Nurs 1014 Health Assessment
Final
What should the external ocular structures be able to do? - Move purposefully
What are the external ocular structures? - Eyebrows, eyelids, eyelashes, eyeballs,
conjuctive, sclera, lacrimal apparatus
What does the diagnostics positions test, test for? - Parallel tracking, nystagmus and lid
lag
What position should the neck be for carotid artery auscultation? - A neutral position
What do you look for when auscultating the carotid artery? - Bruits by using the bell
What should the patient do before auscultating the carotid artery? - Hold their breath
momentarily
Do you auscultate or palpate the carotid arteries first? - Auscultate
What locations would you auscultate for the carotid artery? - The angle of the jaw, the
midcervical and the base of the neck
What part of the eye is the accommodation test for? - The iris and the pupil
What does the accommodation test, test? - Constriction and convergence
What is part of the anterior eyeball? - The cornea, lens, iris and pupil
What size does the pupil rest? - 3-5mm
What is aniscoria? - Unequal pupils
What should the normal left and right pupil fraction be? - 3/1
What does pupillary light reflex need to be? - Direct and consensual
What is the normal response for an anterior eye test? - PERRLA
What is part of the ocular fundus? - The retina, optic disc, physiological cup and the disc
diameter
What color is the selector dial of an opthalmascope for far sighted? - Black/green
,What color is the selector dial of an opthalmascope for near sighted? - Red
What is an opthalmascope? - A large white viewing aperature
What needs to be done when using an opthalmascope? - The room needs to be dark,
the patient should remove their glasses and the focus should be on the red reflex
How do you hold an opthalmascope? - Hold it with your right hand to the right eye to
view the right eye and vice versa
What is a large opthalmascope aperature for? - Dilated pupils
What is a small opthalmascope aperature for? - Undilated pupils
What is a red free filter used for? - To examine hemorrhage in the eye
What is a grid opthalmoscope aperature for? - To determine the fixation patter and to
assess lesions
What is a slit optholmoscope aperature for? - To examine the anterior portion of the eye
What are retina vessels a sign of? - Systemic vascular disease
What would you look for with normal ocular fundus? - The background of the the
fundus, the macula, the fovea which you inspect last
What is kids visual acuity? - Response to objects
What tests can be done for kids visual acuity? - The allen test for 2 and 2.5 year olds,
the snellen e test for 3 to 6 year olds
What age is slight nystagmus normal? - Over two months
What is the best way to examine the fundus in a child? - Let the child hold the
equipment or play a game
What is purpura? - An extensive patch of confluent petechiae
What is important to remember with the health history of an older adult? - Symptoms
may be trivialized, there are effects of aging, they can have a thorough med history, and
there are positive health measures
What is important with documentation? - Be objective, provide complete information like
what was asked, the absence or presence of symptoms and the duration of symptoms
and it is important to not use the term normal or negative to describe findings
,What do you need to wear for palpation? - Gloves
What should be encouraged during palpation? - Relaxation for decreased muscle
tension
What part of the hand should you use when palpating? - The sensitive part of the hand
or fingers
What is the order of palpation? - Light palpation then deep palpation
What does heavy pressure dull? - Sensitivity
What can deep palpation cause? - Pain but it is not a true symptom
How deep should you depress for deep palpation? - 1-2 inches
How should you perform deep palpation? - Bimanually or with one hand
What are you assessing during deep palpation? - Organs and masses deep in the body
cavities
What can be bad during deep palpation? - Prolonged pressure
What is percussion? - Tapping of the skin surface to create and hear sound waves
What can you assess using percussion? - Location, size, shape and density
What do you assess using percussion? - The abdomen and the thorax
How is percussion done? - Firm, rapid, short blows
What are the two types of percussion? - Direct and indirect
What is percussion like in an air filled organ? - It vibrates freely
What is percussion like in a dense organ? - It doesn't vibrate easily
What is amplitude and intensity like with percussion? - Loud vs soft
What is pitch like with percussion? - Hi vs lo
What is quality like with percussion? - Descriptive
What is a flatness percussion sound like? - A flat sound, a dead stop, hi pitch and dense
tissue
, What is a dullness percussion sound like? - Thud like, muffled, hi pitch and soft
What is a resonance percussion sound like? - Hollow, lo pitch and loud
What is a hyperresonance percussion sound like? - Booming, lo pitch, loud sound,
longer duration, abnormal in adults and normal for kids
What is a tympany percussion sound like? - Musical, drum like, hi pitch and loud
How are percussion sounds created? - By changes in density which goes from most
dense to least dense
What are the two types of auscultation? - Direct and indirect
What do you listen for during auscultation? - Presence, absence, pitch, intensity, quality
of sound and duration
What is an important factor in auscultation? - A quiet space, all noise sources need to
be reduced and to concentrate on the sounds
What should you avoid during auscultation? - Rubbing or hitting the tubing
What temperature should auscultation be and why? - Warm to prevent shivering
What is the diaphragm? - The flat piece of the stethoscope?
When should you use the diaphragm of a stethoscope? - For hi pitched sounds
What should you do when using the diaphragm of a stethoscope? - Press firmly to
create a seal
What is the bell? - The cup of the stethoscope
When do you use the bell of a stethoscope? - For lo pitched sounds
How do you use the bell of a stethoscope? - Hold it lightly or it creates a diaphragm
What is physical appearance? - Age, sex, consciousness levels, skin colour, facial
features
What is body structure? - Stature, nutrition, symmetry, posture, body build and contour
What is involved with mobility? - Gait and range of motion
What is involved with behaviour? - Facial expression, mood, affect, speech, dress and
personal hygiene
Final
What should the external ocular structures be able to do? - Move purposefully
What are the external ocular structures? - Eyebrows, eyelids, eyelashes, eyeballs,
conjuctive, sclera, lacrimal apparatus
What does the diagnostics positions test, test for? - Parallel tracking, nystagmus and lid
lag
What position should the neck be for carotid artery auscultation? - A neutral position
What do you look for when auscultating the carotid artery? - Bruits by using the bell
What should the patient do before auscultating the carotid artery? - Hold their breath
momentarily
Do you auscultate or palpate the carotid arteries first? - Auscultate
What locations would you auscultate for the carotid artery? - The angle of the jaw, the
midcervical and the base of the neck
What part of the eye is the accommodation test for? - The iris and the pupil
What does the accommodation test, test? - Constriction and convergence
What is part of the anterior eyeball? - The cornea, lens, iris and pupil
What size does the pupil rest? - 3-5mm
What is aniscoria? - Unequal pupils
What should the normal left and right pupil fraction be? - 3/1
What does pupillary light reflex need to be? - Direct and consensual
What is the normal response for an anterior eye test? - PERRLA
What is part of the ocular fundus? - The retina, optic disc, physiological cup and the disc
diameter
What color is the selector dial of an opthalmascope for far sighted? - Black/green
,What color is the selector dial of an opthalmascope for near sighted? - Red
What is an opthalmascope? - A large white viewing aperature
What needs to be done when using an opthalmascope? - The room needs to be dark,
the patient should remove their glasses and the focus should be on the red reflex
How do you hold an opthalmascope? - Hold it with your right hand to the right eye to
view the right eye and vice versa
What is a large opthalmascope aperature for? - Dilated pupils
What is a small opthalmascope aperature for? - Undilated pupils
What is a red free filter used for? - To examine hemorrhage in the eye
What is a grid opthalmoscope aperature for? - To determine the fixation patter and to
assess lesions
What is a slit optholmoscope aperature for? - To examine the anterior portion of the eye
What are retina vessels a sign of? - Systemic vascular disease
What would you look for with normal ocular fundus? - The background of the the
fundus, the macula, the fovea which you inspect last
What is kids visual acuity? - Response to objects
What tests can be done for kids visual acuity? - The allen test for 2 and 2.5 year olds,
the snellen e test for 3 to 6 year olds
What age is slight nystagmus normal? - Over two months
What is the best way to examine the fundus in a child? - Let the child hold the
equipment or play a game
What is purpura? - An extensive patch of confluent petechiae
What is important to remember with the health history of an older adult? - Symptoms
may be trivialized, there are effects of aging, they can have a thorough med history, and
there are positive health measures
What is important with documentation? - Be objective, provide complete information like
what was asked, the absence or presence of symptoms and the duration of symptoms
and it is important to not use the term normal or negative to describe findings
,What do you need to wear for palpation? - Gloves
What should be encouraged during palpation? - Relaxation for decreased muscle
tension
What part of the hand should you use when palpating? - The sensitive part of the hand
or fingers
What is the order of palpation? - Light palpation then deep palpation
What does heavy pressure dull? - Sensitivity
What can deep palpation cause? - Pain but it is not a true symptom
How deep should you depress for deep palpation? - 1-2 inches
How should you perform deep palpation? - Bimanually or with one hand
What are you assessing during deep palpation? - Organs and masses deep in the body
cavities
What can be bad during deep palpation? - Prolonged pressure
What is percussion? - Tapping of the skin surface to create and hear sound waves
What can you assess using percussion? - Location, size, shape and density
What do you assess using percussion? - The abdomen and the thorax
How is percussion done? - Firm, rapid, short blows
What are the two types of percussion? - Direct and indirect
What is percussion like in an air filled organ? - It vibrates freely
What is percussion like in a dense organ? - It doesn't vibrate easily
What is amplitude and intensity like with percussion? - Loud vs soft
What is pitch like with percussion? - Hi vs lo
What is quality like with percussion? - Descriptive
What is a flatness percussion sound like? - A flat sound, a dead stop, hi pitch and dense
tissue
, What is a dullness percussion sound like? - Thud like, muffled, hi pitch and soft
What is a resonance percussion sound like? - Hollow, lo pitch and loud
What is a hyperresonance percussion sound like? - Booming, lo pitch, loud sound,
longer duration, abnormal in adults and normal for kids
What is a tympany percussion sound like? - Musical, drum like, hi pitch and loud
How are percussion sounds created? - By changes in density which goes from most
dense to least dense
What are the two types of auscultation? - Direct and indirect
What do you listen for during auscultation? - Presence, absence, pitch, intensity, quality
of sound and duration
What is an important factor in auscultation? - A quiet space, all noise sources need to
be reduced and to concentrate on the sounds
What should you avoid during auscultation? - Rubbing or hitting the tubing
What temperature should auscultation be and why? - Warm to prevent shivering
What is the diaphragm? - The flat piece of the stethoscope?
When should you use the diaphragm of a stethoscope? - For hi pitched sounds
What should you do when using the diaphragm of a stethoscope? - Press firmly to
create a seal
What is the bell? - The cup of the stethoscope
When do you use the bell of a stethoscope? - For lo pitched sounds
How do you use the bell of a stethoscope? - Hold it lightly or it creates a diaphragm
What is physical appearance? - Age, sex, consciousness levels, skin colour, facial
features
What is body structure? - Stature, nutrition, symmetry, posture, body build and contour
What is involved with mobility? - Gait and range of motion
What is involved with behaviour? - Facial expression, mood, affect, speech, dress and
personal hygiene
