Providers need to have a competent cultural practice to...
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...adequately understand a patients behaviors and practices
Latex Allergy
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1. Occurs when the body's immune system reacts with proteins found in
latex
2. Skin/mucous membrane contact or airborne exposure
3. Rash, itching, blisters, asthma, GI symptoms, lung damage, anaphylaxis
4. Healthcare workers and patients with multiple surgeries at risk
,History of Present Illness
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O nset
L ocation
D uration
C haracter
A ggravating/associated factors
R elieving factors
T emporal factors
S everity of symptoms
Subjective Data
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Information that patients offer about their condition
-Describe the patient's concerns or unexpected findings by their quality or
character
-Useful way to record expected findings is to indicate the absence of
symptoms (e.g., "no vomiting, diarrhea or constipation)
Achieving cultural competence is a learning process that requires:
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, 1. Self-awareness
2. Reflective practice
3. Knowledge of core cultural issues
Percussion Techniques
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1. Immediate (direct) - finger strikes directly against body
2. Mediate (indirect) - middle finger of dominant hand is hammer; middle
finger of nondominant hand is placed on body and struck
3. Fist - nondominant hand is placed on body and struck with fist of
dominant hand: most commonly used to elicit tenderness arising from the
liver, gallbladder or kidneys
Examination and Findings, cont
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6. Recumbent length - birth to 24 months
7. Weight - Growth and weight charts
8. Head circumference - birth to 2-3 years
9. Chest circumference - if problem suspected
10. Gestational age - prematurity, size for gestation
Percussion Tones
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, Typany - loud, high, drumlike-->gastric bubble
Hyperresonance - very lound, low, booming-->emphysematous lungs
Resonance - loud, low, hollow-->healthy lung tissue
Dullness - soft, moderate, thudlike-->liver
Flatness - soft, high, dull-->muscle
Examination Technique: Percussion
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- One object striking against another produces vibrations and sound waves
- Tapping finger causes vibrations by impact on underlying tissues
- Sound waves arise from vibrations and produce percussion tones
(resonance)
- Tone is related to density of underlying tissue
Plan
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- Need to invoke diagnostic resources
- Therapeutic modalities
- Other professional resources
- Rationale for these decisions
- What you intend to do
Three sections
1. Diagnostics
2. Therapeutics
3. Patient Education
Comprehensive Health History and Physical Examination
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...adequately understand a patients behaviors and practices
Latex Allergy
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1. Occurs when the body's immune system reacts with proteins found in
latex
2. Skin/mucous membrane contact or airborne exposure
3. Rash, itching, blisters, asthma, GI symptoms, lung damage, anaphylaxis
4. Healthcare workers and patients with multiple surgeries at risk
,History of Present Illness
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O nset
L ocation
D uration
C haracter
A ggravating/associated factors
R elieving factors
T emporal factors
S everity of symptoms
Subjective Data
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Information that patients offer about their condition
-Describe the patient's concerns or unexpected findings by their quality or
character
-Useful way to record expected findings is to indicate the absence of
symptoms (e.g., "no vomiting, diarrhea or constipation)
Achieving cultural competence is a learning process that requires:
Give this one a try later!
, 1. Self-awareness
2. Reflective practice
3. Knowledge of core cultural issues
Percussion Techniques
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1. Immediate (direct) - finger strikes directly against body
2. Mediate (indirect) - middle finger of dominant hand is hammer; middle
finger of nondominant hand is placed on body and struck
3. Fist - nondominant hand is placed on body and struck with fist of
dominant hand: most commonly used to elicit tenderness arising from the
liver, gallbladder or kidneys
Examination and Findings, cont
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6. Recumbent length - birth to 24 months
7. Weight - Growth and weight charts
8. Head circumference - birth to 2-3 years
9. Chest circumference - if problem suspected
10. Gestational age - prematurity, size for gestation
Percussion Tones
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, Typany - loud, high, drumlike-->gastric bubble
Hyperresonance - very lound, low, booming-->emphysematous lungs
Resonance - loud, low, hollow-->healthy lung tissue
Dullness - soft, moderate, thudlike-->liver
Flatness - soft, high, dull-->muscle
Examination Technique: Percussion
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- One object striking against another produces vibrations and sound waves
- Tapping finger causes vibrations by impact on underlying tissues
- Sound waves arise from vibrations and produce percussion tones
(resonance)
- Tone is related to density of underlying tissue
Plan
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- Need to invoke diagnostic resources
- Therapeutic modalities
- Other professional resources
- Rationale for these decisions
- What you intend to do
Three sections
1. Diagnostics
2. Therapeutics
3. Patient Education
Comprehensive Health History and Physical Examination
