NR 509 MIDTERM STUDY GUIDE FINAL

NR 509 MIDTERM STUDY GUIDE FINAL Preauricular nodes - CORRECT ANSWER-in front of the ear Posterior auricular node - CORRECT ANSWER-superficial to the mastoid process (behind the ear) Occipital node - CORRECT ANSWER-at the base of the skull posteriorly Tonsillar node - CORRECT ANSWER-at the angle of the mandible Submandibular node - CORRECT ANSWER-midway between the angle and the tip of the mandible. These nodes are usually smaller and smoother than the lobulated subman-dibular gland against which they lie Submental nodes - CORRECT ANSWER-in the midline a few centi-meters behind the tip of the mandible Superficial cervical nodes - CORRECT ANSWER-superficial to the sternocleidomastoid. Posterior cervical nodes - CORRECT ANSWER-along the anterior edge of the trapezius. Deep cervical chain lymph nodes - CORRECT ANSWER-deep to the sternocleidomastoid and often inaccessible to examination. Hook your thumb and fingers around either side of the sterno-cleidomastoid muscle to find them. Supraclavicular nodes - CORRECT ANSWER-deep in the angle formed by the clavicle and the sterno-cleidomastoid. shotty - CORRECT ANSWER-Small, mobile, discrete, nontender nodes, are frequently found in normal people physical assessment techniques - CORRECT ANSWER-Inspection - visual examination; Palpation - tactile examination; Percussion - tactile and auditory examination; Auscultation - auditory examination head and neck - CORRECT ANSWER-Begin the physical assessment by inspecting general appearance of head/neck - CORRECT ANSWER-facial expression, contours, asymmetry comprehensive assessment - CORRECT ANSWER-Seeing patient for first time; Includes all the elements of the health history and the complete physical examination; fundamental and personalized knowledge about the patient that strengthens the clinician-patient relationship; provides a complete basis for assessing these concerns and answering patient questions focused assessment - CORRECT ANSWER-chief complaint such as cough, abdominal pain, sore throat, etc. or a follow-up for a chronic illness; Your history and physical will be much more focused on the chief complaint as you begin diagnosis and management basic - CORRECT ANSWER-maximize patient's comfort, avoid unnecessary changes in position, enhance clinical efficiency, move head to toe, examine the patient from their right side active listening - CORRECT ANSWER-closely attending to what the patient is communicating, connecting to the patient's emotional state, and using verbal and nonverbal skills to encourage the patient to expand on his or her feelings and concerns Empathic responses - CORRECT ANSWER-the capacity to identify with the patient and feel the patient's pain as your own, then respond in a supportive manner Guided questioning - CORRECT ANSWER-show your sustained interest in the patient's feelings and deepest disclosures and allows the interviewer to facilitate full communication, in the patient's own words, without interruption. Nonverbal communication - CORRECT ANSWER-eye contact, facial expression, posture, head position and movement such as shaking or nodding, interpersonal distance, and placement of the arms or legs—crossed, neutral, or open validation - CORRECT ANSWER-helps to affirm the legitimacy of the patient's emotional experience. Partnering - CORRECT ANSWER-When building rapport with patients, express your commitment to an ongoing relationship Summarization - CORRECT ANSWER-Giving a capsule summary of the patient's story during the course of the interview to communicate that you have been listening carefully. Transitions - CORRECT ANSWER-Inform your patient when you are changing directions during the interview empowering the patient - CORRECT ANSWER-encourage patients to ask questions, express their concerns, and probe your recommendations in order to encourage them to adopt your advice, make lifestyle changes, or take medications as prescribed. subjective - CORRECT ANSWER-apparent only to the person affected' perceptions, feelings, thoughts, expectations. Cannot be observed and can be discovered only by asking questions objective - CORRECT ANSWER-detectable by an observer or can be tested against an acceptable standard; tangible, observable facts; includes observation of the clients behavior, medical records, lab and diagnostic tests, data collected by physical exam chief complaint - CORRECT ANSWER-Make every attempt to quote the patient's own words 7 attributes of a symptom - CORRECT ANSWER-Location, quality, quantity or severity, timing - including onset duration and frequency, setting in which it occurs, alleviating/aggravating factors, associated manifestations Past medical history - CORRECT ANSWER-Medications (prescription, OTC and herbs), allergies to drugs foods seasonal environment (document reaction to each), childhood; illness/hospitalizations, adult illnesses (diabetes, HTN, HIV, hispitalizations, gender of sexual partners, sexual practices), surgical history (dates, indications, types), OBGYN (menstrual hx, methods of contraception, sexual function) , psychiatric (illness and time frame, diagnosis, hospitalizations, treatments), health maintenance (immunizations, wellness exams, pap smears, colonoscopy, etc), family history, personal and social history (intersts, stress, spiritual beliefs, lifestyle habits) review of symptoms - CORRECT ANSWER-(1) to obtain additional information about the patient's chief complaint and history of present illness; and (2) to elicit symptoms of potential problems in uninvolved systems; ask yes or no questions and then follow up when there is a response that indicates an abnormality with open-ended questions; head-to-toe approach - remember that the ROS is subjective data ONLY Problem list - CORRECT ANSWER-defined as a list of current and active diagnoses as well as past diagnoses relevant to the current care of the patient; includes all the medical, social, and psychologic problems the patient has or may have; List the most active and serious problems first and record their date of onset. Helps to individualize the patient's care. On follow-up visits, provides a quick summary of the patient's clinical history and a reminder to review the status of problems the patient may not mention differential diagnosis - CORRECT ANSWER-all the medical diseases that may possibly explain the patient's chief complaint or principal problem; A chief complaint must be identified first. Includes all medical diseases that may possibly explain problem/ CC head - CORRECT ANSWER-Areas are associated with the bone that they are in front of salivary glands - CORRECT ANSWER-glands near mandible parotid - CORRECT ANSWER-glands that lie superficial and behind mandible - visible and palpable when enlarged submandibular gland - CORRECT ANSWER-glands beneath the tongue parotid and submandibular - CORRECT ANSWER-openings of these are visible in oral cavity superficial temporal artery - CORRECT ANSWER-artery that is in front of the ear and runs upward - readily palpable common issues with the head - CORRECT ANSWER-Headache; Change in vision - Hyperopia, Presbyopia, Myopia, Scotomas, Diplopia; Hearing loss, earache, tinnitus; Vertigo Hyperopia - CORRECT ANSWER-farsightedness; This makes close-up objects appear blurry presbyopia - CORRECT ANSWER-gradual loss of your eyes' ability to focus on nearby objects myopia - CORRECT ANSWER-nearsightedness Scotoma - CORRECT ANSWER-A spot in your vision that can be dark, very light, blurred, or flickering · Trouble seeing certain colors Diplopia - CORRECT ANSWER-double vision Examination of the head - CORRECT ANSWER-Note skin on face - color, pigmentation, texture, thickness, hair distribution, lesions; Note skull for contours; Ask if patient has noticed anything wrong with the scalp or hair; Remove hair pieces for exam; Note hair for quality, distribution, texture and any hair loss; Part in separate places to look for scaliness, lumps, redness, scaling, nevi, lesions; Depressions, lumps, tenderness of skull observation of the face - CORRECT ANSWER-Facial expressions, contours, asymmetry, involuntary movements, edema, masses skin - CORRECT ANSWER-note for color, pigmentation, texture, thickness, hair distribution, lesions sclera - CORRECT ANSWER-white coloring of eye upper lid - CORRECT ANSWER-covers portion of iris Conjunctiva - CORRECT ANSWER-clear mucous membrane of the eye