N125 Exam 1

what is the purpose of taking a health history

-collect subjective data -history is combined with the objective data from physical examination and lab studies to form the database -the data base is used to make a judgement or diagnosis about the health status of the individual -health history describes the individual as a whole and how the person interacts with enviorn. -records strength & coping skills -can confirm what the pt is doing right & staying well (excercise, diet, substance risk, substance use, risk reduction) -for ill person, can be a screening tool for abnormal Sx, health problems, concenrs

what is nociceptive pain

-develops when functioning and intact nerve fibers in the periphery and CNS are stimulated -4x phases: (1) transduction (2) transmission (3) perception (4) modulation -somatic (dull, aching) -visceral (cramping, sequzing) radiation

Pain with older adults

-find the numeric rating s cale abstract & have difficulty responding, esp with a fluctuating chronic pain experiment -alternative is simple descriptor scale that list words like "no pain, moderate, and severe".

what is neuropathic pain

-pain that does not adhere to typical and rather predictible phases in nociceptice pain -caused by lesion or disease of somatosensory nervous sys -or NERVE pain -sharp, shooting, burning, electrical

what is the moderate risk for women

0.81-0.85

what is the moderate risk for men

0.96-1.0

what pain assessment tools are appropriate to use with different patient populations?

1) Anyone, but can be used for children too --> WONG-BAKER FACES PAIN RATING SCALE 2) Verbal descriptor scale--> use words to describe the pt feelings and meaning of pain for person 3) visual analog scale--> pt an mark along a 10 cm horizontal line from no pain to worst pain imaginable. can be horizontal or vertical 4) Numeric rating scale

what is the health history sequence

1. biographic data 2. reason for seeking care 3. present of history of present illness 4. past history 5. medication reconciliation 6. Family history 7. Review of systems 8. Functional assessment or activities of daily Living (ADLs)

what are the factors controlling blood pressure

1. cardiac output 2. vascular resistance 3. volume 4. viscosity 5. elasticity of arterial walls

what is the normal range for BP

130-90 / 80-60

what is underweight BMI range?

16-18.5

what is the normal range for BMI?

18.5-25

what is the overweight range for BMI?

25-30

what is the normal heart rate range

50-90 beats per min

what is the MAP necessary to perfuse coronary arteries, brain, and kidneys

60

what is the range for mean arterial pressure?

70-110

what is the range of typical oral temperature

96.4-99.1

what is the typical oral temperatuer

98.6

what is the formula for BMI

BMI = [(weight (lb))/(height (in))^2]* 703

Pain with Children

CRIES, FLACC

LOUDCARTS-->what does it mean?

L=Location O=onset U= Understanding D= duration C= characteristics A= Aggrevates & Associates with: R = Relief T= Treatment S= Severity

what is the formula for mean atrial pressure (MAP)?

[(2 x diastolic) + systole] / 3

what is a symptom

a subjective sensation that the person feels from the disorder

What does it mean to advocate for a pt complaining about pain?

advocate for patients by ensuring the pt (or delegated fam member) has adequate knowledge to make informed decisions about pain management

how should you respond when a patient complains of pain?

advocate-->for the patients intervene--> in the health care system to assist the patient/client to achive appropriate management of pain educate--> patients who are reticent to take pain medication

what is the stroke volume

amount of blood every heart beat pumps into aorta (about 70mL in adult)

what is a sign

an objective abnormality that you as the examiner could detect on a physical examination or in lab reports

how to measure temperature for newborn (less than 1 month)?

auxiliary

what is the low risk waist hip ratio for women?

below 0.8

what is the low risk waist hip ratio for men?

below 0.95

what is pulse pressure

difference between systolic and diastolic

LOUDCARTS: example questions for D

how long does the symptom last? is it constant? is it intermittent?

what does it mean to intervene for a pt complaining about pain

in the health care sys to assist the pt/client to achieve appropriate mgmt of pain may include phoning physicians (even in the mid of night) for new medication orders to ensure pt comfort or for reduced dosage orders for pt who is requesting less sedation from medications

what happens to temperature during exercise

increases temperature

what happens to temperature during ovulation?

increases temperature (range when progesterone is 0.5-1 deg F) until menses

what happens with temperature during diurnal cycle?

increases temperature in PM decreases temperature in AM

LOUDCARTS: example questions for T

medications==what meds have you tried for your symptom? nonpharmacological interventions (heat/cold, massage)

is the tympanic or temporal temperature reliable? when would you use it?

no, but it is a good quick assessment of the temperature. typical for 3-24 mos

what is the high risk for women

over 0.85

what is the high risk for men

over 1

what is arterial pressure mean?

pressure forcing blood into tissues, averaged over a cardiac cycle

what does it mean to educate a pt complaining of pain

pt. who are reticient to take pain medication due to fear of addiction to understand the deleterious effects of pain on the . body and that there is minimal risk of addiction when opiods are taken for pain relife

what is the difference between rectal temperature and oral temperature

rectal temperature is higher (golden standard) of 0.7 to 1 deg F

what happens as you age?

temperature decreases from typical temperature from 98.6 deg F to 97.2 deg F

what is the waist to hip ratio?

waist (in) / hip (in)

LOUDCARTS: example questions for U

what does the pt think is the cause?

what is subjective

what hte person says about himself/herself

LOUDCARTS: example questions for S

what is the severity of the symptom 0-10 scale

LOUDCARTS: example questions for R

what makes your symptom better? what medical and non-medical interventions relieve the pain?

LOUDCARTS: example questions for A

what makes your symptom worse? (moving, sitting, walking) are there other symptoms associated with the complaint?

LOUDCARTS: example questions for C

what words describe your symptom? what does your symptom feel like? Quality? what words would you use to describe the symptom? (sharp, dull, mild, moderate, severe)

what is objective

what you observe through measurement, inspection, palpation, percussion, and auscultation

LOUDCARTS: example questions for O

when did you symptom start? how often does it occur? has its intensity changed? what was the pt doing when the symptom began?

what is the gold standard for temperature? and when?

when the mouth and ear isn't available and if pt is in comatose. rectum

LOUDCARTS: example questions for L

where is your symptom located? does it radiate or travel to other sites? touch where your symptom is?

ATC (around the clock) dosing for a pt complaining about pain

can also advocate for pt by recognizing that giving a medication on a regular schedule may result in more constant pain relief