NUR 2092 HEALTH ASSESSMENT FINAL EXAM Complete Solution Pa... - $35.45 Add To Cart
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NUR2092 Health Assessment Exam 2 Questions and Answers (2022-2023) If you are doing a cardiovascular assessment and you are hearing a bruit/swooshing soun... [Show More] ds in the patients carotid artery, what does this mean? -Narrow vessel (Most likely filled with plaque buildup) If you are doing a Snellen eye exam from 20 feet away what are you testing? -Farsided eye sight What are 4 things that the skin does? -Prevention of penetration, temperature regulation, absorbs Vitamin D and wound repair (repairs itself) What cannot the skin do? -Prevent the loss of fluids When you are doing a lung assessment you should listen from what direction to what direction? -Right to left What is the Jaeger card used for? -Testing nearsided eye sight If a mole on a patients skin has abnormal pigmentation and is itchy, at what size does the mole become suspicious? -6mm What are you listening for when listening to bowel sounds? -Gurgling If you do not hear any sounds after 1 minute of listening to bowel sounds, what do you do? -Listen for 4 more minutes for a total of 5 minutes. What is a hypoactive bowel sound? -A distant bowel sound (Likely constipation. Only hearing gurgles every 1-2 minutes) What is an indication if a patient has yellow skin? -Jaundice. A liver problem If you are palpating lymph nodes in front of the ear, what lymph nodes are you palpating? -Preoricular If you are doing an abdominal assessment and you only heat a few gurgles every 1-2 minutes, what should you suspect is going on with the patient? -Constipation What should you always ask a patient when doing an abdominal assessment? -When was your last bm (No bm in 3 days indicates constipation) What is cyanoisis? -No oxygen exchange Which of the following patients would take highest priority: Jaundice yellow skin, Pale skin and vomiting or Cyanotic? -Cyanotic (Patient is not getting proper amounts of oxygen exchange) What are some good assessment questions to ask someone that may be having an allergic reaction? -Have you been using any new soaps, lotions, detergent, etc. When assessing radial pulses, what is it important to do? -Assess one side to the other (Should feel both sides at same time to compare) What sounds will you hear while doing a lung assessment on a patient with an upper airway obstruction? -Stridor. This is an upper airway emergency! When resulting a TB skin test what would you be looking and feeling for if it was irregular? -Red, raised bump/wheal. Greater than 5mm is positive, pink patches What sounds will you hear while doing a lung assessment on a patient with a lower airway obstruction? -Wheezes How long should the skin take to turn back to pink when assessing capillary refill? -Less than 3 seconds (2 seconds or less) If capillary refill takes more than 2 seconds to turn from pink to white, what is this called? -Sluggish or slow If capillary refill takes less than 2 seconds to turn from white to pink, what is this called? -Brisk If doing an assessment you notice that the patient tonsils are touching their uvula, is this an abnormal or normal finding? -Abnormal (Tonsillitis) What should you do if you are testing a patients hearing acuity and gross hearing ability? -Have patient shut their eyes to hear better and so that they cannot see your hands. Rub your fingers next to their ear to assess. The patient must verbalize that they hear the sound of your fingers rubbing together. What order do you assess bowel sounds? -Look, listen, then feel/palpate Why must you listen to bowel sounds before palpating? -Always listen before touching because when you palpate, you can move things around in the abdomen and get a false assessment if listening right after. Which heart sound is the loudest? -S1 Where do you hear S1 heart sounds? -On the right side of the chest, 2nd intercostal space. What are you hearing when listening to S1? -Closure of AV valves. Mitral and biscuspid. Lub sound Where do you hear S2 heart sounds? -On the left side of the chest, 2nd intercostal space. What are you hearing when listening to S2? -Closure of SL valves. Aortic and Pulmonic. Dub sound Where can you hear both S1 and S2? -Erbs Point. Left side of chest, 4th intercostal space What are the 2 phases of the cardiac cycle? -Systole and Diastole In order to feel a patients carotid pulse, where must you feel? -Right by the SCM on the side of the neck. Do NOT feel both sides at the same time. When you are assessing a patients lung sounds, where are normal bronchovascular breath sounds heard? -Next to sternal border If a patient is SOB and cannot breathe while in a lying position what does this patient have? -Orthopnea How should a patient with orthopnea be positioned? -Sitting up with their arms up. (Tripod position) This expands their lungs to make breathing easier. What should you do if you feel an irregular radial pulse? -Listen to an apical heart rate for 1 full minute When doing a thoracic assessment what do you look for first? -Look for chest movement. Make sure that chest is expanding symmetrically. When you are percussing a patients back at the costoverterbral angle, what are you checking for? -Kidney tenderness What is it called when a patient is sitting upright and their jugular vein is enlarged? -Jugular Vein Distention (JVD) What does it mean if a patient has Jugular Vein Distention (JVD)? -Increased blood volume, generally congestive heart failure [Show Less]
NUR2092 Health Assessment Exam #1 COMPLETE SOLUTIONS Steps of the Nursing Process Correct Answer: Assessment - gather data Diagnosis - problem Outcom... [Show More] e Identification - goals, what we want to happen, expect to happen Planning - treatment plan, intervention Implementation - doing the plan Evaluation - Was it successful, meet the goals Define Subjective Data Correct Answer: What patient says about himself or herself during history taking symptoms Define Objective Data Correct Answer: Observed when inspecting, percussing, palpating, and auscultating patient during physical examination signs Factors of Diagnosis Correct Answer: -Cluster of data that seem to be associated in some way. -Validate data, confirm accuracy -Look for gaps in your information -Interpret data and identify problems -Document the diagnosis Factors of Outcome Identification Correct Answer: -Identify expected outcomes related to patient individualization -Ensure outcomes have the SMART components -Specify short-term and long-term goal measurement criteria What does SMART stand for? Correct Answer: Specific, Measurable, Attainable, Realistic, Timely Factors of Planning Correct Answer: -Establish priorities based on meeting patients care goals -Develop outcomes and set time frames for meeting outcomes -Identify relevant interventions and utilize interdisciplinary health care team members for the patient -Document plan of care Factors of Evaluation Correct Answer: -Refer to outcomes -Evaluate patient's condition and compare actual outcomes to expected outcomes -If reached outcome: does something need to be done -If NOT reached: identify reasons for not achieving -Modify plan if needed -Document in plan of care Evidence-Based Decision Making factors Correct Answer: -Best evidence from clinical review of research literature -The providers clinical expertise -Patient's preference and values -Physical examination and assessment of patient Focused Database Correct Answer: Problem-centered Used for a limited or short-term problem Smaller scope and more targeted than the complete database Complete Database Correct Answer: Includes a complete health history and full physical examination Yielding the first diagnosis Steps in Priority Problem Levels Correct Answer: 1. First-level priority: emergent, life threatening, immediate 2. Second- level: next in urgency, requires attention to prevent further deterioration 3. Third-Level: important to patient's health, but can be addressed after urgent problems What are the two parts to Communicating? Correct Answer: 1. Sending 2. Receiving In communication what are the two types in "sending"? Correct Answer: 1. Verbal: words/tone 2. Nonverbal: less conscious In communication, what does "receiving" mean? Correct Answer: Interpretation based on past experiences, culture, and self concept Physical and emotional state Communication does what with a patient? Correct Answer: -Builds a relationship -Builds rapport Key to Communication Correct Answer: Is the receiver getting the message the way it was intended? Active listening Types of questions in Therapeutic Communication Correct Answer: Open-ended: narrative answers, feelings and opinions, develops rapport Close-ended: yes/no questions, used for specific information, limits rapport In Therapeutic Communication, what are the types of responses focused on the client's frame of reference? Correct Answer: CLARIFICATION (rephrase) FACILITATION (nodding, Hmm,hmm) SILENCE (when to use) SUMMARIZE (summarize what pt stated) EMPATHY (likening to others, comfort, "I understand") In Therapeutic Communication, what are the types barriers? Correct Answer: AVOIDANCE LANGUAGE (using other words) CHANGING THE SUBJECT DISTANCING (walking to the door, avoid eye contact) BLAMING (if you didn't smoke...) FALSE REASSURANCE (you'll be fine) FAILURE TO LISTEN GIVING ADVICE Barriers in Communication include: Correct Answer: - lack of interest - physical barriers - patient's inability to hear you - safety - physiological barriers - language/use of medical jargon, or speaking above someone's educational level Substance Abuse Assessment Correct Answer: - Tolerance: carries from person to person - Watch for withdrawal symptoms - Dependence - Addiction Dependence vs Addiction Correct Answer: -Dependence: can be weeded off -Addiction: destructive behaviors with what you are doing Substance Abuse withdrawal symptoms: Correct Answer: - nausea/vomiting - tremor - paroxysmal sweats - anxiety - visual disturbances - headache - disorientation Alcohol Use assessment Correct Answer: - quick assessment: frequency use of alcohol, tobacco, prescription drug for nonmusical use, illicit drugs - AUDIT: Alcohol Use Disorders Identification Test - CAGE: Cut down, Annoyed, Guilty, Eye-opener CAGE questionnaire Correct Answer: Have you ever felt you should Cut down on your drinking? Have people Annoyed you by criticizing your drinking? Have you ever felt bad or Guilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves (Eye-opener)? Domestic Violence Assessment includes: Correct Answer: - need to ask every client needs to be assessed for the risk/evidence of abuse - use own words in nonjudgemental way - Abuse Assessment Screen - Walker's Cycle of Violence: tolerance, explosion, honeymoon Assessment of Intimate Partner Violence (IPV) Correct Answer: - HITS: hurt, insult, threaten, scream - 1-5 points: never to frequently - 10 or more: indicate IPV When should you report for Domestic Violence cases Correct Answer: children/elder adult- not required Warning signs of Human Trafficking include: Correct Answer: - injuries/signs of physical abuse - malnourished - disoriented - lack of identification - few personal belongings - avoids eye contact - minor appearing in relationship with older person - works long hours, lives in work environment - fearful, anxious, submissive - fearful of law enforcement - cannot freely contact friends/family Human Trafficking Screening factors: Correct Answer: - best to speak to client alone: try not to raise suspicions - treat each case as unique - assume victim is at risk of harm - do NOT start with sensitive questions - determine need for interpreter When Should You Do If You Suspect a Patient is a Human Trafficking Victim? Correct Answer: - Call 911 first then call the Human Trafficking Center - victim will need assistance with shelter, medical care, and legal - ICE has a Victim Assistance Program The General Survey Process: Correct Answer: 1. begin with first contact 2. general impressions of client (age, sex, LOC, skin color, facial features) 3. physical appearance (facial expression, speech, dress, hygiene 4. body structure (stature, nutrition, symmetry, posture, position, body build) 5. body movement (gait, ROM, assistive devices, involuntary movements) 6. emotional/mental status and behavior (mood/affect, speech, appropriate behavior for setting) Two primary components of Health History are: Correct Answer: 1. Health History - Subjective date 2. Physical Assessment - Objective data Components of Comprehensive Body System Health History: Correct Answer: - biographic data - reason for seeking care - present health status - past medical history - family history - personal and psychological history - review of body systems Biographic data includes: Correct Answer: name, address, birth date, gender, marital status, ethnic group, occupation, primary language, and source of info/reliability Reason for seeking care is commonly known as Correct Answer: the "chief complaint" this is in the patients words and ask what symptoms they are having Cause of Illness: Biomedical Correct Answer: diseases caused by bacteria, viruses involves scientific theories Cause of Illness: Magicoreligious Correct Answer: Illness caused by supernatural forces May use folk remedies Voodoo, Witchcraft, Faith-healing Cause of Illness: Naturalistic Correct Answer: Illness caused by loss of natural balance Yin/Yang flow of energy Mini-Cog Assessment Correct Answer: Four unrelated word test Repeat at 5 min, 10 min and 30 min Testing for Dementia and Alzheimer's Short-term memory dysfunction What does PQRSTU stand for? Correct Answer: Palliative(provocative), quality, radiate, severity, time, understanding Components of Past Health History Correct Answer: Child illnesses Accidents/injuries Operations/hospital stays Serious /chronic illnesses Obstetric history Immunizations Allergies Current medications Last examination date Components of Social History Correct Answer: Where do they live? Are they safe? Do they have clean water, heat, air-conditioning? Do they work, do they feel safe? Do they exercise? Review of Symptoms components Correct Answer: Be specific gives an opportunity to re-ask questions now that they are comfortable evaluate health promotion practices Factors that affect Nutritional Status Correct Answer: physiologic psychologic developmental cultural economic factors Assessing Nutritional Status methods Correct Answer: 24 hour recall food diary - most comprehensive food frequency typical food intake direct observation- % of food eaten Best Screening Tool for Dietary Intake Correct Answer: 24 hour recall method Nutritional assessment includes Correct Answer: Anthropometric measurements swallowing assessment lab tests Define mental status Correct Answer: Client's level of cognitive and emotional functioning a state of well being Delirium Correct Answer: Acute confusional change or loss of consciousness and perceptual disturbance that may accompany acute illness; usually resolves when underlying cause is treated Dementia Correct Answer: Gradual progressive process, causing decreased cognitive function even though the person is fully conscious and awake; not reversible Components of Mental Health Survey (ABCT) Correct Answer: Appearance Behavior Cognition Thought Process Primary, secondary, tertiary prevention Correct Answer: 1. Primary prevention-- aims to prevent disease BEFORE it occurs. (ex. seat belts, smoking education) 2. Secondary prevention-- aims to REDUCE impact of a disease or injury. (ex. screening for things early). 3. Tertiary prevention-- Aims to soften the impact of an ongoing illness or injury that has lasting effects. Help manage long term problems. (ex. cardiac rehabilitation programs). How does the data base vary according to clinical setting? Correct Answer: It could be complete, focused or problem-centered, follow-up, or emergency (quick assessment to provide immediate care) 4 assessment techniques Correct Answer: Inspection Pulsation Percussion Auscultation Nociceptive pain Correct Answer: Triggered by events outside the nervous system from actual trauma or tissue damage Acute Responsive to opiates/anti-inflamatories Neuropathic Pain Correct Answer: Abnormal processiing from injury to nerve fiber or CNS chronic Poorly responsive to pain medications Pain assessment tools Correct Answer: Numeric rating scales Wong baker FACES FLACC (under 3 years old) CRIES (pre term infants) PAINAD (dementia) Phantom Pain Correct Answer: Pain that feels like it is coming from a body part that has been amputated. Breakthrough Pain Correct Answer: Severe pain that erupts while a patient is already medicated with long-acting painkiller Referred Pain Correct Answer: Felt at a particular site but originates from another location. Both sites are innervated by the same spinal nerve, and it is difficult for the brain to differentiate the point of origin. For example, left arm pain for heart attack. Chronic Pain Behaviors Correct Answer: Bracing, Rubbing, Diminished activity, Change in appetite, Adaptation, Often little indication, Self distribution Acute Pain Behaviors Correct Answer: Grimacing or other facial expressions Bracing or holding injured area Rocking Changes in activity Limping Culture Correct Answer: Customs, beliefs and attitudes that distinguishes one group of people from another. Transmited through language, material objects, ritual, institutions and art, from one generation to the next Ethnicity Correct Answer: Relating to races or large groups of people who have the same customs, religion, origin and culture Acculturation Correct Answer: adapting to and acquiring another culture Assimilation Correct Answer: minority group takes on culture of the dominant culture two way process Biculturalism Correct Answer: divided loyalty identifies with two cultures Ethnocentrism Correct Answer: Belief in the superiority of one's belief or way on life Race Correct Answer: identification of individuals or groups by shared genetics heritage and biological or physical characteristics Material vs. Nonmaterial Correct Answer: material: things you can touch non material: verbal, non verbal language, beliefs, customs, social structures Cultural Competence methods Correct Answer: know self, understand own heritage know the cultures in your area avoid stereotyping be aware of your biases/prejudices learn new communication skills Palpation Correct Answer: process of using one's hands to examine the body [Show Less]
NUR 2092 Health Assessment Final Exam • The nurse is preparing to conduct a health history. Explain this to the patient. Answer: The purpose of a ... [Show More] health history is to provide a database of subjective information about the patient's past and current health history. You might say to the patient, "I will be asking you questions about your past and present health." This information will help the provider along with the physical exam (objective data) to develop a diagnosis or health status. • The nurse is evaluating the reliability of a patient's responses, which of these statements would be correct? The patient: Provided consistent information and therefore is reliable • A patient tells the nurse that she has had abdominal pain for the past week. What would be the nurse's best response? "Can you point to where it hurts?" • Describe a genogram. Graphic family tree that uses symbols to depict the gender, relationship, and age of immediate family. Usually 3 generations- parents, grandparents, siblings. Also highlight the health of close family members and more details such as communicable disease, environmental hazards (smoke), tobacco use, and alcohol use. Any additional information includes the family history. • The nurse is obtaining health history on an 87-year-old woman. Which of the following areas of questioning would be most useful at this time? Current health promotion activities. • A 90-year-old patient tells the nurse that he cannot remember the names of the medication he is taking or why he is taking them. An appropriate response from the nurse would be? Would you have a family member bring in your medications please? • The nurse is performing a functional assessment on an 82-year-old patient who recently had a stroke. Which of these questions would be most important to ask? "Are you able to dress yourself?" • A patient is describing his symptoms to the nurse. Which of these statements reflects a description of the setting of his symptoms? "This pain happens every time I sit down to use the computer." • During a physical examination, a 45-year-old woman states that she has had a crusty, itchy rash on her breast for approximately 2 weeks. In trying to find the cause of the rash, which questions would be important for the nurse to ask? Where did the rash first appear- on the nipple, areola, or the surrounding skin? When did you first notice this? • During an annual physical examination, a 43-year-old patient states that she does not perform monthly breast self-examinations (BSEs). She tells the nurse that she believes that mammograms "do a much better job than I ever could to find a lump." The nurse should explain to her that: Breast self-exams may detect lumps that appear between mammograms • List risk factors for breast cancer 1) History of breast cancer - family history—first-degree relative 2) Medications such as estrogen and progestin combined 3) Certain tumor suppressor genes called BRCA1 and BRCA2 (inherited mutation) 4) Age • During an examination of a woman, the nurse notices that her left breast is slightly larger than her right breast. Which of these statements is true about this finding? Asymmetry is not unusual, but the nurse should verify that this change is not new • During the physical examination, the nurse notices that a female patient has an inverted left nipple. Which statement regarding this is most accurate? Whether the inversion is a recent change should be determined. • The nurse is performing a breast examination. Which of these statements best describes the correct procedure to use when screening for nipple and skin retraction during a breast examination? Have the woman: Slowly lift her arms above her head, and note any retraction or lag in movement. • The nurse is palpating a female patient's breasts during an examination. Which of these positions is most likely to make significant lumps more distinct during breast palpation? Supine with the arms raised over the head • The nurse is conducting a class on BSE. Which of these statements indicates the proper BSE technique? The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period. • The nurse is preparing to teach a woman about BSE. Which statement by the nurse is correct? "BSE on a monthly basis will help you become familiar with your own breasts and feel their normal variations." • A 55-year-old postmenopausal woman is being seen in the clinic for her annual examination. She is concerned about changes in her breasts that she has noticed over the past 5 years. She states that her breasts have decreased in size and that the elasticity has changed so that her breasts seem "flat and flabby." The nurse's best reply would be: The decrease in hormones after menopause causes atrophy of the glandular tissue in the breast and is a normal process of aging. • In performing a breast examination, the nurse knows that examining the upper outer quadrant of the breast is especially important. The reason why is... This is the location for most breast tumors. • In performing an assessment of a woman's elixir lymph system, the nurse should assess which of these nodes? Central, lateral, pectoral, and subscapular. The breast has extensive lymphatic drainage, 75% of the drainage drains into the axillary nodes. There are groups of axillary nodes central, pectoral and subscapular. • A 65-year-old patient remarks that she just cannot believe that her breasts "sag so much". She states it must be from a lack of exercise. What explanation should the nurse offer her? After menopause: The glandular and fat tissue atrophies, causing breast size and elasticity to diminish, resulting in sagging (flat and gabby) breasts. • In examining a 70-year-old male patient, the nurse notices that he has bilateral gynecomastia. Which of the following describes the nurse's best course of action? Explain that this is the result of hormonal changes (testosterone) and recommend a visit to their provider. • During a breast health interview, a patient states that she has noticed pain in her left breast. The nurse's most appropriate response to this would be: To seek more specific information about the pain, such as: When did you first notice it? Is the pain localized or all over? Is it painful to touch? Is the pain in relation to your menstrual cycle? Is the pain associated with activity or exercise? • A 43-year-old woman is at the clinic for a routine examination. She reports that she has had a breast lump in her right breast for years. Recently, it has begun to change in consistency and is becoming harder. She reports that 5 years ago her physician evaluated the lump and determined that it "was nothing to worry about." The examination validates the presence of a mass in the right upper outer quadrant at 1 o'clock, approximately 5 cm from the nipple. It is firm, mobile, and non-tender, with borders that are not well defined. The nurse replies: Because of the change in consistency of the lump, it should be further evaluated by the physician. • The nurse is discussing BSEs with a postmenopausal woman. The best time for postmenopausal women to perform BSEs is? On the same day every month. • During a discussion about BSEs with a 30-year-old woman, what statement by the nurse is most appropriate? Examine your breast shortly after your menstrual period each month. • Peau d' orange- Lymphatic obstruction causes edema, which thickens the skin and exaggerates the hair follicles; this creates a pigskin or orange peel look. Could be an indication of cancer. • Dullness- A high-pitched muffled thud sound obtained by percussing over relatively dense organs such as liver or spleen, distended bladder, mass of adipose tissue • Tympany- A high-pitchedmusical and drum like note obtained by percussing the surface of a large air-containing space, such as the abdomen • Resonance- A low-pitched, clear, hollow note obtained by percussing over normal lung tissue • Hyperresonance- A low-booming note obtained by percussing over the adult lungs that have increased air such as with a patient who has emphysema, present with distended abdomen • Which structure is located in the left lower quadrant of the abdomen? Sigmoid colon • Aneurysm- defect or sec formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defect (aortic aneurysm) • Dysphasia- Difficulty swallowing • Anorexia- Loss of appetite • Ascites abnormal accumulation of serous fluid within the peritoneal cavity, associated with heart failure, cirrhosis, cancer or portal hypertension • Bruit- blowing, swoishing sound her through a stethoscope when an artery is partially occluded • Hepatomegaly- abnormally enlarged liver • Paralytic ileus- complete absence of peristaltic movement that may follow abdominal surgery or complete bowel obstruction • Peritonitis- inflammation of the peritoneum • Nurse suspects a patient has a distended bladder. How should the nurse assess? Percuss and palpate the midline area above the suprapubic bone. • The nurse is aware that one change that may occur in the gastrointestinal system of an aging adult is: Decreased gastric acid secretion. • A patient has hypoactive bowel sounds. The nurse knows that a potential cause of hypoactive bowel sounds is: Peritonitis, • A 29-year-old woman tells the nurse that she has "excruciating pain" in her back. Which would be the nurse's appropriate response to the woman's statement? "How would you say the pain affects your ability to do your daily activities?" • A patient tells the nurse that he is allergic to penicillin. What would be the nurse's best response to this information? "Describe what happens (or the reaction) to you when you take Penicillin." • Stroke or Cerebrovascular Accident (CVA)- Blood flow is interrupted to a part of the brain, the most common type is an ischemic stroke (when a blood clot blocks a blood vessel in the brain) and less common is a hemorrhagic ( a blood vessel in the brain ruptures and causes bleeding). • Common symptoms of a stroke: • Weakness or numbness in the face, arms, or legs, especially when it is on one side of the body • Confusion, trouble speaking or understanding • Changes in vision such as blurry vision or partial complete loss of vision in one or both eyes • Trouble walking, dizziness, loss of balance, or coordination • Severe headache with no reason or explanation Paresis, Paraplegia, Quadriplegia, Hemiplegia • paresis--weakness of muscles rather than paralysis • paraplegia--symmetric paralysis of both lower extremities • quadriplegia--paralysis of all four extremities • hemiplegia--paralysis of one side of the body • Symptoms of Meningeal Inflammation- Sudden fever, stiff neck, severe headache different than normal, nausea and vomiting, seizures, sleepiness, sensitivity to light • The nurse notices that a patient's palpebral fissures are not symmetric. On examination, the nurse may find that damage has occurred to which cranial nerve (CN)? Cranial Nerve 7- Facial • A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The nurse suspects damage to CN and proceeds with the examination by . Cranial Nerve 11- Accessory; asking the patient to shrug her shoulders against resistance • A patient says that she has recently noticed a lump in the front of her neck below her "Adam's apple" that seems to be getting bigger. During the assessment, the finding that leads the nurse to suspect that this may not be a cancerous thyroid nodule is that the lump (nodule): Mobile and not hard 98. 4 areas of the body where lymph nodes are accessible: Head and neck, arms, inguinal area, and axillae 99. A patient, an 85-year-old woman, is complaining about the fact that the bones in her face have become more noticeable. What explanation should the nurse give her? More noticeable facial bones are probably due to a combination of factors related to aging, such as decreased elasticity, subcutaneous fat, and moisture in her skin. • A patient has come in for an examination and states, "I have this spot in front of my ear lobe on my cheek that seems to be getting bigger and is tender. What do you think it is?" The nurse notes swelling below the angle of the jaw and suspects that it could be an inflammation of his: Parotid gland • A patient's thyroid gland is enlarged, and the nurse is preparing to auscultate the thyroid gland for the presence of a bruit. A bruit is a sound that is heard best with the of the stethoscope. Soft, whooshing, pulsatile; bell • A patient visits the clinic because he has recently noticed that the left side of his mouth is paralyzed. He states that he cannot raise his eyebrow or whistle. The nurse suspects that he has: CVA or stroke • During an examination of a female patient, the nurse notes lymphadenopathy and suspects an acute infection. Acutely infected lymph nodes would be: Firm but freely movable • The nurse has just completed a lymph node assessment on a 60- year-old healthy female patient. The nurse knows that most lymph nodes in healthy adults are normally: Nonpalpable • During an examination, the nurse knows that the best way to palpate the lymph nodes in the neck is described by which statement? Using gentle pressure, palpate with both hands to compare the two sides • Visual accommodation- Pupillary constriction when looking at a near object • A patient has a normal pupillary light reflex. The nurse recognizes that this reflex indicates that: Constriction of both pupils occurs in response to bright light • A patient's vision is recorded as 20/30 when the Snellen eye chart is used. The nurse interprets these results to indicate that: The patient can read at 20 feet what a person with normal vision can read at 30 feet. [Show Less]
NUR2092: Health Assessment Exam Study Guide for 2022-2023 Module 1: Chapter 1: Evidence Based Assessment Assessment: Point of Entry in an Ongoing... [Show More] Process Subjective data ➢ What patient says about himself or herself during history taking Objective data ➢ Observed when inspecting, percussing, palpating, and auscultating patient during physical examination Database ➢ Formed from these elements, plus patient’s record and laboratory studies Steps of the Nursing Process: 1. Assessment 2. Diagnosis 3. Outcome Identification 4. Planning 5. Implementation 6. Evaluation Nursing process: Critical Thinking systematically ❖ Assessment ❖ Diagnosis / analysis ❖ Plan ❖ Interventions ❖ Evaluations Nursing Process: Assessment ❖ Collection of data from multiple sources ➢ Review of clinical record ➢ Interview ➢ Health history ➢ Physical examination ➢ Functional assessment • Activities of daily living ➢ Cultural and spiritual assessment ➢ Consultation ➢ Review of the literature Nursing Process: Diagnosis ❖ Interpretation of data by identifying clusters of cues so as to make inferences ❖ Compare clusters of cues with definitions and defining characteristics ❖ Validation of inferences based on findings ❖ Identify related factors ❖ Document the diagnosis Nursing Process: Outcome Identification ❖ Identify expected outcomes related to patient individualization ❖ Ensure outcomes are realistic and measurable ❖ Specify short-term and long-term goal measurement criteria Nursing Process: Planning ❖ Establish priorities based on meeting identified patient care goals 51 Develop outcomes and set time frames for meeting proposed outcomes ❖ Identify relevant interventions and utilize interdisciplinary health care team members in the care planning process for the patient ❖ Document plan of care Question The nurse has a “hunch” that the patient’s elevated blood pressure is due to pain level; however, the patient received blood pressure and pain medication 45 minutes ago. What should the nurse consider in regards to this hunch? 1. Research supports that the pain and blood pressure medications will take 30 minutes to become effective. The nurse should wait until the next prescribed time and reevaluate pain level 2. The nurse should consider consulting with the pain management team to evaluate the effectiveness of the pain medication regimen. 3. The nurse should disregard the hunch because hunches are not effective at incorporating evidence-based practices 4. The nurse should administer pain medication based on the hunch Correct Answer: 2 Nursing Process: Implementation ❖ Determine patient readiness and involve patient(s) in health care process ❖ Review planned interventions with interdisciplinary health care team members to facilitate collaborative effort ❖ Utilize principles of delegation, being mindful of supervision and evaluation ❖ Counsel person and significant others ❖ Refer for continuing care ❖ Document care provided Nursing Process: Evaluation ❖ Refer to established outcomes ❖ Evaluate individual’s condition and compare actual outcomes with expected outcomes ❖ Summarize results of evaluation ❖ Identify reasons for failure to achieve expected outcomes ❖ Take corrective action to modify plan of care ❖ Document evaluation in plan of care Critical Thinking Principles ❖ Proceed through sequential steps from novice to expert ➢ Incorporation of experience provides foundation for development of clinical practice ❖ Utilize a multidimensional thinking approach to interpret data ➢ Use an organized, systematic assessment format ❖ Validate and confirm findings based on nonjudgmental interpretation of data ➢ Check and corroborate accuracy and reliability of data ❖ Cluster data information to support evidence as well as rule out inconsistent clinical findings in terms of differential diagnosis ➢ Distinguish relevant signs and symptoms Priority Problems Level ❖ First-level priority ➢ Emergent, life threatening, and immediate ❖ Second-level priority ➢ Next in urgency, requiring attention so as to avoid further deterioration ❖ Third-level priority ➢ Important to patient’s health but can be addressed after more urgent problems are addressed ❖ Collaborative problems ➢ Approach to treatment involves multiple disciplines Problems and Outcomes ❖ Identify patient outcomes and delineate measurable goals ➢ Qualify short-term and long-term goals that are realistic and patient centered ❖ Include evaluation methods that will allow for validation of results or adjustments to care planning ➢ Incorporation of planning methods is a critical element in the delivery of care ❖ Continuously evaluate the plan of care ➢ Analyze and implement changes as needed in order to maintain pathway toward goal achievement Comprehensive Plan of Care ❖ Evaluate and update plan ❖ Record revised plan and keep it up-to-date ❖ Communicate revised plans to multidisciplinary team ❖ Be aware that this is a legal document, and accurate recording is important for evaluation, insurance reimbursement, and research Evidence-Based Assessment ❖ Current and best clinical practice based on research standards focused on systematic reviews of randomized clinical trials (RCTs) ❖ Utilizing evidenced-based practice (EBP) in conjunction with provider experience will lead to better health outcomes for patients ❖ Fostering a “culture of EBP” at both the undergraduate and graduate levels will assist health educators to make EBP the “gold standard” of practice Question What is the best electronic resource for incorporating evidence-based practice into health assessment? 1. Wikipedia.org 2. Nursingworld.org. 3. Mayoclinic.com 4. WebMD.com Correct Answer: 2 Collecting Four Types of Data ❖ Complete total health database ➢ Includes complete health history and full physical examination ➢ Describes current and past health state and forms baseline to measure all future changes ➢ Yields first diagnoses Episodic or problem-centered database ➢ For limited or short-term problems ➢ Collect “mini” database, smaller scope and more focused than complete database ➢ Concerns mainly one problem, one cue complex, or one body system ➢ History and examination follow direction of presenting concern Collecting Four Types of Data (Cont.) ❖ Follow-up database ➢ Status of all identified problems should be evaluated at regular and appropriate intervals ➢ Note changes that have occurred ➢ Evaluate whether problem is getting better or worse ➢ Identify coping strategies being used ❖ Emergency database ➢ Rapid collection of data, often compiled concurrently with lifesaving measures ➢ Diagnosis must be rapid and comprehensive in nature Expanding the Concept of Health ❖ Assessment: collection of data about an individual’s health state ❖ A clear idea of health is important because it determines assessment data to be collected Holistic Model of Health ❖ Mind, body and spirit are interdependent and function as a whole ❖ Multifaceted basis of disease ❖ Individual and human environment are open systems ❖ Expanded assessment factors such as lifestyle behaviors, culture and values, family and social roles, self-care behaviors, job-related stress, developmental tasks, failures and frustrations of life ❖ Health promotion and disease prevention form the core of nursing Healthy People 2020 Web Site ❖ http://www.healthypeople.gov/ ❖ Review the tabs at the top of the website Healthy People 2020 Goals ❖ Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. ❖ Achieve health equity, eliminate disparities, and improve the health of all groups. ❖ Create social and physical environments that promote good health for all. ❖ Promote quality of life, healthy development, and healthy behaviors across all life stages Frequency of Assessment ❖ Interval of assessment varies with illness and wellness needs ➢ Ill people seek care because of pain or abnormal signs and symptoms ➢ This prompts an assessment: gathering a complete, episodic, or emergency database • Screening history for dietary intake, physical activity, tobacco/alcohol/drug use, and sexual practices • Counseling for injury prevention, substance use, sexual behavior, diet and exercise, and dental health Frequency of Assessment (Cont.) ❖ Routine periodic examination might include the following services for preventive health care: ➢ Screening history for dietary intake, physical activity, tobacco/alcohol/drug use, and sexual practices ➢ Counseling for injury prevention, substance use, sexual behavior, diet and exercise, and dental health ➢ Immunizations ➢ Chemoprophylaxis for multivitamin with folic acid for females capable of or planning pregnancy Frequency of Assessment (Cont.) ❖ For well persons, opinions are changing about assessment intervals ➢ Annual checkup is vague: What does it constitute? Is it necessary? Does it sometimes give an implicit promise of health and thus provide false security? ➢ Timing of formerly accepted procedures is now variable: for example, annual Pap tests ➢ Same annual routine physical examination cannot be recommended for all persons because health priorities vary among individuals, age groups, and risk categories Assessment through the Life Cycle ❖ Age-specific charts for periodic health examinations are a positive approach to health assessment ➢ Define lifetime schedule of health care, organized into packages for four specific age groups ➢ Each chart lists a frequency schedule for periodic health visits and preventive services for age group • These services include screening factors to gather during the history, and age-specific items for physical examination and laboratory procedures, counseling topics, and immunizations Assessment through the Life Cycle (Cont.) ❖ Age-specific charts focus on major risk factors specific for each age group based on lifestyle, health needs, and problems ➢ Shift emphasis from an annual physical examination toward rational and varying periodicity ➢ Incorporate health promotion and disease prevention at every health visit, not just at one annual physical examination ➢ Health education and counseling are highlighted as means to promote health Cross-Cultural Care Concepts ❖ A holistic model of health care assessment must include culture ❖ Inclusion of heritage assessment is of paramount importance to gather meaningful data and intervene with culturally sensitive and appropriate care ➢ With the rapid increases in numbers of individuals from diverse cultural backgrounds in the United States, a concern for the cultural beliefs and practices of people is increasingly important in health care Cross-Cultural Care Principles A serious conceptual problem arises as nurses and physicians are expected to know, understand, and meet health needs of people from culturally diverse backgrounds without formal preparation for doing so ❖ International interchanges are increasing among nurses and physicians, making attention to cultural aspects of health and illness an even greater priority High-Level Assessment Skills ❖ Attention to life cycle, holism, and culture must not detract from the importance of assessment skills themselves ❖ Assessment skills require hands-on expertise refined to a high level ➢ The nurse is the first and often only health professional to see an individual in many communities ➢ The nurse is the only health professional continually present at bedside in hospitals Cost Containment Principles ❖ Efforts at cost containment result in hospital populations composed of people with increased acuity, shorter stays, and earlier discharges than in the past ➢ Nurses must make faster, more efficient assessments ➢ Nurses required to go people’s homes for follow-up assessment and diagnosis ➢ First-rate assessment skills grounded in holistic approach and knowledge of age-specific problems are required Healthfinder.gov ❖ A BOLD new initiative from the USDHHS, Center for Disease Control, Centers for Medicaid and Medicare, Food and Drug Administration and NIH. to help Americans live longer, better and healthier lives. nih.gov advances ❖ NIH-supported research has led to: ❖ Death rates from heart disease and stroke fell by 40% and 51%, respectively, between 1975 and 2000. ❖ Overall 5-year survival rate for childhood cancers rose to nearly 80% during the 1990s from under 60% in the 1970s. ❖ Number of AIDS-related deaths fell by about 70% between 1995 and 2001. ❖ Sudden infant death syndrome rates fell by more than 50% between 1994 and 2000. ❖ Infectious diseases—such as rubella, whooping cough, and pneumococcal pneumonia—that once killed and disabled millions of people are now prevented by vaccines. nih.gov more advances ❖ Quality of life Americans suffering with depression has improved due to more effective medication and psychotherapy. ❖ The sequencing of the human genome set a new course for developing ways to diagnose and treat diseases like cancer, Parkinson's Disease and Alzheimer's Disease. ❖ In response to the anthrax attacks of 2001, the NIH launched and expanded research to prevent, detect, diagnose, and treat diseases caused by potential bioterrorism agents. What else have we done? ❖ New and improved imaging techniques let scientists painlessly look inside the body and detect disease in its earliest stages when it is often most effectively treated. ❖ Progress in understanding the immune system may lead to new ways to treat and cure diabetes, arthritis, asthma and allergies. ❖ New, more precise ways to treat cancer are emerging, such as drugs that zero in on abnormal proteins in cancer cells. ❖ Novel research methods are being developed that can identify the causes of outbreaks, such as Severe Acute Respiratory Syndrome (SARS), in weeks rather than months or years Lab Book Practice Questions: 1. The concept of health and healing has evolved in recent years. Which is the best description of health? a. Health is the absence of disease. b. Health is a dynamic process toward optimal functioning. c. Health depends on an interaction of mind, body, and spirit within the environment. d. Health is the prevention of disease. 2. Which would be included in the database for a new patient admission to a surgical unit? a. All subjective and objective data gathered by a health practitioner from a patient b. All objective data obtained from a patient through inspection, percussion, palpation, and auscultation c. A summary of a patient’s record, including laboratory studies d. All subjective and objective, and data gathered from a patient and the results of any laboratory or diagnostic studies completed 3. You are reviewing assessment data of a 45-year-old male patient and note pain of 8 on a scale of 10, labored breathing, and pale skin color on the electronic health record. This documentation is an example of: a. Hypothetical reasoning b. Diagnostic reasoning c. Data cluster d. Signs and symptoms 4. A patient is in the emergency department with nausea and vomiting. Which would you include in the database? a. A complete health history and full physical examination b. A diet and GI history c. Previously identified problems d. Start collection of data in conjunction with lifesaving measures 5. A patient has recently received health insurance and would like to know how often he should visit the provider. How do you respond? [Show Less]
NUR2092: Health Assessment Exam Study Guide for 2022-2023 Module 1: Chapter 1: Evidence Based Assessment Assessment: Point of Entry in an Ongoing... [Show More] Process Subjective data ➢ What patient says about himself or herself during history taking Objective data ➢ Observed when inspecting, percussing, palpating, and auscultating patient during physical examination Database ➢ Formed from these elements, plus patient’s record and laboratory studies Steps of the Nursing Process: 1. Assessment 2. Diagnosis 3. Outcome Identification 4. Planning 5. Implementation 6. Evaluation Nursing process: Critical Thinking systematically ❖ Assessment ❖ Diagnosis / analysis ❖ Plan ❖ Interventions ❖ Evaluations Nursing Process: Assessment ❖ Collection of data from multiple sources ➢ Review of clinical record ➢ Interview ➢ Health history ➢ Physical examination ➢ Functional assessment • Activities of daily living ➢ Cultural and spiritual assessment ➢ Consultation ➢ Review of the literature Nursing Process: Diagnosis ❖ Interpretation of data by identifying clusters of cues so as to make inferences ❖ Compare clusters of cues with definitions and defining characteristics ❖ Validation of inferences based on findings ❖ Identify related factors ❖ Document the diagnosis Nursing Process: Outcome Identification ❖ Identify expected outcomes related to patient individualization ❖ Ensure outcomes are realistic and measurable ❖ Specify short-term and long-term goal measurement criteria Nursing Process: Planning ❖ Establish priorities based on meeting identified patient care goals 51 Develop outcomes and set time frames for meeting proposed outcomes ❖ Identify relevant interventions and utilize interdisciplinary health care team members in the care planning process for the patient ❖ Document plan of care Question The nurse has a “hunch” that the patient’s elevated blood pressure is due to pain level; however, the patient received blood pressure and pain medication 45 minutes ago. What should the nurse consider in regards to this hunch? 1. Research supports that the pain and blood pressure medications will take 30 minutes to become effective. The nurse should wait until the next prescribed time and reevaluate pain level 2. The nurse should consider consulting with the pain management team to evaluate the effectiveness of the pain medication regimen. 3. The nurse should disregard the hunch because hunches are not effective at incorporating evidence-based practices 4. The nurse should administer pain medication based on the hunch Correct Answer: 2 Nursing Process: Implementation ❖ Determine patient readiness and involve patient(s) in health care process ❖ Review planned interventions with interdisciplinary health care team members to facilitate collaborative effort ❖ Utilize principles of delegation, being mindful of supervision and evaluation ❖ Counsel person and significant others ❖ Refer for continuing care ❖ Document care provided Nursing Process: Evaluation ❖ Refer to established outcomes ❖ Evaluate individual’s condition and compare actual outcomes with expected outcomes ❖ Summarize results of evaluation ❖ Identify reasons for failure to achieve expected outcomes ❖ Take corrective action to modify plan of care ❖ Document evaluation in plan of care Critical Thinking Principles ❖ Proceed through sequential steps from novice to expert ➢ Incorporation of experience provides foundation for development of clinical practice ❖ Utilize a multidimensional thinking approach to interpret data ➢ Use an organized, systematic assessment format ❖ Validate and confirm findings based on nonjudgmental interpretation of data ➢ Check and corroborate accuracy and reliability of data ❖ Cluster data information to support evidence as well as rule out inconsistent clinical findings in terms of differential diagnosis ➢ Distinguish relevant signs and symptoms Priority Problems Level ❖ First-level priority ➢ Emergent, life threatening, and immediate ❖ Second-level priority ➢ Next in urgency, requiring attention so as to avoid further deterioration ❖ Third-level priority ➢ Important to patient’s health but can be addressed after more urgent problems are addressed ❖ Collaborative problems ➢ Approach to treatment involves multiple disciplines Problems and Outcomes ❖ Identify patient outcomes and delineate measurable goals ➢ Qualify short-term and long-term goals that are realistic and patient centered ❖ Include evaluation methods that will allow for validation of results or adjustments to care planning ➢ Incorporation of planning methods is a critical element in the delivery of care ❖ Continuously evaluate the plan of care ➢ Analyze and implement changes as needed in order to maintain pathway toward goal achievement Comprehensive Plan of Care ❖ Evaluate and update plan ❖ Record revised plan and keep it up-to-date ❖ Communicate revised plans to multidisciplinary team ❖ Be aware that this is a legal document, and accurate recording is important for evaluation, insurance reimbursement, and research Evidence-Based Assessment ❖ Current and best clinical practice based on research standards focused on systematic reviews of randomized clinical trials (RCTs) ❖ Utilizing evidenced-based practice (EBP) in conjunction with provider experience will lead to better health outcomes for patients ❖ Fostering a “culture of EBP” at both the undergraduate and graduate levels will assist health educators to make EBP the “gold standard” of practice Question What is the best electronic resource for incorporating evidence-based practice into health assessment? 1. Wikipedia.org 2. Nursingworld.org. 3. Mayoclinic.com 4. WebMD.com Correct Answer: 2 Collecting Four Types of Data ❖ Complete total health database ➢ Includes complete health history and full physical examination ➢ Describes current and past health state and forms baseline to measure all future changes ➢ Yields first diagnoses Episodic or problem-centered database ➢ For limited or short-term problems ➢ Collect “mini” database, smaller scope and more focused than complete database ➢ Concerns mainly one problem, one cue complex, or one body system ➢ History and examination follow direction of presenting concern Collecting Four Types of Data (Cont.) ❖ Follow-up database ➢ Status of all identified problems should be evaluated at regular and appropriate intervals ➢ Note changes that have occurred ➢ Evaluate whether problem is getting better or worse ➢ Identify coping strategies being used ❖ Emergency database ➢ Rapid collection of data, often compiled concurrently with lifesaving measures ➢ Diagnosis must be rapid and comprehensive in nature Expanding the Concept of Health ❖ Assessment: collection of data about an individual’s health state ❖ A clear idea of health is important because it determines assessment data to be collected Holistic Model of Health ❖ Mind, body and spirit are interdependent and function as a whole ❖ Multifaceted basis of disease ❖ Individual and human environment are open systems ❖ Expanded assessment factors such as lifestyle behaviors, culture and values, family and social roles, self-care behaviors, job-related stress, developmental tasks, failures and frustrations of life ❖ Health promotion and disease prevention form the core of nursing Healthy People 2020 Web Site ❖ http://www.healthypeople.gov/ ❖ Review the tabs at the top of the website Healthy People 2020 Goals ❖ Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. ❖ Achieve health equity, eliminate disparities, and improve the health of all groups. ❖ Create social and physical environments that promote good health for all. ❖ Promote quality of life, healthy development, and healthy behaviors across all life stages Frequency of Assessment ❖ Interval of assessment varies with illness and wellness needs ➢ Ill people seek care because of pain or abnormal signs and symptoms ➢ This prompts an assessment: gathering a complete, episodic, or emergency database • Screening history for dietary intake, physical activity, tobacco/alcohol/drug use, and sexual practices • Counseling for injury prevention, substance use, sexual behavior, diet and exercise, and dental health Frequency of Assessment (Cont.) ❖ Routine periodic examination might include the following services for preventive health care: ➢ Screening history for dietary intake, physical activity, tobacco/alcohol/drug use, and sexual practices ➢ Counseling for injury prevention, substance use, sexual behavior, diet and exercise, and dental health ➢ Immunizations ➢ Chemoprophylaxis for multivitamin with folic acid for females capable of or planning pregnancy Frequency of Assessment (Cont.) ❖ For well persons, opinions are changing about assessment intervals ➢ Annual checkup is vague: What does it constitute? Is it necessary? Does it sometimes give an implicit promise of health and thus provide false security? ➢ Timing of formerly accepted procedures is now variable: for example, annual Pap tests ➢ Same annual routine physical examination cannot be recommended for all persons because health priorities vary among individuals, age groups, and risk categories Assessment through the Life Cycle ❖ Age-specific charts for periodic health examinations are a positive approach to health assessment ➢ Define lifetime schedule of health care, organized into packages for four specific age groups ➢ Each chart lists a frequency schedule for periodic health visits and preventive services for age group • These services include screening factors to gather during the history, and age-specific items for physical examination and laboratory procedures, counseling topics, and immunizations Assessment through the Life Cycle (Cont.) ❖ Age-specific charts focus on major risk factors specific for each age group based on lifestyle, health needs, and problems ➢ Shift emphasis from an annual physical examination toward rational and varying periodicity ➢ Incorporate health promotion and disease prevention at every health visit, not just at one annual physical examination ➢ Health education and counseling are highlighted as means to promote health Cross-Cultural Care Concepts ❖ A holistic model of health care assessment must include culture ❖ Inclusion of heritage assessment is of paramount importance to gather meaningful data and intervene with culturally sensitive and appropriate care ➢ With the rapid increases in numbers of individuals from diverse cultural backgrounds in the United States, a concern for the cultural beliefs and practices of people is increasingly important in health care Cross-Cultural Care Principles A serious conceptual problem arises as nurses and physicians are expected to know, understand, and meet health needs of people from culturally diverse backgrounds without formal preparation for doing so ❖ International interchanges are increasing among nurses and physicians, making attention to cultural aspects of health and illness an even greater priority High-Level Assessment Skills ❖ Attention to life cycle, holism, and culture must not detract from the importance of assessment skills themselves ❖ Assessment skills require hands-on expertise refined to a high level ➢ The nurse is the first and often only health professional to see an individual in many communities ➢ The nurse is the only health professional continually present at bedside in hospitals Cost Containment Principles ❖ Efforts at cost containment result in hospital populations composed of people with increased acuity, shorter stays, and earlier discharges than in the past ➢ Nurses must make faster, more efficient assessments ➢ Nurses required to go people’s homes for follow-up assessment and diagnosis ➢ First-rate assessment skills grounded in holistic approach and knowledge of age-specific problems are required Healthfinder.gov ❖ A BOLD new initiative from the USDHHS, Center for Disease Control, Centers for Medicaid and Medicare, Food and Drug Administration and NIH. to help Americans live longer, better and healthier lives. nih.gov advances ❖ NIH-supported research has led to: ❖ Death rates from heart disease and stroke fell by 40% and 51%, respectively, between 1975 and 2000. ❖ Overall 5-year survival rate for childhood cancers rose to nearly 80% during the 1990s from under 60% in the 1970s. ❖ Number of AIDS-related deaths fell by about 70% between 1995 and 2001. ❖ Sudden infant death syndrome rates fell by more than 50% between 1994 and 2000. ❖ Infectious diseases—such as rubella, whooping cough, and pneumococcal pneumonia—that once killed and disabled millions of people are now prevented by vaccines. nih.gov more advances ❖ Quality of life Americans suffering with depression has improved due to more effective medication and psychotherapy. ❖ The sequencing of the human genome set a new course for developing ways to diagnose and treat diseases like cancer, Parkinson's Disease and Alzheimer's Disease. ❖ In response to the anthrax attacks of 2001, the NIH launched and expanded research to prevent, detect, diagnose, and treat diseases caused by potential bioterrorism agents. What else have we done? ❖ New and improved imaging techniques let scientists painlessly look inside the body and detect disease in its earliest stages when it is often most effectively treated. ❖ Progress in understanding the immune system may lead to new ways to treat and cure diabetes, arthritis, asthma and allergies. ❖ New, more precise ways to treat cancer are emerging, such as drugs that zero in on abnormal proteins in cancer cells. ❖ Novel research methods are being developed that can identify the causes of outbreaks, such as Severe Acute Respiratory Syndrome (SARS), in weeks rather than months or years Lab Book Practice Questions: 1. The concept of health and healing has evolved in recent years. Which is the best description of health? a. Health is the absence of disease. b. Health is a dynamic process toward optimal functioning. c. Health depends on an interaction of mind, body, and spirit within the environment. d. Health is the prevention of disease. 2. Which would be included in the database for a new patient admission to a surgical unit? a. All subjective and objective data gathered by a health practitioner from a patient b. All objective data obtained from a patient through inspection, percussion, palpation, and auscultation c. A summary of a patient’s record, including laboratory studies d. All subjective and objective, and data gathered from a patient and the results of any laboratory or diagnostic studies completed 3. You are reviewing assessment data of a 45-year-old male patient and note pain of 8 on a scale of 10, labored breathing, and pale skin color on the electronic health record. This documentation is an example of: a. Hypothetical reasoning b. Diagnostic reasoning c. Data cluster d. Signs and symptoms 4. A patient is in the emergency department with nausea and vomiting. Which would you include in the database? a. A complete health history and full physical examination b. A diet and GI history c. Previously identified problems d. Start collection of data in conjunction with lifesaving measures 5. A patient has recently received health insurance and would like to know how often he should visit the provider. How do you respond? [Show Less]
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