Phase of the interview where the purpose and process is explained
Introduction Phase
Pain that is typically sudden in onset, and lasts less than 6 months
The first step in the nursing process
Assessment
Sign
Scale used to assess the level of consciousness in patients.
Glasgow Coma Scale
Type of interview question that requires precise details.
Directive questions
The most reliable indicator of a patients pain.
What the patient states their pain is.
Sources of data gathered in the physical exam in the nursing process
Patient interview; Physical assessment data; vital signs; diagnostic test results' general observation
Subjective data perceived and reported by the patient.
Symptom
Medical term for a respiratory rate over 20 breaths per minute
Tachypnea
Three behaviors that can interfere with the interview process.
Using medical terminology; Expressing value judgement; interrupting the patient; being authoritarian/paternalistic; using 'why' questions
The "O" in OLDCARTS symptom analysis and an example of what could be asked.
Another name for an 'actual' nursing diagnosis
Problem-Focused Nursing Diagnosis
An assessment performed on a patient at a health fair
Screening assessment
Term for a nurse using their hands to feel texture, size, and shape in a physical assessment
Palpation
Type of health history that is performed on a new patient in any clinical setting.
Comprehensive health history
Pain tool that is appropriate for an alert and oriented adult patient's pain level.
1-10 numeric rating scale.
P (Problem); E (Etiology); S (Signs/Symptoms)
A short assessment done on a specific problem or complaint
Problem-based, or focused assessment
Tool, used for assessing vibratory sensation, and auditory screenings (Click for image in response)
Section of the patient health history that focuses on the patients current health conditions, medications they are currently taking, and known allergies
Present Health Status
Each word in the mnemonic OLDCARTS.
Onset, Location, Duration, Characteristics, Aggravating factors, Related symptoms, Treatment by the patient, Severity
The 'defining characteristics' in this nursing diagnostic statement: "Impaired Physical Mobility, related to decrease muscle mass, as evidenced by limited range of motion"
Level of health promotion that involves immunizations
Primary prevention
Orthostatic hypotension