Questions And Answers| Latest Updates|
Orthostatic hypertension - ANSWER -- Decreased BP with change in position
- Drop in SBP of 25 mmHg or DBP of 10 mmHG
- Symptoms
1) Dizziness
2) Weakness
3) Blurred vision
4) Syncope
5) Changes in BP/HR
- Causes
1) Hypovolemia
2) Impaired vasoconstriction
3) Medications
Precautions in someone with orthostatic hypertension - ANSWER -- change
positions slowly
- falls risk
- assist back to bed if symptomatic
What is the main objective of the health history - ANSWER -- To gather accurate
information to provide immediate care
- Establish rapport with the client
What does establishing a positive patient relationship depend on - ANSWER -1)
courtesy
2) comfort
3) connection
4) confirmation
5) confidentiality
What questions should you begin with for a health history interview - ANSWER -
Open ended questions
Approaching Sensitive Issues - ANSWER -- Use language that is understandable.
- Do not apologize for broaching the issue.
- Ensure privacy.
,- Be direct and firm.
- Do not preach.
- Do not push too hard.
CAGE questionnaire - ANSWER -Cutting down
Annoyance
Guilty feeling
Eye-openers
- Helps diagnose alcoholism
TACE questionnaire - ANSWER -T - how many drinks does it TAKE to make
you feel right
A - Have people ANNOYED you by criticizing your drinking
C - Have you felt you out to cut down on your drinking
E - Have you had an EYE -OPENER first thing in the morning
CRAFFT questionnaire - ANSWER -- Screening tool for alcohol and substance
abuse in adolescents
Car
Relax
Alone
Forget
Friends
Trouble
What is the goal of a screening tool? - ANSWER -To find out if the problem
exists
Three questions to detect partner violence - ANSWER -- Have you ever been hit,
kicked, punched, or otherwise hurt by someone within the past year?
- Do you feel safe in your current relationship?
- Is there a partner from a previous relationship who is making you feel unsafe
now?
HITS questionnaire - ANSWER -The wording of the question is "In the last year
how often did your partner:
1) Hurt you physically?"
2) Insult or talk down to you?"
3) Threaten you with physical harm?"
4) Scream or curse at you?"
, FICA - ANSWER -Faith
Importance and Influence
Community
Address/action in care
Format of interview - ANSWER -CC
HPI
PMH
PSH
FH
SH
ROS
Is pain subjective or objective - ANSWER -Subjective
PMH - ANSWER -1) Allergies
2) Childhood and adult illnesses
3) Immunizations
4) Diagnostic and lab results
Symptom analysis tool - ANSWER -OLDCARTS
Complete history - ANSWER -Most often recorded the first time you see the
patient
Inventory history - ANSWER -- Related to but does not replace the complete
history
- Touches on major points without complete detail
- Entire history will be completed in more than one session
Problem (or focused) history - ANSWER -Taken when a problem is acute so that
only the need of the moment is given full attention
Interim history - ANSWER -- Designed to chronicle events that have occurred
since your last meeting with the patient
- Substance determined by nature of problem and need of the moment
- Should always be complemented by the patient's previous medical record
Transduction of pain - ANSWER -Action potential moves to the spinal cord
, Transmission of pain - ANSWER -Pain impulse moves from spinal cord to the
brain
Modulation of pain - ANSWER -Neurons from the brain stem release
neurotransmitters that block the pain impulse
Steps in pain - ANSWER -1) Noxious stimuli and transduction
2) Transmission
3) Perception of pain
4) Modulation
Neuropathic pain - ANSWER -- Pain within nervous system
- Abnormal processing of pain from nerve fibers
- Often chronic
Visceral pain - ANSWER -- Originates from larger internal organs
- Often described as crampy
- Physical pain based on site of organ
Somatic pain - ANSWER -Originates from MS system
Referred pain - ANSWER -Pain is felt from a different site other than where it
originates
Gallbladder referred pain - ANSWER -The shoulder
Kidney referred pain - ANSWER -The lower back
Acute pain - ANSWER -- Less than 6 mos
Chronic pain - ANSWER -- pain lasting longer than 6 months
- Hard to treat
Elderly and pain - ANSWER -- No evidence exists to suggest that older
individuals perceive pain to a lesser degree or that sensitivity is diminished
Infants and pain - ANSWER -- Do not have adequate number of inhibitory
neurotransmitters, so thought to be more sensitive to pain (premies > full-term)