Nr 302 Exam 1 Study Guide

Radiating- EX: MI radiates to jaw and arm

Acute- sudden on set

Chronic- long lasting

Somatic - deep pain usually in organs

Refereed- pain at the synapse of the nerves

Phantom- amputee who has pain in fake limb

Neuropathic - pain in the nerves endings

O - Onset

L - Location

D - Duration

C - Characteristics

A- Aggravation factors

R- Relieving factors

T- Treatment

I - Impact on ADL's

C- Coping strategies

E - Emotional response

Caucasians have the highest rate

Black skin people have the highest rates of dying of skin cancer

A - Asymmetry

B - Boarder

C - Color

D - Diameter

E - Evolving changes

It is the formation of a hard scare after the skin has been damaged

shape and contour

Consistency

Color

Hair loss

Color

General pigmentation

Areas of hyper or hypopigmentation

Abnormal color changes

Temperature

Moisture

Texture

Thickness

Edema

Mobility and turgor

hygiene

Vascularity or Brusing

You would assess using the ABCDE

A- asymmetrical

B - Border

C- color

D - distribution

E - evolution

when the skin comes white for a period of time because there is not enough RBC's circulating through there body

EX: when you press on the fingernail for 5 sec then release it the color should return in less than three seconds

The body getting ride of the toxic waste through the skin due to renal failure

Texture

Distribution

Any scalp legions

Sweating due to increased metabolic rate, heavy activity or fever

Disease S&S = Thyrotoxicosis, heart attack, anxiety, or pain

1+ = Mild pitting, slight indentation

2+ = Moderate pitting, Indentation resides fast

3+ = Deep pitting, indentation remain for short time, leg show signs of swelling

4+ = Very deep pitting, indentation remain for a while, legs are very swollen

The primary is the initial pimple then once you pop that bitch it becomes a secondary lesion

Test to see if you have clubing of the finger nails

There is chronic hypoxia some where in there body

Cause by infection endocarditis

1. Assessmet

2. Diagnosis - from Nurse perspective

3. Planning - Make a smart goal

4. Implementation - Shows how are you going to accomplish said smart goal

5. Evaluation - Did it work?

1. Make a list : current meds, current med history, allergies, reason for seeking care

2. Determine if there is a relationship among the principle problem

3. Setting priority is a dynamic and every changing environment

A - Airway problems

B - Bleeding problems

C - Cardiac/Circulation problems

V - Vital sign concerns

When a PT has cardiac arrest and CPR should be started immediately

1. Mental status change

2. Untreated med problems needing immediate treatment

3. Acute pain

4. Acute urinary elimination

5. Abnormal lab values

6. At risk for infection, safety, or security

Anything outside the list of first and second priorities

ex: family coping, lack of knowledge, rest, or activity

What a PT tells you

ex: Pain, nausea, headache etc

What you see on the PT.

Ex; Necrosis, Pallor, cyanosis, enlarged lymph nodes... etc

1. Gonorrhea

2. Syphilis

3. AIDS

4. Firearm injuries

5. TB

6. Homicide

7. Drug-induced death

Be Empathy

Engage in active listening

Be self aware

Demonstrate the ability to listen

Know your PT and their culture to ensure that the environment is at the optimal state to ensure a smooth interview process

1. Ensure privacy

2. Refuse interruptions

3. Comfortable physical environment

Zone 1 - Intimate zone (0 - 1 1/2 ft)

Zone 2 - Personal zone (1 1/2 - 4 ft)

Zone 3 - Social zone (4 - 12 ft)

Zone 4 - Public distance (12 ft +)

1. Providing false reassurance

2. Giving unwanted advice

3. Using authority

4. Using avoiding language

5. Distancing your self

6. Using medical terminology with PT

7. Using leading or biased questions

8. Talking to much

9. Interrupting

10. Using why questions

1. Posture

2. Gestures

3. Facial expression

4. Eye contact

5. Voice

6. Touch

4 thumbs

Caused by the dominant version of the chicken pox Varicella zoster virus (VZV).

Small groups of lesions appear along the Cutaneous sensory nerve. Pain is very severe and long lasting

Common in PT over the age of 50.

Acute appearance, unilateral, DOSE NOT CROSS MID LINE!!!!!

Most common on trunk but can happen any where

Found on upper lip, Oral mucosa, & tounge

Early signs are Skin tingling and sensitivity, then lesion erupt around the are area in tight vesicles followed by pustules and acute gingivostomatitis with many shallow and painful ulcers

Anemia

Shock

Local arterial insufficiency

Albinism

Vitiligo

Sign of decrease hemocrit & shock

Light skin- General pallor all over

Brown skin - appears yellow-brown, dull

Black skin appears ashen gray, dull skin loses its healthy glow

Light skin - Marked local pallor in lower extremities

Dark skin - Ashen gray, dull; cool to palpation

Total absence of pigment melanin throughout the integument system

Light skin - Whitish pink skin throughout entire body with light eyes as well

Dark skin - Tan, cream, white color of skin

Patchy depigmentation from the destruction of melanocytes

Light skin - Patchy milky white spots often systemic bilaterally throughout body

Dark skin - same as above

Central : Cardiac or pulmonary disease cause arterial desaturation

Peripheral : Exposure to cold and anxiety

Is cause by an increase amount of deoxygenated blood circulation in the system

Light skin : Dusty blue skin throughout and dusky nail beds

Dark skin: Look dull and lifeless only severe cyanosis will appear in skin, check conjunctiva, oral mucosa, nail beds

Hyperemia

Polycythemia

Carbon monoxide poisoning

Venous stasis

Caused by increased blood flow through enlarged arteries

EX: Inflammation, fever, alcohol & blushing

Light skin - Red, pink color

Dark skin - Purplish but hard to see, must palpate to feel the warmth beneath in his skin

Caused by increased red blood cells & capillary stasis

Light skin - Ruddy blue color in face, conjunctiva, hands, feet, & oral mucosa

Dark skin - Well concealed check for redness in lips.

Light - Bright cherry red face and upper body

Dark skin- Cherry red nail beds, lips, and oral mucosa

Caused by decreased blood flow to an area due to enlarged venules

Light skin: Dusky rubor of dependent extremities, a precursor to necrosis with pressure sores

Dark skin: Easily masked use palpation for warmth and edema

Increased serum bilirubin

Carotenemia

Uremia

Caused by increased serum of bilirubin from liver inflammation, hemolytic disease burns & some infections

Light skin: Yellow In hard plate, sclera, mucus membranes the over skin

Dark skin: Check sclera, and confirm with assessment of hard and soft plate and palms of hands because it is hard to see in the skin

Cause by increased serum carotene from ingestion of large amount of carotene foods.

Light skin: Yellow-orange forehead, palms, & soles, but no yellowing of sclera or mucus membranes

Dark skin: Yellow orange tinge on palms and soles

Caused by Renal failure which causes urochrome pigment in the blood?

Light skin: Orange-green or gray from overlaying pallor of anemia.

Dark skin: Easily masked, rely on labs and clinical findings.

Vitamin C deficiency

gums become swollen, ulcerated, and bleed from the basement membrane and periodontal collagen fibers

Caused my Vitamin D and calcium deficiencies affects children and adults differently

Kids: Disrupts the growth at the epiphyseal growth plate

Adults: Osteomalacia

Riboflavin deficiency

If pale: sign of iron deficiency

If a beefy red: sign of vitamin b complex deficiency

Caused by a diet high in Cal's but low in protein

Shows as well-nourished look with edematous

Serum albumin <3.5 g/dl

Serum Transferrin <150mg/dl

obese feature

Weight >120% of standard for height

Triceps skin fold (TSF) >10%

Waist-to-hip ratio Men >1/ Women >.8

BMi>40% is morbid or extreme obese

Results of inadequate protein and calories, or prolonged starvation

Characterized by losing weight, adipose tissue loss, and Muscle wasting.

Weight <80% for the standard

TSF <90%

Mid-upper-arm-muscle circumference (MAMC)

<90% standard

<18.5 = Underweight

18.5-24.9 = Normal weight

25-29.9 = Overweight

30-39.9 = Obesity

>40% = Extreme Obesity

(Weight (Lb) / Height (in) squared)*703

EX: Weight = 237lb & Height = (72in)^2 = 32.14% BMI

OR

(Weight (Kg) / Height (M) squared)

EX: 107.501KG / 1.8288m^2 = 32.14 BMI

Caused by endocrine or metabolic dysfunction or occasional idiopathic

Results in the formation of excess body hair on a female. (upper lip, face, chest, abdomen, arms, & legs

characterized by red, swollen, tender inflammation in nail folds

Acute = bacterial infection with pus in proximal end of nail fold pain and throbbing

Chronic = fungal infection that got in through a break in the cuticle

Caused by trauma, acute illness, or toxic reaction that impairs nail formation.

The dent will appear at the cuticle and will grow and move down the nail formation as the nails grows.

Will look like a transverse furrow or groove that extends across the nail.

Can result from systemic disease (vasculitis) & trauma or sport-related illness

Shows signs of red=brown linear streaks from damage to nail bed capillaries

is a fungal infection that has gone ramped in your toe nails in particular

Fungus can change color, texture, & thickness with nail crumbling or dislodging from nail plate

Results from increase in platelet -derived growth factors which cause the fragmented to become trapped in the finger tips and from new vessels with in tips of finger.

Can be reversed it the blood flow is returned to normal

Is spread from person to person by sharing of and infected item EX: sharing a hat, underware etc...

Wash everything in hot water, use OTC shampoos to kill them

School age children common to get it

No known cause

S&S : sudden appearance of sharply circumscribed, round oval patches. has the ability to grow back

Cause by trauma from hair rollers , tight braids, tight pony tail, or barrettes.

S&S: linear or oval patches of hair loss along hair line with scattered distribution