ANSWERS RATED A+
✔✔pneumonia vaccines - ✔✔65 years old and less , 13 once then 23 one year later.
High risk pt get them q 10 yrs until 65, then done.
✔✔tone of voice - ✔✔should be low and not loud, even.
✔✔body language - ✔✔"i'm fine." Don't always take that at face value, dig deeper. Sit
with them and ask questions.
✔✔gestures - ✔✔don't overdo
✔✔facial expressions - ✔✔keep them positive
✔✔eye contact - ✔✔face to face, on same level
✔✔speed of conversation - ✔✔don't talk too fast or too slow
✔✔timing - ✔✔wait for an answer and keep eye contact
✔✔touch - ✔✔if vision or hearing impaired, use light caring touch
✔✔silence - ✔✔let it be, give it time
✔✔empathy - ✔✔you can put yourself in their shoes, active listening, trying to see
things from their perspective
✔✔informing - ✔✔verify information before telling pt or family members
✔✔direct questioning - ✔✔"May I insert this catheter for a urine specimen?" or "I need
to ask you some questions if I may"
✔✔Open-ended questions - ✔✔a good technique to use
✔✔Therapeutic communication - ✔✔1. depends upon empathetic listening
2. assess for and correct communication barriers
3. utilize a variety of communication techniques
4. depends on the information you exchange
5. using medical terms can be a barrier
6. want to engage in social communication
7. You want to build a good relationship
✔✔A1C - ✔✔normal is 5, less than 7 is the goal
, ✔✔Diabetic foot exam - ✔✔look between toes, look all over foot, redness? sores?
check circulation (cap refill, temp, color, edema), check sensation (monofilament test),
pedal pulse
✔✔Benadryl - ✔✔should not be taken for sleep, should not be mixed with alcohol
✔✔Home health - ✔✔Aides assist in home care/Adls and IADLS (aides do not assess
or give meds)
✔✔KATZ index - ✔✔for independence in ADLs dressing, showering, transfer, feed,
toilet
✔✔Home Health Hx - ✔✔setting altered for assessing and interviewing: make sure
there is plenty of time, use good communication techniques, know how to move
conversation along, take cultural and age related values pertaining to modesty, etc., use
formal name until they tell you otherwise, speak directly to pt (not their children), make
sure lighting is good, no background noise, provide privacy, make sure bathroom is
near
✔✔Best Practice guidelines for VS - ✔✔1. establish baseline to identify changes
2. T-oral, unless poor muscle control or bone loss in mouth, may use sensor across
forehead (reading can be inaccurate)
3. P-radial (do not fully occlude), apical (auscultate for one whole minute)
4. R-changes can be sign of infection
5. BP-upper extremity, level with heart. Orthostatic BP, especially if dizzy or
lightheaded, (positive is a shift of 20+)
✔✔Full health assessment - ✔✔Family Hx, Physical exam (BMI, cognitive, functional),
VS, health promotion activities, Advanced directives
✔✔Onset - ✔✔When did this start?
✔✔Precipitating - ✔✔What caused the start? What led up to you first noticing the pain?
✔✔Provocation - ✔✔What makes it worse?
✔✔Palliative - ✔✔What makes it better? This suggests a Tx
✔✔Quality - ✔✔What does it feel like?
✔✔Quantity? - ✔✔On a scale of 1-10, with 10 being the worst pain you can imagine...
✔✔Region - ✔✔Where is it?