nur 155 exam 1
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1. Steps of the Nursing Process: Assessment
Diagnosis
Planning
Implementation
Evaluation
2. Maslow's Hierarchy of Needs: physiological, safety, love/belonging, esteem, self-actualization
3. ABCs: airway, breathing, circulation
4. Goal Characteristics: realistic, patient focused, measurable, time-limited
5. Methods of Assessment: -observation
-patient interview
-physical assessment
6. Data Collection: primary - directly from PT , Secondary - family, friends, healthcare workers , Subjective -
spoken (pt feelings or comments) , objective - med records, lab results, tests
7. types of physical assessment: comprehensive, focused, emergency
8. Patient interview phases: Orientation, working, termination
Health history is gathered
9. Assessment Techniques: Inspection
Palpation
Percussion
Auscultation
10. General Survey: age, sex gender, clothing, hygiene/grooming, affect/mood,safety, alcohol/drugs, speech,
gait, vitals, hight/weight
11. Preparation of physical assessment: gather equipment, prep patient, allow for privacy, integrate
assessment with other nursing activities
12. inspection: general observation of the patient as a whole, progressing to specific body areas
13. palpation: to examine by touch
14. percussion: exam technique used to assess body tissue and structures
15. auscultation: listening to sounds within the body
16. Skin inspection: Visual examination of skin for abnormalities.
17. Albumin: congenital loss of pigment
18. Cyanosis: bluish discoloration of the skin
19. erythema: redness of the skin
1/4
Study online at https://quizlet.com/_a6gxft
1. Steps of the Nursing Process: Assessment
Diagnosis
Planning
Implementation
Evaluation
2. Maslow's Hierarchy of Needs: physiological, safety, love/belonging, esteem, self-actualization
3. ABCs: airway, breathing, circulation
4. Goal Characteristics: realistic, patient focused, measurable, time-limited
5. Methods of Assessment: -observation
-patient interview
-physical assessment
6. Data Collection: primary - directly from PT , Secondary - family, friends, healthcare workers , Subjective -
spoken (pt feelings or comments) , objective - med records, lab results, tests
7. types of physical assessment: comprehensive, focused, emergency
8. Patient interview phases: Orientation, working, termination
Health history is gathered
9. Assessment Techniques: Inspection
Palpation
Percussion
Auscultation
10. General Survey: age, sex gender, clothing, hygiene/grooming, affect/mood,safety, alcohol/drugs, speech,
gait, vitals, hight/weight
11. Preparation of physical assessment: gather equipment, prep patient, allow for privacy, integrate
assessment with other nursing activities
12. inspection: general observation of the patient as a whole, progressing to specific body areas
13. palpation: to examine by touch
14. percussion: exam technique used to assess body tissue and structures
15. auscultation: listening to sounds within the body
16. Skin inspection: Visual examination of skin for abnormalities.
17. Albumin: congenital loss of pigment
18. Cyanosis: bluish discoloration of the skin
19. erythema: redness of the skin
1/4
