NURSING > STUDY GUIDE > NURS 190 PA FINAL Exam Study Guide, Latest 2020. (All)

NURS 190 PA FINAL Exam Study Guide, Latest 2020.

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NURS 190 PA FINAL Exam Study Guide, Latest 2020.________________________________________ Inspection technique (3): ● FIRST technique with general survey ● General survey: ○ Observing mobility / gait, physical appearance, general wellness/health, mood & behavior (facial expressions, interactions), mental status (observing patient’s body language and response when asking questions) ● Do it the SAME WAY every time → less likely to forget something ● Do not rush it, especially with anxious patients ○ Make sure the patient is comfortable ○ Temperature in the room is suitable for the patient ● Make sure that you have everything that you need → so that the patient has confidence in you ● Know normal vs abnormal when surveying appearance & symmetry ○ Compare ANYTHING that has a pair ○ Eyes- level, equal, is there eyelid drooping? ○ Smile- is there a droop? ○ Always compare the two sides to ensure that there is no abnormality between the two sides ● Listen for natural sounds ○ Abnormal sounds: wheezing, labored breathing, crepitus during ROM ● Detect abnormal odors: ○ CDIFF, alcohol on a patient, acetone / sugary breath ● Try not to assume anything ! → use critical thinking! ○ Ex: someone with low blood sugar or issues with hypoxia can appear intoxicated ● Know your normal values: ○ Blood pressure, HR, RR, O2 sats, temperature ○ For each age levels ■ Infants: must faster RR than elderly ________________________________________ Percussion technique (3) ● Types: ○ Direct percussion- tapping body with fingertips of dominant hand ■ For a small infant → direct percussion on the chest ■ Adult → on the sinuses on the face ○ Blunt percussion- place palm of nondominant hand flat against the surface and strike it with closed-fist dominant hand ■ Used to assess the kidneys → assessing for pain / tenderness (UTI) ○ Indirect percussion- most commonly used ■ Plexor = hammer or tapping finger ■ Pleximeter = device or surface that accepts the tap ● Sounds: ○ Intensity of amplitude: softness or loudness ○ Pitch or frequency: high or low (vibrations per second) ○ Duration: length of time ○ Quality: recognizable overtones or drumlike sounds ● Tympany- sound heard over stomach or intestines ○ Loud, high-pitched, drum-like tone ● Resonance- normal sound heard over lungs ○ Loud, low-pitched, hollow tone ● Hyperresonance- air trapped in lungs ○ Abnormally loud, low tone of longer duration than resonance ■ COPD, trauma or lung collapse ● Dullness- over solid body organs (liver) ○ High-pitched tone, soft and short ● Flatness- over solid tissue, muscle, or bone ○ High-pitched tone, very soft & shorter than dullness ■ Ex: ribs

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