What's my data?
Information retrieved from physical assessment.
What is objective data?
The best location to assess blood pressure.
What is the upper arm or brachial artery?
This test is used to assess ocular muscle movement.
What is the 6 gaze test?
Skin assessment finding that indicates dehydration
What is turgor?
Last step in assessment process.
What is auscultation?
"Tell me any spiritual customs that you'd like to follow while hospitalized."
What is cultural assessment data or question?
This elevated temperature point is considered abnormal.
What is greater than 99F (37.2C)?
This test is used to detect unilateral hearing loss.
What is the Weber test?
Characteristics of normal lymph nodes.
What are soft, mobile, painless, uniform in shape and defined borders?
True or False: Deep palpation is they only type of palpation that should be done.
What is false? (begin with light palpation and move to deep palpation when appropriate, especially in abdominal assessments)
A trauma patient with profuse bleeding is prioritized for care over a patient with ear pain using this framework.
What is A B C ? (Circulation)
True or False: A nurse should consider intervening if a patients SpO2 is 87%
What is true? (A normal range for SpO2 is greater than 95%)
The Snellen chart's use and interpretation.
What is visual acuity AND distance from chart (20) and distance person with "normal" vision can see the same line?
An infected skin wound may have this assessment finding.
What is erythema?
What is assessment of organ borders, presence of fluid or air in lungs or abdominal cavity?
Documenting an allergy is completed with this follow up information.
What is the reaction to the allergy?
Location of pulse points (8).
What are carotid, brachial, radial, ulnar, femoral, popliteal, posterior tibial, and dorsalis pedis?
Symptoms of sinusitis.
What are enlarged or swollen sinuses on palpation, headache, dizziness, tenderness or pain?
True or false: The thyroid gland can always be palpated.
What is false? (typically only palpated when thyroid gland is enlarged or possibly during pregnancy)
Considerations when performing a head to toe assessment on an older adult.
What are adjusting for sensory changes, physical limitations or length of time needed?
Shrugging shoulders or eye rolling is this type of communication.
What is nonverbal?
Diastolic reading from a blood pressure is interpreted as this.
What is the force of pressure when blood is pumped out of the heart?
Normal assessment finding is shiny, translucent with pearl grey color.
What is the tympanic membrane?
Provoking, quality, region, severity and timing.
What is pain assessment (PQRST)?
True of False: Inspection is a necessary first step in the assessment process.
What is true? (Provides a baseline, early cues to abnormalities, helps decide whether other steps should be done such as palpation)