Maryville 612 Exam 1 Questions With 100% Correct Answers

Maryville 612 Exam 1 Questions With 100% Correct Answers Claudication - answera condition in which cramping pain in the leg is induced by exercise, typically caused by obstruction of the arteries. May be characterized as a dull ache with accompanying muscle fatigue and cramps. Usually appears with sustained exercise. Site of pain is distant to narrowing. How do you test EOM? - answerEye movement is controlled by 6 extraocular muscles and 3 cranial nerves, III, IV, and VI. To evaluate eye movement, use 4 techniques. ● First have the patient watch your finger move through the 6 cardinal fields of gaze. Jerking or sustained nystagmus is abnormal. A few beats of horizontal nystagmus may occur. ● Second have the patient follow your finger vertically from the ceiling to the floor.The globes and the upper eyelids should move smoothly without eyelid lag or exposure of the sclera. ● Third, test extraocular muscle balance using the corneal light reflex. WIth the patient looking at a nearby object, shine a light on the nasal bridge. The eyes should converge and reflect the light symmetrically. ● Fourth, if the corneal light reflex is imbalanced, perform the cover-uncover test. As the patient stares at a fixed point nearby, cover one eye and observe the uncovered eye. Then remove the cover and observe that eye as it focuses on the object. Note any eye movement. Your patient should be able to follow your finger with full, smooth extraocular movements and without nystagmus, or "shaky" eye motion. Normal extraocular movements indicate intact cranial nerves III, IV, and VI. *******What is the difference between objective and subjective data? What components of the health history are objective and subjective? *********** - answerSeidel pg 618: objective: "direct observation, what you see, hear, and touch". This includes vital signs and actual assessment. Subjective: "information patients offer about their condition or feelings." This includes chief complaint, past medical history, history or present illness, family history, and review of symptoms. Erb's point - answerErb's point is the auscultation location for heart sounds and heart murmurs located at the third intercostal space and the left lower sternal border. Erb's point, found two interspaces below the pulmonic area, does not reflect sound from one particular heart valve, but is a common listening post, lying halfway between the base and the apex of the heart. Tonsil assessment - answer• Enlargement; Acute infection, 2+, 3+, or 4+ o 1+ - visible o 2+ halfway between tonsillar pillars o 3+ touching uvula o 4+ touching each other Order physical assessment is done - answerInspection, Palpation, Percussion, Auscultation Proper use of Otoscope on adult or child - answerAdult- straighten the external auditory canal by pulling auricle up and back Child- face child sideways with one arm around parents waist. Pull auricle either downward and back or upward and back to gain best view of tympanic membrane. How do you assess for sensoineural hearing loss - answerair conduction heard longer than bone conduction with Rinne Test; lateralization to unaffected ear; loss of high-frequency sounds How do you assess for conductive hearing loss - answerbone conduction heard longer than air conduction with Rinne Test; lateralization to affected ear with Weber Test; loss of low frequency sounds; loss of 11-30 decibels on audiometry with cerumen impaction. Rinne Test***** - answerhelps distinguish whether patient hears better by air or bone conduction. Place the tuning fork at base of vibrating tuning fork against the patient's mastoid bone and ask patient to tell you when the sound is no longer heard. Time this interval of bone conduction noting number of seconds. Continue timing the interval of sound due to by air conduction heard by the patient. Compare # of seconds air vs. bone. Air conducted should be heard twice as long as bone conducted sounds. (If bone conducted heard for 15 seconds, air conducted should be heard for additional 15 seconds). Weber Test - answerhelps assess unilateral hearing loss. Place base of fork on mid-line of patient's head. Ask patient if sound heard equally in both ears or in one ear (lateralization of sound). Should hear sound equally. Presbyopia - answerProgressive weakening of accommodation (focusing power). The major physiologic change that occurs after the age of 45 years; the lens becomes more rigid, and the ciliary muscle becomes weaker. Strabismus - answera condition in which both eyes do not focus on the object simultaneously, although either eye can focus independently; may be paralytic or non-paralytic. Photopsia - answerpresence of perceived flashes of light. (Most commonly associated with posterior vitreous detachment, migraine with aura, retinal break, or detachment). Amblyopia - answeralso called lazy eye; is disorder of sight d/t eye and brain not working well together. Results in decreased vision in an eye that otherwise typically appears normal. Most common cause of decreased vision in a single eye among children and younger adults. Macular Degeneration - answeris caused when part of the retina deteriorates; dry (atrophic) from gradual breakdown of cells in macula resulting in gradual blurring of central vision and wet (exudative or neovascular)- new abnormal vessels grow under the center of the retina; the blood vessels leak, bleed, and scar the retina, distorting or destroying central vision. In contrast to dry, vision loss may be rapid. Is leading cause of blindness in older than 55 years of age in U.S. Xanthelasma - answercondition characterized by elevated plaque of cholesterol; commonly found on the nasal portion of the eyelid. Snellen Test***** - answerThe optic nerve is assessed by testing for visual acuity and peripheral vision. Visual acuity is tested using a snellen chart, for those who are illiterate and unfamiliar with the western alphabet, the illiterate E chart, in which the letter E faces in different directions, maybe used. The chart has a standardized number at the end of each line of letters; these numbers indicates the degree of visual acuity when measured at a distance of 20 feet. The numerator 20 is the distance in feet between the chart and the client, or the standard testing distance. The denominator 20 is the distance from which the normal eye can read the lettering, which correspond to the number at the end of each letter line; therefore the larger the denominator the poorer the version. Measurement of 20/20 vision is an indication of either refractive error or some other optic disorder. In testing for visual acuity you may refer to the following: 1. The room used for this test should be well lighted. 2. A person who wears corrective lenses should be tested with and without them to check fro the adequacy of correction. 3. Only one eye should be tested at a time; the other eye should be covered by an opaque card or eye cover, not with client's finger.