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Lecture 24

DST 614 Lecture 24: 87-Qs

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Disability Studies
DST 614

Assessment Exam Review 87 Qs 510 SATA, no multiple multiples Identifying some pictures doing, of?, a test, a lesion, ROM Fill in the blank FOCUS ON THE SYSTEM: i.e. respiratory, cardio, etc. know what falls under each system Fall semester = 11 Communication: Relational approach to nursing A lot of communication questions, best responses know how to communicate wpt.s, how to respond to things Priority and most appropriate health history Qs related to specific system, i.e. pt. in 3 trimester, has shortness of breath = normal, follow up Q = can you tell me about that shortness of breath Want openended Qs to determine priority now the best Q active listening Know which is the most urgent Q some may be all good, but need to determine PRIORITY Q Vital Signs: Know how to take BP pulse, temp result, how to, know auscultatory gap (how to), kortcoff sounds what they represent AND diff routes for temp why we would do the diff routes Know normal vitals and abnormal BP, RR, etc. Know abnormal and normal vitals throughout life span fetal older adults and pregnant woman know when you would be concerned and when you wouldnt be Know cultural and ethnic findings Pain assessment throughout the life span Neonatal behaviours: HR, movement Child wonbaker faces scale, hot and cold scales Head, neck, mouth, nose normal findings: what would a normal finding be? List of 45, know how to determine normal trachea and thyroid issues Breast assessment how to assess Tanner stages Development throughout lifespan Know how to conduct eye test know Snellen, know pupillary eye reflex, accommodation, 6 signs of cardinal gaze, NOT optomoscope => know how to conduct the tests, findings, normalabnormal and the involvement of CN Hearing test > whisper test, hearing assessment, hearing loss throughout life span and how to assess and what findings would indicate hearing loss Neurological memory, orientation, LOC things that would indicate neurological problems going on Winter semester MSK = 8 Heart and Neck vessels = 7 (FOCUS EXAM STUFF) o Angles of ROM o Know how to do carotid assessment correctly o Full and partial ROM o If you find something critical what would you do next o Normalabnormal i.e. 50, 80 degrees o Know where jugular vein is and findings: varies with respiration, ungulent o Lordosis, scolosis, kyphosis what were looking for, why is it occurring and diffused, 2 visible ways o Ex. Pregenant woman relaxation of joints o Pericardium inspection of anterior chest, o Iliac crests, base of shouldersscapula o Apical impulse (1x2 cm), heaves and lifts, what you are looking for, o Inspection Muscle atrophy, colour, etc. normal i.e. pregnant woman apical impulse: may be higher, may be 2x2 o Palpation muscle deformity, masses, etc. cm = concerning bc is a cardiac problem s o ROM, muscle testing grading o Know what heave or lift may indicate o Functional assessment how would you do that, questions to ask how it o Know tactile fremitus is related to ADLs o Valves assessment s1s2, extra heart sounds, murmurs: PRIORITY o Joint assessment S1S2 and then we listen for murmurs o Subjectiveobjective findings o Land marking the valves o ROM for ADLs brushing hair, reaching up, undoing bra, etc. o Normal variations across the lifespan o Be able to identify from pictures the ROM o 2 day old baby heart murmur not that concerning BUT if PV system = 7 o 2 day old baby turning blue w. intercostal retraction o Lymphatic sys. fall term stuff o why do pregnant women have murmurs increased blood flow, increased o Lymph node assessment 2 fingers, pressure, less than 1cm, non pressure tender, soft, movable, discrete o Know difference between innocent murmurs and definite murmurs o Know lymph nodes in relation to other areas too, not just head o When to refer to high level of care o Epitrochlear, ingonal regions o HEALTH PROMOTION who needs it the most? o PV and skin integrity o 4 clients come on who would take the priority o Edema o Bilateral Thorax and lungs = 8 o Cardiac o know how to do anterior and posterior assessments priority for either o Venous statsis side o Aterial ulcers o Trachea and thyroid issues o Varicous veins o changing breath sounds o Know what they each look like o collapsed lung displaced o Varicous veins assessment standing, press the top and bottom feel o concerned if occluded the blood coming down o respiratory muscles and functions throughout lifespan o PPE for wound assessment o babies nose breathers, increased RR, o What should you be looking for PV, venous and arterial distress use of intercostal muscles nasal flaring o Physical assessment how to? different trimester things for women o IPPA and when to change it up why youre changing it up older adults decreased compliance of thorax o Capillary refill what were assessing, how to do it correctly, when would o Know different trimester respiratory changes for pregnant woman this be critical o Outline developmental changes o Can we deal with it or do we need to refer them further o Findings rt cyanosis in people w. dark pigmented skin, pallor o Inguinal and epitrochlear lymph nodes o other things you might look at if you cant see o Assessing pulses o Inspect, palpate, percuss, auscultate what and where o What were looking for: rate, rhythm, force and BILATERAL! o Percussion: resonance, tymphany over stomach, dullness over liver, o Normalabnormal findings for pulses whats next hyperresonance if lungs overflated, dullness = mass, dull over spleen, Ex. Weak thread pulse 1+ what to do next? thicker chest wall = dull o Know diff. breath sounds, what they mean crackles, wheezing, striator o Most important technique = bilateral and auscultation o Crepitus diff than MSK bc it is air trapped under skin, feels like bubble wraprice krispeys popping under skin o Most relevant questions and most appropriate responses
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