ADVANCE HEALTH ASSESSMENT TEST 2 QUESTIONS WITH COMPLETE ANSWERS.

ADVANCE HEALTH ASSESSMENT TEST
2 QUESTIONS WITH COMPLETE
ANSWERS.

What are the most common respiratory related CCs? What are some of the
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causes of these conditions? - ANSWER: 1- Cough (could be anything)
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- hemoptysis = scary, TB, cancer, bronchitis
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2- Shortness of breath
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- wheeze (anxiety, asthma, HF, COPD, PE)
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3- Chest Pain
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- cardiac or thoracic? - assess their O2 status!!
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What are some chronic diseases that warrant a respiratory assessment? -
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ANSWER: - COPD
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- asthma
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- SLEnn


- RA nn


- sarcoidosis
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What is one consideration that we should have as astute clinicians concerning our
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clinical decision making? - ANSWER: Will my next step affect patient outcomes?
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How do health disparities affect respiratory health? - ANSWER: - EXPOSURE
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(cooking w/o ventilation)
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- $$ prescriptions
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- smog
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- histoplasmosis
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- obesity
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smoking
- pesticides/herbicides
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**THESE ARE AREAS WHERE WE CAN INTERVENE AND EDUCATE**
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What is a tool that we can use to ascertain information about air quality? -
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ANSWER: Air Quality Indices - Messages for Patients
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What does an air quality health index of 1-3 equate to? How does it affect the
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general population? What populations are at risk? - ANSWER: **LOW RISK!!**
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AT RISK: Enjoy your usual outdoor activities
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GENERAL POPULATION: Ideal air quality for outdoor activities
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,What does an air quality health index of 4-6 equate to? How does it affect the
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general population? What populations are at risk? - ANSWER: **MODERATE
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RISK!!**
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AT RISK: Consider reducing or rescheduling strenuous activities outdoors if you
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are experiencing symptoms
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GENERAL POPULATION: No need to modify your usual outdoor activities unless
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you experience symptoms such as coughing and throat irritation.
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What does an air quality health index of 7-10 equate to? How does it affect the
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general population? What populations are at risk? - ANSWER: **HIGH RISK!!**
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AT RISK: Reduce or reschedule strenuous activities outdoors. Children and the
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elderly should also take it easy.
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GENERAL: Consider reducing or rescheduling strenuous activities outdoors if you
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experience symptoms such as coughing or throat irritation
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What does an air quality health index above 10 equate to? How does it affect the
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general population? What populations are at risk? - ANSWER: **VERY HIGH
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RISK!!**
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AT RISK: Avoid strenuous activities outdoors. Children and the elderly should also
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avoid outdoor physical exertion
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GENERAL: Reduce or reschedule strenuous activities outdoors, especially if you
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experience symptoms such as coughing and throat irritation
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What are some key point regarding preventive care for the respiratory system? -
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ANSWER: 1- SMOKING CESSATION AND AVOIDANCE: 1st and 2nd hand
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smoke, pack year history
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2- EXPOSURES: pollution, air quality, local environment, respiratory pathogens
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3- VACCINES: influenza, pneumovax, TB skin tests, childhood immunizations
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4- OPTIMAL MANAGEMENT OF CHRONIC DISEASES: COPD, asthma,
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sarcoidosis, obesity, exercise, diet, sleep, stress, sleep apnea
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5- SCREENINGS? CXRs, PPDs
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How do you compute a pack year history? - ANSWER: # of packs smoked a day
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x years smoking
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What part of a TB skin test should you read? - ANSWER: the induration, not the
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erythema
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What are the 5 As of smoking cessation? - ANSWER: ASK
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ADVISE
ASSESS
ASSIST
ARRANGE

Who should get the pneumovax vaccine? - ANSWER: - >65 years old
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- smokers 19-65
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,- cochlear implants
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- immunocompromised adults >2
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- 2 - 64 yo with chronic illness
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Who should get the flu vaccine? - ANSWER: EVERYONE!!
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- adults with chronic pulmonary and medical conditions, immunosuppressed or
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morbidly obese
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- pregnant women
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- residents of nursing homes and LT care
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- American Indian and Alaskan Natives
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- Health Care workers
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- Household contacts and caregivers of kids under 5 and 50+ yo with medical risk
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for complications
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What are the differentials related to respiratory complaints? - ANSWER: URIs
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Asthma
COPD
Pneumonia
Bronchitis
Nosocomial pneumonia nn


TB
Cancer
Interstitial Lung Disease nn nn


Sleep Apnea nn


Smoking

What is the time frame of an acute cough? - ANSWER: 0 - 2 weeks
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What is the time frame for a subacute cough? - ANSWER: 3 - 8 weeks
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What does this documentation sound like: "Thorax symmetric with moderate
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kyphosis, lungs hyperresonant, delayed expiratory phase, fremitus decreased?" -
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ANSWER: COPD
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What all should be included in the HPI component of a SOAP note for someone
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with a respiratory complaint? - ANSWER: Timing, location, setting, quality,
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severity, relieving and exacerbating factors, associated symptoms or status of
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chronic illness
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What all should be included in the past medical history of someone with a
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respiratory CC? - ANSWER: 1- CHRONIC ILLNESSES:
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- asthma, COPD, TB, HIV, sarcoidosis, SLE
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- CHF? CAD?
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- cancer
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2- SURGERIES/HOSPITALIZATIONS/ TRAUMA:
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- pneumonia, lobectomies, exacerbation of chronic illness, worried about rib trauma
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, 3- TESTING:
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- CXR, CT, PPD, Pulmonary Function Tests?
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4- IMMUNIZATIONS:
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- flu, pneumovax, childhood immunizations
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5- MEDICATIONS:
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- inhalers, steroids, antibiotics, oral contraceptives (blood clots), anticoagulants
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(bleeding), ACE-I
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6- SLEEP APNEA - DIAGNOSED? CONTROLLED?
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- Ask spouse! Snore? Well rested?
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What are the components of a social history of a client with a respiratory
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complaint? - ANSWER: 1- EXPOSURES:
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- recent travel
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- hobbies (carpenters)
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- employment (coal miner, house cleaners)
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- air quality/hazards
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- flu/TB/CAP (ill contacts, living environments)
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2- TOBACCO USE/ 2ND HAND EXPOSURE:
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- type
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- pack years
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- onset
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- attempts to quit
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3- ALCOHOL AND DRUG USE:
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4- NUTRITIONAL STATUS:
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- obese? emaciated?
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5- EXERCISE:
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- tolerance, location, air exposre
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What are the aspects of a family history for patients with a respiratory CC? -
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ANSWER: - TB
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- cystic fibrosis
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- emphysema/COPD
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- cancer - smokers?
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- allergies
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- asthma
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- systemic disease (RA, SLE, sarcoidosis)
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- Dermatitis (eczema)
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What are the components of a general ROS for someone with a CC of respiratory
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problems? - ANSWER: - Any chest pain or trouble breathing?
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- Cough? Productive or not?
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- SOB?
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- Wheezing?
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- Feeling tired?
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- Exercise intolerance?
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- Orthopnea
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