NR 509 APEA ADVANCED PHYSICAL ASSESSMENT EXAM WITH CORRECT ANSWERS GRADED A+

NR 509 APEA ADVANCED PHYSICAL ASSESSMENT EXAM WITH CORRECT ANSWERS GRADED A+ 5 R's off cultural humility - Reflection— what did I learn? Respect—did I treat everyone involved w respect? Regard—did unconscious bias drive this encounter? Relevance—how was cultural humility relevant? Resiliency—how did my personal resilience affect this interaction? Core Values of Medical Ethics - nonmaleficence, beneficence, respect for autonomy, decisional capacity, confidentiality, informed consent, truth telling, justice Focused Health History - ALL components of the Complete Health History with the focus on the specific reason the client is seeking care. Comprehensive Health History - includes biographic data, reason for seeking care, present health status, past medical history, family history, personal and psychosocial history, and a review of all body systems Psych Obstetrics Surgery c-section goes here Hospital stays Components of Health History - 1) Demographic information 2) Source of history 3) Chief concern 4) History of present illness ——OLDCARTS 5) Past health history and current health status 6) Family history 7) Social history 8) Health promotion behaviors 9) ROS ——all subjective The interview process - Initiating the session Gathering information Physical examination Explanation and planning Closing the session These steps are proving structure and building the relationship interviewing techniques - Nonverbal communication Empathy Active listening Validation reassurance partnering summarize Guided questioning Empowerment Setting the stage for examination - Explaining point for point what the examination will entail, preparing, privacy, awareness of the setting in which the exam is taking place, do not assume it is ok to have others in the room, being aware of disabilities. Establishing Rapport - Earning trust, following through, showing empathy and compassion, being knowledgeable of the information provided Gender Pronouns - How a person would like to be referred to. Ex: "She/Her" "He/Him" "They/Them" etc. How would you describe your sexual identity How would you describe your gender identity What is the sex on your original birth certificate FIFE model - Feelings Ideas Functioning Expectations Helps explore the patient's perspective about their health and illness Patient-centered medical care - Involving the patient in their care and coming up with a plan with the provider. Provider must acknowledge their own personal biases while being aware of what is the safest Sam's most effective plan for the patient Fundamentals of skilled interviewing - Active listening, empathetic responses, guided questioning, nonverbal communication, validation, reassurance, partnering, summarization, transitions, empowering the patient verbal communication - expressing ideas to others by using spoken words nonverbal communication - communication using body movements, gestures, and facial expressions rather than speech Determining the Scope of patient assessment - The patient's symptoms, age, and health history help determine the scope of the focused examination, as does your knowledge of disease patterns. seven attributes of a symptom - 1. Location 2. Quality 3. Quantity or severity 4. Timing (including onset, duration, and frequency) 5. The setting in which it occurs 6. factors that have aggravated or relieved the symptom 7. associated manifestations subjective data - what the person says about himself or herself during history taking objective data - information that is seen, heard, felt, or smelled by an observer; signs Modifying of the clinical interview for various settings - Interviews may vary based on where the interview is taking place. Ideal situations are a quiet, uninterrupted environment however the ER setting, home setting, urgent care, nursing home, and inpatient setting will differ greatly from information obtained to what can be visualized by the clinician in the setting. Interruptions are likely during lengthy interview processes. Watch interviewing during the examination. Determining the scope of examination - Is the exam going to be focused or comprehensive? Review chart for information to make the decision on what to focus on or be prepared to do a comprehensive assessment. Techniques of Examination - 1. Inspection 2. Palpation 3. Percussion