Nur-634 Advanced Physical Assessment Midterm Study Guide

NUR-634 ADVANCED PHYSICAL
ASSESSMENT MIDTERM STUDY GUIDE

SubjectiveooDataoo-ooans---
symptomsoofromootheooclient'soopointooofooviewooandooinclude:oofeelings,ooperceptions,ooa
ndooconcerns
-whatootheoopatientootellsooyou

ObjectiveooDataoo-ooans---
whatootheoohealthooprofessionalooobservesoobyooinspecting,oopalpating,oopercussing,ooan
dooauscultatingooduringootheoophysicalooexamination
-observedoosigns

Assessmentoo-ooans---
theooclinicalooreasoningooprocessoothatoointerpretsootheoopatient'soohistoryooandoophysical
ooexamination,oosinglesoooutooidentifiedooproblems,ooandoomovementoofromooeachooprobl
emsootoooitsooactionooplan

Planoo-ooans---
incorporatesoopatientooeducation,oochangesooinoomedications,ooneededootests,ooreferrals
ootooootherooclinicians,ooandooreturnoovisitsooforoocounselingooandoosupport
-
requiresoogoodoointerpersonalooskillsooandoosensitivityootoootheoopatientsoogoals,ooecono
micoomeans,oocompetingooresponsibilities,ooandoofamilyoostruggles/dynamics

Percussionoo-ooans---
aoodiagnosticooprocedureoodesignedootooodetermineootheoodensityooofooaoobodyoopartooby
ootheoosoundooproducedoobyootappingootheoosurfaceoowithootheoofingers
-
useooofootheoostrikingooorooplexoroofingeroo(usuallyootheoo3rd)ootooodeliverooaoorapidootapoo
orooblowooagainstootheoodistaloopleximeteroofingeroo(usuallyootheoodistaloo3rdoofingerooofoot
heooleftoohandoolaidooagainstootheoosurface)ootoooevokeooaoosoundoowave
-theoo5oosoundsooareooresonant,ooflat,oodull,oohyperooresonant,ooandootympanic
-
Resonantoosoundsooareoolowoopitched,oohollowoosoundsooheardoooveroonormaloolungootis
sue.
-Flatooareoonormallyooheardoooveroosolidooareasoosuchooasoobones.oothigh
-
Dulloooroothudlikeoosoundsooareoonormallyooheardoooveroodenseooareasoosuchooasootheoo
heartooorooliver.ooDullnessooreplacesooresonanceoowhenoofluidoooroosolidootissueooreplace

, sooair-
containingoolungootissues,oosuchooasoooccursoowithoopneumonia,oopleuralooeffusions,oooro
otumors.
-
Hyperresonantoosoundsoothatooareoolouderooandooloweroopitchedoothanooresonantoosound
sooareoonormallyooheardoowhenoopercussingootheoochestsooofoochildrenooandooveryoothinoo
adults.ooHyperresonantoosoundsoomayooalsooobeooheardoowhenoopercussingoolungsoohyp
erinflatedoowithooair,oosuchooasoomayoooccurooinoopatientsoowithooCOPD,oooroopatientsooh
avingooanooacuteooasthmaticooattack.ooAnooareaooofoohyperresonanceooonoooneoosideooof
ootheoochestoomayooindicateooaoopneumothorax.
-
Tympanicoosoundsooareoohollow,oohigh,oodrumlikeoosounds.ooTympanyooisoonormallyoohe
ardoooverootheoostomach,oobutooisoonotooaoonormaloochestoosound.ooTympanicoosoundsoo
heardoooverootheoochestooindicateooexcessiveooairooinootheoochest,oosuchooasoomayoooccu
roowithoopneumothorax.

AttributesooofooaooSymptomoo-ooans---sevenooattributes
-OPQRSToo&ooAssociatedoomanifestationsoo(anythingooelseooaccompanyingooit)
-onset,ooprovocative/palliative,ooquality,ooregion/radiation,ooseverity,ootiming

TalkativeooChallengingooPatientooInterventionoo-ooans---giveoo5-
10oominutesoouninterrupted
-focusooonooandooaskooquestionsootooowhatooseemsoomostooimportantootooopatient
-summarizeooconcernsooandoofocusooonoo#1ooconcernootoday
-avoidooimpatience

AngryooChallengingooPatientooInterventionoo-ooans---
acknowledgeooanyooinvolvementooyouoomayoohaveooinootheirooangerooandoomakeooamen
ds
-avoidooreinforcingoocriticismooofoootherooclinicians
-validateootheiroofeelingsoowithoutooagreeingoowithootheirooreasons
-ensureooaoosafeooenvironment,ooalertoostaff/security
-stayoocalmooandooavoidoobeingooconfrontational
-keepooaoorelaxedooandoononthreateningooposture

SilentooChallengingooPatientooInterventionoo-ooans---
beooattentiveooandoorespectfulooandooencourageoopatientootooocontinueoowhenootheyooare
ooready
-watchooforoononverbaloocuesoosuchooasoodifficultyoocontrollingooemotions
-watchooforoosignsooofoodepression
-askoowhyootheyooareooquiet

ConfusingooChallengingooPatientooInterventionoo-ooans---
guideooquestions,ooaskooforooclarification,ooandoosummarize
-watchooforoounderlyingooissueooifoothereooisoointerferenceoowithoocommunication