UNIT 1-Seidel physical exam chapter 1 | Questions and Answers with complete solution

primary objective of he history and interviewing process - *discover details about the patient's concern *explore pt expectations about the encounter *display interest establishing a positive patient relationship depends on... - *communication *courtesy *comfort *connection *confirmation What is a major cause of mortality in preteen and teenagers? - suicide how to give structure to the present illness in the interview - give it chronological and sequential framework assessments for alcoholism by population - CAGE- general TACE- pregnant women CRAFFT- adolescents CAGE - Screening for alcoholism *cutting down *annoyance of criticism of drinking *guilty *eye opener in the morning TACE - screening for alcoholism in pregnant women*how many drinks does it TAKE to feel high? *have people ANNOYED you with their criticism? *have you felt you should CUT down? *EYE opener answer to T or two ACE suggests problem CRAFFT - screening for alcohol problem in adolescents *C - Have you ever ridden in a CAR driven by someone (including yourself) who was "high" or had been using alcohol or drugs? R - Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in? A - Do you ever use alcohol/drugs while you are by yourself, ALONE? F - Do you ever FORGET things you did while using alcohol or drugs? F - Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use? T - Have you gotten into TROUBLE while you were using alcohol or drugs? What does the HITS- assess for? - Screening for domestic violence has your partner in the last year... *H- hurt you *I- insulted you / talked down *T- threatened you with physical harm *S screamed /cursed at you US Preventive Services Task Force validated Partner Violence Screen (PVS) - *have you been kicked, hit, punched hurt by someone in the past year? *Do you feel safe in your current relationship? *Is there a partner that is making you feel unsafe now?Abuse in older adults is ____ - Underreported Risk for abuse in older adults is greater if - *adult has mental illness *physically or cognitively impaired *living in a dependent situation *inadequate financial resourses assessing adolescents for violence (and sexual violence ) *clues that violence is happening - Clues- changes in behavior, dress, makeup, school effort, sleeping, eating, drugs, alcohol What is a positive screen on the PVS - a positive response on any question FICA - what does it assess? - questions to explore a client's spirituality *FAITH, belief, meaning- spiritual preference *IMPORTANCE/influence- how have beliefs influenced how you handle stress? *COMMUNITY- belong to religious community? *ADDRESS/ action in care-how do your religious beliefs affect your decisions? a complete HPI includes - *chronological order of events *state of health just before the onset of the problem *description of the first sx *sx analysis - onset, duration, frequency, exacerbating, relieving *description of attack and persistence *environmental hazards? *impact of lifestyle- sexual, leisure, work, coping *immediate reason that prompted the person to seek care *appropriate relevant system review*medications- current, past *use of alternative/complimentary medicine Past medical history - the basis for assessing the present condition *general health *childhood illness *major adult illness *immunizations *surgeries *serious injury *limitation of functioning *medications *allergies *tranfusions *recent screening tests *emotional status family history- how far to assess back - *health of relatives - first degree- (parents, children, siblings) second degree,(grandparents, grandchildren, aunts, uncles nieces, nephews) third degree - (first cousins) **3 generations personal and social history - *personal status- demographics *habits- diet, nutrition, tobacco, alcohol, exercise *self-care *self-care- *sexual history- partners, practices, protection, past history of STIs, prevention of pregnancy*home conditions- housing *occupation *environment *military *access to care 5 Ps of sexual history - *partners *practices *protection STDs *past hx of STDs *prevention of pregnancy ROS - *constitutional *skin, hair, nails *head *eyes *ears *nose *throat *lymph nodes *chest/lung *breast *heart *peripheral vascular *GI *diet *endocrine *genitourinary *musculoskeletal*neurologic *psychiatric females- menses, pregnancy males- puberty onset, testicular pain, etc At what age can children be dependable reporters of their health? - Age 7 What do the HEEADSSS AND PACES assess for? - screening tools for adolescent issues HEEADSSS AND PACES - *hee hee adolescent issues....HP teens H-home environment E-education/ employment E-eating A-activities D-drugs S- sexuality S-suicide/ depression S- safety P-parents / peers A- accidents, alcohol, drugs C-cigarettes E-emotional issues S- school, sexuality types of histories - *complete history- 1st visit*inventory history- touches on major points without going into detail. Useful when it must be completed in one session *problem focused- acute/ life threatening problem *interim- chronicles events that have occurred since last visit with the patient rate of post partum depression - 1 of 5 women what is the functional assessment? - patient's ability to achieve basic ADLs For what populations should a functional assessment be done? - *all older adults *any person limited by disease or disability categories to assess on the functional assessment - *mobility *upper extremity function *housework *instrumental activities of daily living (bathing, eating, toileting , etc) define frailty - loss of physical reserve and increased risk for loss of physical function and independence *prevalence increases with age (usually past 80) but age and frailty not synonymous *characterized by weakness, weight loss, low activity, diminished ability to respond to stress, associated with adverse health outcomes open ended questions - gives the patient more discretion abut the extent of the answerwhen to use direct questions - seeking specific info, " how long ago did this happ