Erstellt von claire.m.sm
vor mehr als 10 Jahre
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Frage | Antworten |
Ataxia | Loss of muscle control; drunken walk |
2 pt discrimination | ability to determine between 2 stimuli on the skib |
Dysphagia | trouble swallowing, gluglug |
Dysphasia | difficulty with motor speech |
graphesthesia | inability to recognize #/letter drawn on hand |
stereognosis | inability to recognize object placed in hand |
tinnitus | ringing in ear |
vertigo | room is spinning |
Interview Process | 1) Bio Date 2) Chief Complaint 3) HPI 4) Allergies and Meds 5) Past History 6) Family History 7) ROS 8) Functional asessment of ADL |
For children what is their subjective data? | The same as adult + Developmental Status Nutritional Status |
Psychosocial Interview for Adolescents | Home Education Eating Activities Drugs Sexuality Suicide and Depression Safety |
ADPIE | nursing process Assessment Diagnosis Planning Intervention Evaluation |
Assessment | Collection of data |
Diagnosis | Problem NANDA approved r/t Etiology AEB Sx/S ( could be at actual, at risk or wellness) |
Nursing Care Plan | 1) Identify most important problem 2)Goals (nurse's approach to problem) 3) Outcomes (pt centered) 4) Evaluate pt's response to care plan |
BMI | weight (kg)/ height (m^2) |
BMI interpretation | <18.5 underweight 18.5- 25 healthy 25-30 overweight 30-39.9 obesity >40 extreme obesity |
MAP | Diastolic + 1/3 PP PP= systolic-diastolic |
Physical Examination Techniques | 1) Inspect 2) Palpate 3)Percussion 4) Ausculate |
Inspect | Look |
Palpate | Touch feel for temperature or abnormalities |
Percussion | Tap to hear for abnormalities 1)Lungs- resonant 2) Spleen/liver-thud 3) |
Ausculation | Listen 1) Bell=low sounds 2) diaphragm= high sounds |
Normal Blood Pressure | 120/80 |
Pre hypertension | 120-139 8-89 |
Hypertension | 140-159 90-99 |
Stage 2 Hypertension | Above 160 Above 100 |
Componnts of Mental Status Exam | Appearance behavior Cognition Thought process |
Appearance | Dress Body movement Hygiene |
Behavior | Level of Conciousness Facial Expression Speech Mood and Affect |
Cognition | Orientation (person, place, time) Attention span Recent Memory Remote memory New learning Judgment Higher Intellectual Fx |
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