Health Assessment HESI Review #2
Characteristics of palpable
nodes Location
Size
Shap
e
Delimitatio
n Mobility
Consistenc
y
Tendernes
s
Myxedema (Hypothyroidism)
A deficiency of the thyroid hormone. This reduces metabolic rate, and when
severe causes non pitting edema or myxedema.
Symptoms: fatigue, cold intolerance, coarse/dry hair and skin, and
weight gain. What is the best indicator of Parathyroid Problems?
Decrease in client's calcium compared with preoperative value.
Grave's Disease (hyperthyroidism)
Increased production of thyroid hormones causes an increased metabolic
rate. Symptoms: exophthalmos, fatigue, nervousness, weight loss, cramps,
and heat intolerance.
Cushing Syndrome
Excessive secretion of ACTH and chronic
steroid use. Symptoms: "moon like" face,
Buffalo hump, hirsutism
Lymphadenopathy
Enlargement of lymph nodes greater than 1 cm. This occurs from infection,
allergy, or neoplasm.
Contusion (Bruise)
1. Red, blue, or purple
2. Blue to purple
3. Blue- green
4. Yellow
5. Brown to disappearing
Serous Exudate
Clear or straw colored.
,Normal part of healing process.
Serosanguineous Exudate
Pink colored due to blood mixed with serous
drainage. Normal part of healing process.
Sanguineous Exudate
Red drainage from trauma to a blood vessel. May occur with wound cleansing
or put her trauma to the wound bed. Abnormal to the wound healing process.
Hemorrhage Exudate
Frank blood leaking from a blood vessel. May require emergency treatment to
control bleeding.
And a normal part of the healing process.
Purulent Drainage
Yellow, gray, or green drainage due to infection in the wound.
Polycyclic
Annular lesions grow
together (Lichen planus,
psoriasis)
ABCDE
rule
Asymmetr
y Border
Color
Diameter greater than
6mm Elevation or
Evolution
Xerosi
s Dry
skin
Senile purpura
Common in the aging Adult
- a minor trauma that may produce dark red discolored areas.
Function of the
skin Protection
Prevents
penetration
, Perception
Temperature
regulation
Characteristics of palpable
nodes Location
Size
Shap
e
Delimitatio
n Mobility
Consistenc
y
Tendernes
s
Myxedema (Hypothyroidism)
A deficiency of the thyroid hormone. This reduces metabolic rate, and when
severe causes non pitting edema or myxedema.
Symptoms: fatigue, cold intolerance, coarse/dry hair and skin, and
weight gain. What is the best indicator of Parathyroid Problems?
Decrease in client's calcium compared with preoperative value.
Grave's Disease (hyperthyroidism)
Increased production of thyroid hormones causes an increased metabolic
rate. Symptoms: exophthalmos, fatigue, nervousness, weight loss, cramps,
and heat intolerance.
Cushing Syndrome
Excessive secretion of ACTH and chronic
steroid use. Symptoms: "moon like" face,
Buffalo hump, hirsutism
Lymphadenopathy
Enlargement of lymph nodes greater than 1 cm. This occurs from infection,
allergy, or neoplasm.
Contusion (Bruise)
1. Red, blue, or purple
2. Blue to purple
3. Blue- green
4. Yellow
5. Brown to disappearing
Serous Exudate
Clear or straw colored.
,Normal part of healing process.
Serosanguineous Exudate
Pink colored due to blood mixed with serous
drainage. Normal part of healing process.
Sanguineous Exudate
Red drainage from trauma to a blood vessel. May occur with wound cleansing
or put her trauma to the wound bed. Abnormal to the wound healing process.
Hemorrhage Exudate
Frank blood leaking from a blood vessel. May require emergency treatment to
control bleeding.
And a normal part of the healing process.
Purulent Drainage
Yellow, gray, or green drainage due to infection in the wound.
Polycyclic
Annular lesions grow
together (Lichen planus,
psoriasis)
ABCDE
rule
Asymmetr
y Border
Color
Diameter greater than
6mm Elevation or
Evolution
Xerosi
s Dry
skin
Senile purpura
Common in the aging Adult
- a minor trauma that may produce dark red discolored areas.
Function of the
skin Protection
Prevents
penetration
, Perception
Temperature
regulation
