I Got This!
What is the normal range for temporal temperature?
97.4-100.3 degrees F
What is subjective Data?
Assessment findings that a person TELLS you that are only known by them.
SBAR stands for:
Situation
Background
Assessment
Recommendation
The muscle can only move if resistance of gravity is removed. How would you grade this muscle strength?
2
What are the different types of health assessment?
- Initial comprehensive assessment
- Ongoing/Partial assessment
- Focused Assessment
- Emergency assessment
Palpate the pulse for a FULL MINUTE
What is the nursing process?
-A: assess
-D: diagnosis
-P: plan
-I: implementation
-E: evaluation
What is clubbing?
It affects fingers and toes. Proliferation of distal tissues results in thickening and widening of extremities of the digits. Nails are curved and shiny. Happens because of HYPOXIA!!!!!
What are the values for tachycardia and bradycardia?
Tachy: greater than 100
Brady: less than 60
The patient is moving their arm TOWARD the midline of the body. This movement describes...
Adduction
What value qualifies a person for Stage 2 hypertension?
Systolic >140/ Diastolic >90
During a physical, the nurse assesses vital signs of a 20 y/o marathon runner. Results include temp: 97.4, Pulse 58 bpm regular, RR 16 breaths/minute, BP 98/68. What can the nurse conclude from these results?
These are the results of a normal, healthy, athletic adult
What are 2-4 interview adaptations for an anxious patient?
-Give simple, organized, information
-Ask simple, concise questions
-Do not rush
-Decrease external stimuli
A 22 y/o woman comes to the clinic at the instance of her brother. She was wearing black combat boots and a black lace nightgown over the top of her clothes. Her hair is dyed bright pink with black streaks throughout. What should be done first?
More information should be gathered to decide whether her dress is appropriate! (aka why do I care? she's here for her brother lol)
What are the steps of Assessment?
- Collection of subjective data
- Collection of objective data
- Validation of data
- Documentation of data
What are 2 reasons behind a patient having black stools?
-Iron supplements
-Upper GI bleed
Joint/Muscle pain may feel like...
-Aching
-Sharp
-Knife-like
Why is it important to stress the importance of Breast Self-Exams?
Preventative measures may be able to detect lumps or other abnormal signs early!
What is the pattern with osteoporosis pain?
-Begins in one set of joints on one side, feels like deep joint pain
-Improves with rest
-Worsens with rainy weather
-Stiffness early in morning that improves with movement
Which tool will the nurse use to BEST assess a patient's dietary habits?
24 hour dietary recall (of all foods AND fluids consumed)
What are the normal lab values for hemoglobin?
-Males: 13-18 g/dL
-Females: 13-16 g/dL
What are 2 S/S of venous insufficiency?
-Aching and cramping pain
-Present but difficult to palpate pulses
-Edema, skin is thickened and tough
-Skin is a reddish-blue color
What are some S/S of glaucoma?
-Mostly asymptomatic
-Loss of peripheral vision or side vision
-Seeing halos around lights
-Redness in the eye
-Eye that looks hazy
Name at least 3 things that should be taught in patient education about hearing loss.
-WEAR HEARING PROTECTORS!!
-Have hearing exams
-Immunize children
-Treat infections
-AVOID INSTRUMENTS TO REMOVE WAX!!
In Benign Breast Disease, which dietary factor can aggravate the condition?
Caffeine