Chamberlain College of Nursing - NR 509 Focused Exam. Chest Pain objective. Advanced Health Assessment - Chamberlain, NR509-April-2018.Objective Data Collection: 32 of 33 (96.97%)

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Focused Exam: Chest Pain Results | Turned In Advanced Health Assessment - Chamberlain, NR509-April-2018 Return to Assignment Your Results Lab Pass Objective Data Collection: 32 of 33 (96.97%) Cor... rect Partiallycorrect Incorrect Missed Inspected face 1 of 1 point Appearance (1/1 point) No Evidence of trauma (scar, laceration, or bruising) Inspected for jugular venous distension 1 of 1 point Height Of Venous Pressure (1/1 point) 4 cm or less above the sternal angle More than 4 cm above the sternal angle Inspected chest 1 of 1 point Symmetry (1/2 point) rmal Intercostal retraction while breathing Excessive use of accessory muscles while breathing Overview Transcript Subjective Data Collection Objective Data Collection Education & Empathy Documentation Skin growths (freckles or moles) t Symmetry (1/3 point) Symmetric Asymmetric Appearance (1/3 point) No visible abnormal findings Rash Striae Bulging around umbilicus Distension Visible masses (warts, cysts, or tumors) Freckles, birthmark, or discoloration Excessive hair growth Contour (No point) Flat Rounded Protuberant Hollowed Inspected hands and fingernails 1 of 1 point Right: Appearance (1/4 point) Right: Nail Changes (1/4 point) No visible abnormal findings No visible abnormal findings Redness Pallor Moles or skin tags Cyanosis Scarring Laceration, lesion, or wound Bruising Rash sis Masses (warts, cysts, or tumors) Splinter hemorrhages Freckles, birthmark, or other discoloration Clubbing Excessive dry or flaking skin Purpura Scarring5/22/2018 Focused Exam: Chest Pain | Completed | Shadow Health toenails 1 of 1 point Right: Appearance (1/4 point) Right: Nail Changes (1/4 point) No visible abnormal findings No visible abnormal findings Visible distortion or swelling Pallor Brownish pigmentation Cyanosis Skin thickening Splinter hemorrhages Ulceration Clubbing Varicose veins Left: Appearance (1/4 point) Left: Nail Changes (1/4 point) No visible abnormal findings No visible abnormal findings Visible distortion or swelling Pallor Br Varicose veins Inspect lower extremities for edema 1 of 1 point Right: Edema (1/4 point) No edema Pitting Non-pitting Left: Edema (1/4 point) No edema Pitting Non-pitting Right: Severity Of Edema (1/4 point) No edema disappears in 10 to 15 seconds 3+ Noticeably deep pit that lasts more than a minute No edema 1+ Slight pitting 2+ Deeper pit, disappears in 10 to 15 seconds 3+ Noticeably deep pit that lasts more than a minute 4+ Very deep pit that lasts 2 to 5minutes Tested capillary refill time 1 of 1 point Fingers (1/2 point) No bruit Bruit Auscultated heart sounds 1 of 1 point Heart Sounds (1/2 point) Murmur Friction rub Valve clicks Auscultated breath sounds 0.33 of 1 point Breath Sounds (1/3 point) Present in all areas Diminished in some areas Absent in some areas Location (No point) All areas clear Adventitious sounds in anterior right upper lobe Wheezing Fine crackles Stridor Rhonchi Rales Auscultated abdominal aorta 1 of 1 point Sounds (1/1 point) No bruit Bruit Auscultated abdominal and lower extremity arteries 1 of 1 point Right: Renal (1/6 point) Left: Renal (1/6 point) No bruit No bruit Bruit Bruit s (1/2 point) Absent Hypoactive Normoactive Hyperactive Location Of Non Normoactive Bowel Sounds (1/2 point) All quadrants normoactive Right upper quadrant Right lower quadrant Left upper quadrant Left lower quadrant Palpated carotid arteries 1 of 1 point Right: Vibration (1/4 point) No thrill Thrill Left: Vibration (1/4 point) 3+ Increased 4+ Bounding pulse Left: Amplitude (1/4 point) 0 Absent 1+ Diminished or barely palpable Palpated PMI 1 of 1 point Location (1/3 point) Present at midclavicular line and 5th intercostal space Displaced laterally Amplitude (1/3 point) t) Less than 3 cm Greater than 3 cm Palpated brachial arteries 1 of 1 point Right: Vibration (1/4 point) No thrill Right: Amplitude (1/4 point) Thrill Left: Vibration (1/4 point) No thrill Thrill 1+ Diminished or barely palpable 2+ Expected 3+ Increased 4+ Bounding pulse Palpated radial arteries 1 of 1 point Right: Vibration (1/4 point) Right: Amplitude (1/4 point) 0 Absent 1+ Diminished or barely palpable 2+ Expected 3+ Increased 4+ Bounding pulse Left: Amplitude (1/4 point) Left: Vibration (1/4 point) No thrill Thrill Palpated femoral arteries 1 of 1 point Right: Vibration (1/4 point) Right: Amplitude (1/4 point) 0 Absent 1+ Diminished or barely palpable 2+ Expected 3+ Increased 4+ Bounding pulse Left: Amplitude (1/4 point) 0 Absent 1+ Diminished or barely palpable 2+ Expected 3+ Increased 4+ Bounding pulse No thrill Thrill Left: Vibration (1/4 point) No thrill Thrill Palpated popliteal arteries 1 of 1 point Right: Vibration (1/4 point) No thrill Thrill Right: Amplitude (1/4 point) 0 Absent No thrill Thrill Left: Amplitude (1/4 point) 0 Absent Palpated tibial arteries 1 of 1 point Right: Vibration (1/4 point) Right: Amplitude (1/4 point) 0 Absent 1+ Diminished or barely palpable Left: Amplitude (1/4 point) Left: Vibration (1/4 point) No thrill Thrill Palpated dorsalis pedis arteries 1 of 1 point Right: Vibration (1/4 point) Right: Amplitude (1/4 point) 0 Absent 1+ Diminished or barely palpable 2+ Expected le Tenderness reported Location Of Tenderness (1/3 point) No quadrants tender Right upper quadrant No additional observations Left upper quadrant Left lower quadrant Palpated abdomen - deep 1 of 1 point Presence Of Unexpected Mass (1/2 point) No palpable mass Palpable mass Location Of Mass (1/2 point) No palpable mass Right upper quadrant Palpated liver 1 of 1 point Detection (1/1 point) Not palpable Palpable Palpated spleen 1 of 1 point neys 1 of 1 point Right (1/2 point) Not palpable Palpable Left (1/2 point) Not palpable Palpable Tested skin turgor 1 of 1 point Observations (1/1 point) Liver (1/2 point) No friction rub Audible friction rub Spleen (1/2 point) No friction rub Audible friction rub Percussed abdomen 1 of 1 point Observations (1/1 point) point Spleen (1/1 point) Tympany Dullness Percussed liver 1 of 1 point Liver Span (1/1 point) Smaller than 6 cm Between 6 and12 cm Greater than 12 cm Performed EKG 1 of 1 point Sinus Rhythm (1/2 point) St Changes (1/2 point) No ST elevation [Show More]

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