

a complex concept that often implies geographical and national affiliation

Back 10

ethnicity

Front 11

_____ is an ambiguous concepts because it can encompass multiple different aspects such as origin, ancestry, identity, language, and religion

Back 11

ethnicity

Front 12

a socially constructed category used to classify humans according to common ancestry and reliant on differentiation by physical characteristics with to basis in biological reality and no meaning independent of it's social definitions

Back 12

race

Front 13

a process by which ethno-racial groups are categorized, stigmatized, inferiorized, and marginalized as the "others", may be intended and deliberate or unconscious and unintended

Back 13

racialization

Front 14

the denial of equitable treatment and opportunities to individuals or groups

Back 14

discrimination

Front 15

a racializing term, by which people are classified according to skin color or other physical characteristics

Back 15

visible minority

Front 16

focusing on an individual's particular understandings, explanations, values, and practices related to health and illness will help you to obtain information relevant to health and avoid masking assumptions, this allows you to provide _____

Back 16

culturally safe care

Front 17

awareness and accommodation of people's beliefs, values, customs, and practices, and examination of how they intersect with broader social determinants and power relations that shape health and healthcare

Back 17

cultural sensitivity

Front 18

the application of knowledge, skills, attitudes, or personal attributes required by nurses to maximize respectful relationships with diverse populations

Back 18

cultural competence

Front 19

knowing these five things will promote _____

- you own ethno-cultural and social background

- culture of nursing and related professions

- culture of healthcare

- significance of social, economic, and cultural contexts

- ability to critically examine own assumptions about all of these areas

Back 19

cultural safety and cultural competence

Front 20

a process and an outcome whose goal is to promote greater equity by focusing on the root causes power imbalances and inequitable social relationships in healthcare

Back 20

cultural safety

Front 21

first language learned at home in childhood and still understood at the time data is collected

Back 21

mother tongue

Front 22

Canada's population as a whole is _____

Back 22

aging

Front 23

life expectancy is longer for _____

Back 23

women

Front 24

projection of assumed cultural characteristics, differences, or identities onto members of particular groups, not based on actual differences, but on stereotypes

Back 24

othering

Front 25

colonialism, the Indian Act, the process of registering for status, reserves, and residential schools, social conditions, systemic racism, discrimination, are all examples of _____

Back 25

factors affecting the health of aboriginal peoples in canada

Front 26

language, social isolation, access barriers, few interpreter services, lack if system information, waiting periods, discrimination, racism, low levels of social support are all factors that may affect this canadian population

Back 26

immigrants

Front 27

differences, variations, and disparities in the health status if individuals and groups, tat are unnecessary and avoidable, and considered unfair and unjust

Back 27

health inequities

Front 28

the primary cause of poor health among canadians

Back 28

poverty

Front 29

the situation in which individuals are unable to carry out or participate in the activities expected in a particular nation

Back 29

relative poverty

Front 30

umbrella term that encompasses numerous individual therapies and health care approaches including traditional chinese medicine, relfexology, homeopathy, massage, chiropractic services, relaxation therapy, traditional aboriginal medicine, and other healing and health practices

Back 30

complementary and alternative health care

Front 31

a variety of products such as herbal medicines, homeopathic remedies, nutritional supplements, vitamins, and minerals

Back 31

natural health products

Front 32

this concept is more central to the human experience than religion, and may refer more generally to the search for meaning

Back 32

spirituality

Front 33

building trust, engaging through listening, conveying respect of people's lives and choices, are all keys to _____

Back 33

culturally safe health assessment

Front 34

the individual's own perception of the health state

Back 34

subjective data

Front 35

signs perceived by the examiner through the physical examination

Back 35

objective data

Front 36

concentrated watching of the individual as a whole and then each body system

Back 36

inspection

Front 37

this part of the assessment is always performed first

Back 37

inspection

Front 38

applying your sense of touch to assess texture, temperature, moisture, organ location and size, swelling, vibration, pulsation, rigidity, spasticity, crepitation, lumps, masses, tenderness, or pain

Back 38

palpation

Front 39

this part of the hand is best for tactile discrimination, to assess skin texture, swelling, pulsation, and presence of lumps

Back 39

fingertips

Front 40

these parts of the hand are best used for detecting position, shape, and consistency of organs or masses using a grasping action

Back 40

fingers and thumb

Front 41

these parts of the hands are best used for determining temperature because the skin is thinner

Back 41

dorsa/backs of hands

Front 42

these parts of the hand are best used to detect vibration

Back 42

base of fingers or ulnar surface of hands

Front 43

palpation using the pads of your fingertips to detect surface characteristics and to accustom the pt to being touched

Back 43

light palpation

Front 44

tapping the pt's skin with short, sharp strikes to assess underlying structures, the strokes yield a palpable vibration and characteristic sound that depicts the location, size, and density of the underlying structure

Back 44

percussion

Front 45

this method of assessment is useful for mapping location and size of organs, signalling density, detecting abnormal masses if fairly superficial, eliciting pain on inflammation, eliciting deep tendon reflex

Back 45

percussion

Front 46

in this type of percussion, the striking hand contacts the body wall directly producing a sound

Back 46

direct percussion

Front 47

in this type of percussion, the striking hand contacts the stationary hand which is fixed on the person's skin, yielding a sound and subtle vibration

Back 47

indirect percussion

Front 48

this type of percussion is used most often

Back 48

indirect percussion

Front 49

you need a _____ to percuss pts who are obese and for those with very muscular body walls

Back 49

stringer percussion strike

Front 50

loudness or softness of a sound

Back 50

amplitude/intensity

Front 51

the number of vibrations or cycles per second (cps), more rapid make this higher

Back 51

pitch/frequency

Front 52

subjective difference in a sound's distinctive overtones

Back 52

quality/timbre

Front 53

length of time the note lingers

Back 53

duration

Front 54

a structure with more _____ produces a note that is louder, deeper, and longer because it vibrates freely

Back 54

air

Front 55

a structure that produces a softer, higher, shorter sound does not vibrate as easily because it is _____

Back 55

denser/more solid

Front 56

listening to sounds produced by parts of the body

Back 56

auscultation

Front 57

this tool illuminates the internal eye structures using a system of mirrors and lenses enabling you to look at the fundus through the pupil

Back 57

ophthalmoscope

Front 58

this ophthalmic aperture is used for dilated pupils

Back 58

large/full spot

Front 59

this ophthalmic aperture is used for undilated pupils

Back 59

small

Front 60

this ophthalmic aperture is used to examine the optic disc for hemorrhage (black) and melanin deposits (grey)

Back 60

red-free filter

Front 61

this ophthalmic aperture is used to determine fixation pattern and assess size and location of lesions on the fundus

Back 61

grid

Front 62

this ophthalmic aperture is used to examine the anterior portion of the eye and to assess elevation or depression of lesions on the fundus

Back 62

slit

Front 63

you should designate _____ and _____ areas for your equipment

Back 63

clean and used

Front 64

infection acquired during hospitalization

Back 64

nosocomial infection

Front 65

the most important step to reduce risk of microorganism transmission

Back 65

hand washing

Front 66

these should be used with all patients regardless of their risk for or presumed infection status, and mean that gloves should be worn if there will be potential contact with blood, any body fluids, non-intact skin, and mucus membranes

Back 66

routine precautions

Front 67

these precautions should be used when working with pts with documented or suspected transmissible infections, and are to be used in addition to routine practices

Back 67

transmission-based precautions

Front 68

contact (direct, indirect, droplet), airborne, vehicle, vectorborne

Back 68

modes of transmission of infection

Front 69

_____ can be reduced for the pt if the examiner is confident and self-assured, considerate, and unhurried

Back 69

anxiety

Front 70

find a _____ of physical assessment that works for you, limits repositioning of the pt, and will become natural so as not to miss any steps, write it out and refer to it as you proceed

Back 70

routine sequence

Front 71

an infant should be placed ____ on a padded exam table for assessment

Back 71

supine

Front 72

as much of the examination as possible should be conducted with the infant sitting in the parent's lap once ____

Back 72

the baby can sit without support

Front 73

listen to the heart, lungs, and abdomen of an infant when he/she is _____

Back 73

sleeping

Front 74

save these more invasive steps until last when assessing babies

Back 74

eyes, ears, nose, throat

Front 75

elicit this reflex at the very end of the assessment as it may cause the baby to cry

Back 75

moro/startle

Front 76

_____ should be sitting up on the parent's lap for all of the examination, sit knee to knee with the parent for parts of the exam where the pt must be supine

Back 76

toddlers

Front 77

when initially interacting with _____ and parents, focus more on the parent at first to allow the child to gradually get used to you

Back 77

toddlers

Front 78

eye contact, smiling, talking, or accepting toys or equipment from you signals that the toddler is

Back 78

ready to bein the examination

Front 79

when assessing _____ use clear, firm instructions, and only offer a choice when there really is one to be made, offer limited options, and praise for cooperation

Back 79

toddlers

Front 80

this age group is often cooperative, helpful, and easy to involve, and can be in the parents lap or on the examination table with the parent present

Back 80

preschoolers

Front 81

with this age group, use short and simple explanations, explain steps exactly, offer choice when possible, allow them to help, and use games to engage the child, compliment cooperation

Back 81

preeschoolers

Front 82

this age group is usually cooperative and interested, and language is more sophisticated, however, understanding may not match speech, so be careful not to treat them like little adults

Back 82

school-age

Front 83

this age group should sit on the examination table, and older children in this age group may be able to decide whether parents should be present, demonstrate equipment and explain how the body works

Back 83

school-age

Front 84

this age group is increasingly self-conscious and introspective, they can sit on the exam table with or without parents present

Back 84

adolescents

Front 85

in this age group, the body is rapidly changing, and the child needs feedback that the body is healthy and developing normally, emphasize wide variety among the age group and focus on positive attitudes regarding health and wellness

Back 85

adolescents

Front 86

these pts can sit on the examination table, and are adjusting to changes in physical strength and health, allow rests and use a sequence with as little repositioning as possible

Back 86

older adults

Front 87

do not mistake diminished vision or hearing for _____

Back 87

confusion

Front 88

in an ill patient, immediate assessment of body areas appropriate to the problem will allow you to collect a _____, then complete the assessment after the initial distress has subsided

Back 88

mini-database

Front 89

study of the whole person, covering the general health state, and any obvious physical characteristics

Back 89

general survey

Front 90

a general survey begins _____

Back 90

as soon as you encounter the pt

Front 91

four areas of a general survey:

Back 91

- physical appearance

- body structure

- mobility

- behavior

Front 92

age, sex, level of consciousness, skin color, and facial features are part of this section of the general survey

Back 92

physical appearance

Front 93

stature, nutrition, symmetry, posture, position, build, and contour are parts of this section of the general survey

Back 93

body structure

Front 94

gait and range of motion are parts of this section of the general survey

Back 94

mobility

Front 95

facial expressions, mood, affect, speech, dress, and personal hygiene are parts of this section of the general survey

Back 95

behavior

Front 96

the three sections of health assessment:

Back 96

- general survey

- measurment

- vital signs

Front 97

weight, height, BMI, and waist-to-hip ratio are part of this section of the health assessment

Back 97

measurement

Front 98

weight (kg) / height (m) =

Back 98

BMI

Front 99

waist circumference / hip circumference =

Back 99

waist-to-hip ratio

Front 100

temperature, pulse, respirations, blood pressure are all part of this section of the health assessment

Back 100

vital signs

Front 101

temperature is regulated by the _____

Back 101

hypothalamus

Front 102

this form of temperature measurement is accurate and convenient

Back 102

oral

Front 103

this site of temperature measurement has a rich blood supply from carotid arteries that quickly responds to changes in the inner core temperature

Back 103

oral sublingual

Front 104

if the pt has taken hot or iced liquids, wait _____ before taking temperature

Back 104

20 min

Front 105

if pt has just smoked, wait _____ to take temperature

Back 105

2 min

Front 106

if pt has been chewing gum, wait _____ minutes after the pt stops

Back 106

5 min

Front 107

caused by pyrogens secreted by toxic bacteria during infections or as a result of tissue breakdown

Back 107

hyperthermia/fever

Front 108

usually caused by accidental, prolonged exposure to cold, or can be purposefully induced to lower oxygen requirements during some surgery and during hemorrhage

Back 108

hypothermia

Front 109

this site for taking temperature is best for infants and young children

Back 109

axillary

Front 110

this method of taking temperature should only be used when other methods are impractical, such as in comatose or confused patients, or those who cannot close the mouth

Back 110

rectal

Front 111

a rectal thermometer should be inserted no more than _____ into the adult rectum, directed toward the umbilicus

Back 111

2-3cm/1inch

Front 112

this site of temperature taking senses infrared emissions from the eardrum, which has the same vascular supply as the hypothalamus

Back 112

tympanic membrane thermometer

Front 113

note these three characteristics of the pulse:

Back 113

- rate

- rhythm

- force

Front 114

normal stroke volume in adults

Back 114

70 mL

Front 115

to measure the pulse

Back 115

count the number of beats in 30 seconds, multiply by 2

Front 116

always count the pulse for _____ if the rhythm is irregular

Back 116

one full minute

Front 117

when assessing pulses bilaterally, add this characteristic to the list

Back 117

equality

Front 118

normal pulse rate

Back 118

60-110 bpm

Front 119

the pulse rate is ____ in infancy and childhood

Back 119

more rapid

Front 120

pulse rate under 60 bpm

Back 120

bradycardia

Front 121

_____ occurs normally in well trained athletes because the heart muscle is larger and more efficient, increasing stroke volume

Back 121

bradycardia

Front 122

pulse rate faster than 100 bpm

Back 122

tachycardia

Front 123

_____ is normal with anxiety and increased exercise

Back 123

tachycardia

Front 124

stroke volume x rate =

Back 124

cardiac output

Front 125

the amount of blood pumped into the aorta with each beat

Back 125

stroke volume

Front 126

this condition is common in children and young adults and occurs when the heart rate varies with the respiratory cycle, speeding up at the peak of inspiration, and slowing to normal with expiration

Back 126

sinus arrhythmia

Front 127

in this condition, inspiration momentarily causes a decreased stroke volume from the left side of the heart, causing the rate to increase to compensate

Back 127

sinus arrhythmia

Front 128

this characteristic of pulse is recorded on a three point scale

Back 128

force

Front 129

a value of 0 on the force scale for pulse rate =

Back 129

absent

Front 130

a value of +1 on the force scale for pulse rate =

Back 130

weak, thready

Front 131

a value of +2 on the force scale for pulse rate =

Back 131

normal

Front 132

a value of 3+ on the force scale for pulse rate =

Back 132

full, bounding

Front 133

normal newborn respirations (jarvis)

Back 133

30-40

Front 134

normal adult respirations (jarvis)

Back 134

10-20

Front 135

normal pulse to respirations ratio

Back 135

4:1

Front 136

force of blood pushing against the side of the blood vessel wall

Back 136

blood pressure

Front 137

maximum pressure felt on the artery during ventricular contraction

Back 137

systolic blood pressure

Front 138

ventricular contraction

Back 138

systole

Front 139

the elastic recoil, or resting, pressure that the blood exerts constantly between each contraction

Back 139

diastolic blood pressure

Front 140

the difference between the systolic and diastolic blood pressures

Back 140

pulse pressure

Front 141

the pressure forcing blood into the tissues, averaged over the cardiac cycle

Back 141

mean arterial pressure

Front 142

normal adult blood pressure

Back 142

120/80

Front 143

daily cycle of blood pressure in which the BP is highest in later afternoon/early evening, then declines to an early morning low

Back 143

diurnal rhythm

Front 144

the opposition to blood flow through the arteries

Back 144

peripheral vascular resistance

Front 145

when blood viscosity is thicker, blood pressure _____

Back 145

rises

Front 146

the width of the rubber bladder should equal _____ of the circumference of the arm

Back 146

40%

Front 147

the length of the bladder should equal _____ of the circumference of the arm

Back 147

80%

Front 148

using a cuff that is too narrow yields _____ BP results, because it takes extra pressure to compress the artery

Back 148

falsely high BP

Front 149

the period when korotkoff's sounds disappear during auscultation of blood pressure

Back 149

auscultatory gap

Front 150

a difference in BP of both arms of _____may indicate arterial obstruction on the side with the lower reading

Back 150

more than 10-15 mmHg

Front 151

a drop in systolic blood pressure of more than 20 mmHg or pulse increase of 20 bpm or more occurring with a quick change to standing position

Back 151

orthostatic hypotension

Front 152

physical appearance, body structure, mobility, response to stimuli, level of alertness, and parental bonding are key components of this section of the assessment of infants and children

Back 152

general survey

Front 153

this section of assessment for infants and children includes weight, length, head circumference

Back 153

measurement

Front 154

this section of health assessment for infants and children includes temperature, pulse, respirations, BP

Back 154

vital signs

Front 155

_____ increases in older adults, making the distinction between normal aging values and abnormal values difficult

Back 155

blood pressure

Front 156

aging causes decreases in _____ and _____ in relation to respirations, causing increased respiratory rate in older adults

Back 156

vital capacity and inspiratory reserve volume

Front 157

deficiency in growth hormone, causing retardation of growth, delayed puberty, hypothyroidism, adrenal insufficiency, causing pt to appear much younger than chronological age and have infantile features and chubbiness

Back 157

hypopituitary dwarfism

Front 158

excessive secretion of growth hormone by anterior pituitary, results in overgrowth of entire body causing increased height and weight and delayed sexual development

Back 158

gigantism

Front 159

excessive secretion of growth hormone in adulthood, causes overgrowth of bone in face, hands, feet, no change in height, internal organs may enlarge

Back 159

acromegaly / hyperpituitarism

Front 160

congenital skeletal malformation caused by genetic disorder in converting cartilage to bone, large head with frontal bossing, midplace hypoplasia, short stature and limbs, thoracic kyphosis, lumbar lordosis, abdominal protrusion

Back 160

achrondroplastic dwarfism

Front 161

serious psychological disorder, severe and life threatening weight loss, amenorrhea, fanatic concern about weight, aversion to food, distorted body image, starvation diets, frenetic exercise, perfectionism

Back 161

anorexia nervosa

Front 162

inherited connective tissue disorder, tall thin stature, arachnodactyly, hyperextensible joints, arm span greater than height, pubis to sole exceeding crown to pubis, early morbidity and mortality due to cardio complications

Back 162

marfan's syndrome

Front 163

excessive adrenocorticotropic hormone (ACTH), stimulates adrenal cortex to secrete excess cortisol, weight gain, edema, with central trunk and cervical obesity, round face, muscle wasting, weakness and thinness of arms and legs , reduced height, thinness and fragility of skin, purple abdominal striae, bruising, acne

Back 163

endogenous obesity/cushing's syndrome

Front 164

faster pulse, dizziness, diaphoresis, confusion, blurred vision, cool/clammy skin, are symptoms of this issue with blood pressure

Back 164

hypotension

Front 165

the degree of balance between nutrient intake and nutrient requirements

Back 165

nutritional status

Front 166

_____ initiates data collection and provides framework for nutrition monitoring and evaluation

Back 166

nutritional assessment

Front 167

the purpose of this assessment is to identify individual requirements, provide information for designing a nutrition plan, and establish baseline data

Back 167

nutritional assessment

Front 168

potential information gaps in this common method of obtaining dietary information are:

- inability to recall

- time frame may by atypical of usual intake

- alteration of the truth for many reasons

- snacks and condiments unaccounted for

Back 168

24 hour recall/24 hour food diary

Front 169

this is designed to convey information about the nutrition content of food in a standardized format which allows for comparison of foods

Back 169

nutrition labelling in canada

Front 170

%DV

Back 170

percent daily value

Front 171

the %DV on a nutrition label represents the needs of a healthy individual who consumes _____ calories daily

Back 171

2000-25000

Front 172

this value is used to express food content of nutrients

Back 172

percent daily value (%DV)