NURS 340 HEALTH ASSESSMENT FINAL EXAM. 259
ACTUAL QUESTIONS AND CORRECT VERIFIED
ANSWERS|100% GUARANTEED TO PASS CONCEPTS|
ALREADY GRADED A+.
Subjective data gathering for breast exam 1
Ø Pain, lump, and discharge
Ø Rash, swelling, trauma
Ø History of breast disease
Ø Surgery or radiation
Ø Medications
Ø Patient-centered care
Ø Perform breast self-examination/last mammogram
· If a patient reports complaints of breast pain, do not dismiss their symptoms. We need to ask the
patient more information about their pain.
· Trauma
o Any trauma or injury to the breasts?
o Presentation: Did it result in any swelling, lump, or break in skin?
· History of breast disease
o Any history of breast disease yourself?
o Diagnosis: What type? How was this diagnosed?
o Medical management: When did this occur? How is it being treated?
o Family history: Any breast cancer in your family? Who? Sister, mother, maternal grandmother,
maternal aunts, daughter?
o At what age did this relative have breast cancer?
· Preadolescent girl
o Appearance: Have you noticed your breasts changing?
o Onset: How long has this been happening?
o Description: What have you noticed?
o Feelings: What do you think about all this?
,· Pregnant woman
o Appearance: Have you noticed any enlargement or fullness in the breasts?
o Presentation: Is there any tenderness or tingling?
o Medical history: Do you have inverted nipples?
o Anticipatory planning: Are you planning to breastfeed your baby?
· Menopausal woman
o Have you noticed any change in breast contour, size, or firmness?
Patient teaching for breast exam
i. Lie down, press the 3 middle fingers in a circular motion and uses 3 levels of pressure. Follow an up
and down pattern
ii. Sit up. Examine underarm with arm slightly raised
iii. Note surface changes with hands pushed on hips, shoulders hunched.
1. Self-breast exams should be performed once a month
-----------------------------------------------------------
· The self-breast exam should be performed once a month
· The simpler the plan, the more likely the person is to comply.
· Describe correct technique and rationale and expected findings to note as woman inspects her own
breasts.
· Teach woman to do this in front of a mirror while she is disrobed to waist.
· At home, she can start palpation in shower, where soap and water assist palpation.
· Then palpation should be performed while lying supine.
· Encourage woman to palpate her own breasts while you monitor her technique.
· Use of model for return demonstration as well as pamphlets may be helpful.
· **Keep it simple**
Important regions of the breast exam that are especially important when palpating for breast lumps
a. Upper outer quadrant of the breast
tail of spense, the nipple and areola
mammogram screening guidelines for women's health
a. all women over the age 40 years should have an annual mammogram.
,· Optional annual screening for those at average risk at ages 40 to 44 years and definite annual
mammography beginning at age 45 years
abnormal findings during inspection of breast exam
a. A sudden increase in the size of one breast signifies inflammation or new growth
b. Redness, bulging, or dimpling
c. Skin lesions, rashes, focal vascular pattern
d. edema
phalen's test
i. Phalen test reproduces numbness and burning in a person with carpal tunnel syndrome
Phalen test procedure
a. Ask the person to hold both hands back-to-back while flexing the wrist 90 degrees.
Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand.
procedure for performing plantar flexion
a. (Push on the gas pedal) against your resistance
crepitation
a. Patient complaints of dry, crackling or grating sounds
-An audible and palpable crunching or grating that accompanies movement.
positions/movements for normal range of motion of the ankle
a. Sitting and standing and walking
i. Compare feet, contour of joints, summitry
ii. Normally flat feet
iii. Toes point straight forward and lie flat
· Inversion—Moving the sole of the foot inward at the ankle
· Eversion—Moving the sole of the foot outward at the ankle
· Hinge joint: limited to flexion (dorsiflexion) and extension (plantar flexion) in one plane
lordosis
a. Pronounced lumbar curve seen in obese people/pregnancy
kyphosis
, a. Enhanced thoracic curve typically seen in aging people
common, with a backward head tilt to compensate
osteoporosis
a. Loss of bone density from decreased mineralization
-higher - denser bone
-lower - consistent predictor of hip and vertebral fractures
abduction
moving a limb away from the midline of the body
adduction
moving a limb toward the midline of the body
ligaments
a. Fibrous bands from one bone to another that strengthen the joint and prevent unwanted movement
supination
a. Turning the forearm so the palm is up
passive range of motion
a. Performing ROM on patient to prevent contractures
common exam findings along with symptoms of patients with rheumatoid arthritis
a. Fatigue
b. Weakness
c. Anorexia
d. Weight loss
e. Low-grade fever
f. Lymphadenopathy
· Inflammation of synovial tissues, hyperplasia, and swelling lead to fibrosis, cartilage and bone
destruction, which limit motion and show as deformity
· Chronic inflammatory pain
swan-neck deformity
Flexion contracture resembles curve of a swan's neck, as in metacarpophalangeal joint.
Then hyperextension of the PIP joint, and flexion of the DIP joint.
ACTUAL QUESTIONS AND CORRECT VERIFIED
ANSWERS|100% GUARANTEED TO PASS CONCEPTS|
ALREADY GRADED A+.
Subjective data gathering for breast exam 1
Ø Pain, lump, and discharge
Ø Rash, swelling, trauma
Ø History of breast disease
Ø Surgery or radiation
Ø Medications
Ø Patient-centered care
Ø Perform breast self-examination/last mammogram
· If a patient reports complaints of breast pain, do not dismiss their symptoms. We need to ask the
patient more information about their pain.
· Trauma
o Any trauma or injury to the breasts?
o Presentation: Did it result in any swelling, lump, or break in skin?
· History of breast disease
o Any history of breast disease yourself?
o Diagnosis: What type? How was this diagnosed?
o Medical management: When did this occur? How is it being treated?
o Family history: Any breast cancer in your family? Who? Sister, mother, maternal grandmother,
maternal aunts, daughter?
o At what age did this relative have breast cancer?
· Preadolescent girl
o Appearance: Have you noticed your breasts changing?
o Onset: How long has this been happening?
o Description: What have you noticed?
o Feelings: What do you think about all this?
,· Pregnant woman
o Appearance: Have you noticed any enlargement or fullness in the breasts?
o Presentation: Is there any tenderness or tingling?
o Medical history: Do you have inverted nipples?
o Anticipatory planning: Are you planning to breastfeed your baby?
· Menopausal woman
o Have you noticed any change in breast contour, size, or firmness?
Patient teaching for breast exam
i. Lie down, press the 3 middle fingers in a circular motion and uses 3 levels of pressure. Follow an up
and down pattern
ii. Sit up. Examine underarm with arm slightly raised
iii. Note surface changes with hands pushed on hips, shoulders hunched.
1. Self-breast exams should be performed once a month
-----------------------------------------------------------
· The self-breast exam should be performed once a month
· The simpler the plan, the more likely the person is to comply.
· Describe correct technique and rationale and expected findings to note as woman inspects her own
breasts.
· Teach woman to do this in front of a mirror while she is disrobed to waist.
· At home, she can start palpation in shower, where soap and water assist palpation.
· Then palpation should be performed while lying supine.
· Encourage woman to palpate her own breasts while you monitor her technique.
· Use of model for return demonstration as well as pamphlets may be helpful.
· **Keep it simple**
Important regions of the breast exam that are especially important when palpating for breast lumps
a. Upper outer quadrant of the breast
tail of spense, the nipple and areola
mammogram screening guidelines for women's health
a. all women over the age 40 years should have an annual mammogram.
,· Optional annual screening for those at average risk at ages 40 to 44 years and definite annual
mammography beginning at age 45 years
abnormal findings during inspection of breast exam
a. A sudden increase in the size of one breast signifies inflammation or new growth
b. Redness, bulging, or dimpling
c. Skin lesions, rashes, focal vascular pattern
d. edema
phalen's test
i. Phalen test reproduces numbness and burning in a person with carpal tunnel syndrome
Phalen test procedure
a. Ask the person to hold both hands back-to-back while flexing the wrist 90 degrees.
Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand.
procedure for performing plantar flexion
a. (Push on the gas pedal) against your resistance
crepitation
a. Patient complaints of dry, crackling or grating sounds
-An audible and palpable crunching or grating that accompanies movement.
positions/movements for normal range of motion of the ankle
a. Sitting and standing and walking
i. Compare feet, contour of joints, summitry
ii. Normally flat feet
iii. Toes point straight forward and lie flat
· Inversion—Moving the sole of the foot inward at the ankle
· Eversion—Moving the sole of the foot outward at the ankle
· Hinge joint: limited to flexion (dorsiflexion) and extension (plantar flexion) in one plane
lordosis
a. Pronounced lumbar curve seen in obese people/pregnancy
kyphosis
, a. Enhanced thoracic curve typically seen in aging people
common, with a backward head tilt to compensate
osteoporosis
a. Loss of bone density from decreased mineralization
-higher - denser bone
-lower - consistent predictor of hip and vertebral fractures
abduction
moving a limb away from the midline of the body
adduction
moving a limb toward the midline of the body
ligaments
a. Fibrous bands from one bone to another that strengthen the joint and prevent unwanted movement
supination
a. Turning the forearm so the palm is up
passive range of motion
a. Performing ROM on patient to prevent contractures
common exam findings along with symptoms of patients with rheumatoid arthritis
a. Fatigue
b. Weakness
c. Anorexia
d. Weight loss
e. Low-grade fever
f. Lymphadenopathy
· Inflammation of synovial tissues, hyperplasia, and swelling lead to fibrosis, cartilage and bone
destruction, which limit motion and show as deformity
· Chronic inflammatory pain
swan-neck deformity
Flexion contracture resembles curve of a swan's neck, as in metacarpophalangeal joint.
Then hyperextension of the PIP joint, and flexion of the DIP joint.
