Health Assessment Exam 2 Study Guide

Technical Equipment and Uses: a. Bell - for low pitch sounds b. Diaphragm - is used for high pitch sounds 1. Parts of the Stethoscope Stethoscope a. Ask the PT to say 99 while you listen with a stethoscope. If abnormal it will sound more distinct through the stethoscope then normal. 2. What is Bronchophony? a. Ask PT to pronounce 'ee-ee-ee--ee" sound. If the noise changes, it is abnormal. 3. What is egophony? Health Assessment: Skills; inspection, palpation, percussion, auscultation a. 1st inspect, 2nd auscultate, 3rd percuss, 4th palpate i. Auscultate before percussing or palpating the abdominal b. What step do you do first in physical exam of the abdominal? 1. Assessing Abdominal Tenderness i. Palpation uses the sense of touch to assess the patient for these factors. ii. Inspection involves vision iii. Percussion assesses through the use of palpable vibrations and audible sounds iv. Auscultation uses the sense of hearing a. Inspection, Palpation, Percussion, Auscultation i. Palpation Which of these techniques uses the sense of touch to assess texture, temperature, moisture, and swelling when the nurse is assessing a patient? b. temporal external Carotids Brachial Radial Ulnar Aortic Femoral Popliteal Dorsalis pedis Posterior tibial c. Where do you palpate the pulses? i. Acronym is APETM 1. Aortic - 2nd intercostal space, right of sternal border 2. Pulmonic - 2nd intercostal space left sternal border 3. Erb's point- 3rd intercostal space at the left sternal border 4. Tricuspid- 4th or 5th intercostal space at the left lower sternal border. 5. Mitral- 5th intercostal space near the left midclavicular line, apex of the heart d. How many steps and names to the steps of Auscultating HEART SOUNDS? 2. Skills in order Pull the pinna up and back on adult or older child. Pull pinna down for child younger than 3. a. Which way to you pull the ear for adult Vs. child? b. What do you try to locate on the tympanic membrane? 1. Hearing/Ear Other Assessments: hearing, skin, vision, balance Health Assessment Exam 2 Study Guide Monday, August 6, 2018 8:30 AM New Section 1 Page 1 This study source was downloaded by from CourseH on :23:13 GMT -05:00 Cone of light b. What do you try to locate on the tympanic membrane? Whisper test c. What is the gross hearing test? anything less than 20/40 should be referred for correction i. Use the Snellen eye chart. Stand 20 feet away from the chart. Test one eye at a time a. How to test for Visual acuity 2. Visual/ Eyes i. Note characteristics of: Color Edema Moisture Temperature Texture Mobility and turgor Lesions ii. ABCDE of skin assessment A- asymmetry B- Border irregularity C- color D- diameter E- evolution or elevation a) Commonly called liver spots , these are small, flat, brown macules - forearms and dorsa of the hands 1) Senile lentigines are common variations of hyperpigmentation. a) Overgrowths of normal skin that form a stalk and are polyp-like - eyelids, cheeks and neck, and axillae and trunk 2) Acrochordons, or “skin tags,” a) Develop mostly on the trunk but also on the face and hands and on both unexposed and sun -exposed areas. 3) Keratoses are raised, thickened areas of pigmentation that look crusted, scaly, and warty, looks dark, greasy, and “stuck on iii. Color and Pigmentation a. Techniques of examination of the skin: 3. Skin a. Romberg test - balance test 4. Balance location, duration, quality, intensity, and aggravating/relieving factors. 1. Initial Pain Assessment Provocation/palliation Quality/quantity Region/radiation Severity Scale Timing 2. PQRST method of pain a. Tension(head band) b. Migraine (localized spot in front) c. Cluster (stabbing pains/excruciating)