LAB MANUAL to ACCOMPANY: HEALTH ASSESSMENT in Nursing
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Assessment Module
Assessment Module 1 | Page Assessment May 2017 Table of Contents About this Module/Overview/Objectives……………………………………………...Page 3 Pre-test…………………………………………………………………………………Pages 4-5 Chapter 1……………………………………………………………………………....Pages 6-12 Overview Focused Assessment vs. Comprehensive Assessment Considerations in preparing for a physical exam Geriatric Assessment Nursing Components Considerations in Elderly Residents Chapter 2……………………………………………………………………………...Pages 12-14 Root Cause of Behaviors Physiologic Social Environmental Psychosocial Chapter 3……………………………………………………………………………...Pages 14-16 Risk Assessment Eyes Ears Hemiparesis Paraplegia Where to place the resident in the room Chapter 4……………………………………………………………...………………Pages 16-18 Texas Board of Nursing and Assessments Federal Nursing Facility Regulations F272: Comprehensive Assessments State Nursing Facility Regulations Chapter 5………………………………………………………………………….......Pages 18-19 Resources “This is me” “This is me: My Care Passport” Alternate Communication Boards Pain, Pain Go Away Presentation Appendices……………………………………………………………………………Pages 20-48 2 | Page Assessment May 2017 About this Module: Assessment is a key component of nursing practice, required for planning and the provision of resident and family centered care. Information that is obtained from an accurate assessment serves as the foundation for age-appropriate nursing care, enhancing the residents’ quality of life and independence. The LVN must have a specific set of skills in order to adequately and effectively assess the resident, including: a physical assessment; a functional assessment; and any additional information about the resident that would be used to develop the care plan. This module will provide you with all of the information necessary to ensure adequate assessments are completed for each resident in the facility, meeting the state and federal requirements for resident assessment. Overview: Conditions such as functional impairment and dementia are common in nursing home residents. -
HEENT EXAMINIATION ______HEENT Exam Exam Overview
HEENT EXAMINIATION ____________________________________________________________ HEENT Exam Exam Overview I. Head A. Visual inspection B. Palpation of scalp II. Eyes A. Visual Acuity B. Visual Fields C. Extraocular Movements/Near Response D. Inspection of sclera & conjunctiva E. Pupils F. Ophthalmoscopy III. Ears A. External Inspection B. Otoscopy C. Hearing Acuity D. Weber/Rinne IV. Nose A. External Inspection B. Speculum/otoscope C. Sinus areas V. Throat/Mouth A. Mouth Examination B. Pharynx Examination C. Bimanual Palpation VI. Neck A. Lymph nodes B. Thyroid gland 29 HEENT EXAMINIATION ____________________________________________________________ HEENT Terms Acuity – (ehk-yu-eh-tee) sharpness, clearness, and distinctness of perception or vision. Accommodation - adjustment, especially of the eye for seeing objects at various distances. Miosis – (mi-o-siss) constriction of the pupil of the eye, resulting from a normal response to an increase in light or caused by certain drugs or pathological conditions. Conjunctiva – (kon-junk-ti-veh) the mucous membrane lining the inner surfaces of the eyelids and anterior part of the sclera. Sclera – (sklehr-eh) the tough fibrous tunic forming the outer envelope of the eye and covering all of the eyeball except the cornea. Cornea – (kor-nee-eh) clear, bowl-shaped structure at the front of the eye. It is located in front of the colored part of the eye (iris). The cornea lets light into the eye and partially focuses it. Glaucoma – (glaw-ko-ma) any of a group of eye diseases characterized by abnormally high intraocular fluid pressure, damaged optic disk, hardening of the eyeball, and partial to complete loss of vision. Conductive hearing loss - a hearing impairment of the outer or middle ear, which is due to abnormalities or damage within the conductive pathways leading to the inner ear. -
General Signs and Symptoms of Abdominal Diseases
General signs and symptoms of abdominal diseases Dr. Förhécz Zsolt Semmelweis University 3rd Department of Internal Medicine Faculty of Medicine, 3rd Year 2018/2019 1st Semester • For descriptive purposes, the abdomen is divided by imaginary lines crossing at the umbilicus, forming the right upper, right lower, left upper, and left lower quadrants. • Another system divides the abdomen into nine sections. Terms for three of them are commonly used: epigastric, umbilical, and hypogastric, or suprapubic Common or Concerning Symptoms • Indigestion or anorexia • Nausea, vomiting, or hematemesis • Abdominal pain • Dysphagia and/or odynophagia • Change in bowel function • Constipation or diarrhea • Jaundice “How is your appetite?” • Anorexia, nausea, vomiting in many gastrointestinal disorders; and – also in pregnancy, – diabetic ketoacidosis, – adrenal insufficiency, – hypercalcemia, – uremia, – liver disease, – emotional states, – adverse drug reactions – Induced but without nausea in anorexia/ bulimia. • Anorexia is a loss or lack of appetite. • Some patients may not actually vomit but raise esophageal or gastric contents in the absence of nausea or retching, called regurgitation. – in esophageal narrowing from stricture or cancer; also with incompetent gastroesophageal sphincter • Ask about any vomitus or regurgitated material and inspect it yourself if possible!!!! – What color is it? – What does the vomitus smell like? – How much has there been? – Ask specifically if it contains any blood and try to determine how much? • Fecal odor – in small bowel obstruction – or gastrocolic fistula • Gastric juice is clear or mucoid. Small amounts of yellowish or greenish bile are common and have no special significance. • Brownish or blackish vomitus with a “coffee- grounds” appearance suggests blood altered by gastric acid. -
Nursing Students' Perspectives on Telenursing in Patient Care After
Clinical Simulation in Nursing (2015) 11, 244-250 www.elsevier.com/locate/ecsn Featured Article Nursing Students’ Perspectives on Telenursing in Patient Care After Simulation Inger Ase Reierson, RN, MNSca,*, Hilde Solli, RN, MNSc, CCNa, Ida Torunn Bjørk, RN, MNSc, Dr.polit.a,b aFaculty of Health and Social Studies, Institute of Health Studies, Telemark University College, 3901 Porsgrunn, Norway bFaculty of Medicine, Institute of Health and Society, Department of Nursing Science, University of Oslo, 0318 Oslo, Norway KEYWORDS Abstract telenursing; Background: This article presents the perspectives of undergraduate nursing students on telenursing simulation; in patient care after simulating three telenursing scenarios using real-time video and audio nursing education; technology. information and Methods: An exploratory design using focus group interviews was performed; data were analyzed us- communication ing qualitative content analysis. technology; Results: Five main categories arose: learning a different nursing role, influence on nursing assessment qualitative content and decision making, reflections on the quality of remote comforting and care, empowering the pa- analysis tient, and ethical and economic reflections. Conclusions: Delivering telenursing care was regarded as important yet complex activity. Telenursing simulation should be integrated into undergraduate nursing education. Cite this article: Reierson, I. A., Solli, H., & Bjørk, I. T. (2015, April). Nursing students’ perspectives on telenursing in patient care after simulation. Clinical Simulation in Nursing, 11(4), 244-250. http://dx.doi.org/ 10.1016/j.ecns.2015.02.003. Ó 2015 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/). -
CORRECTION of DEFORMITIES of the JAW by Patrick Clarkson M.B.E., M.B., B.S., F.R.C.S
CORRECTION OF DEFORMITIES OF THE JAW by Patrick Clarkson M.B.E., M.B., B.S., F.R.C.S. Casualty Surgeon, Guy's Hospital and Plastic Surgeon, Basingstoke Plastic;Ccntre. I. INTRODUCTION Degrees of Deformity and Pathology. Cooperation between Surgeon and Orthodontist. Surgical Treatment: Indication and Scope. Choice between radical surgery and " masking" operations. II. SURGICAL METHODS OF CORRECTION 1. Symmetrical Prognathism of the Mandible. 2. Asymmetrical Prognathism of the Mandible. 3. Symmetrical Recession of the Mandible. 4. Asymmetrical Recession of the Mandible. 5. The Jaw Deformities in Cleft Palate: Mandible and Maxilla. 6. Combined Jaw and Nasal Reductions. III. SUMMARY AND CONCLUSION I. INTRODUCTION A deformity of the jaw can be defined as any variation in these bones from the normal for the sex, age, and race of the patient; but only rela- tively gross variations come within the field of surgical repair. It is always possible by close examination to discover some degree of asymmetry in soft and bony tissues of the face, but the great majority of variations in facial skeleton, both symmetrical and unilateral, are scarcely noticeable to ordinary examination and require no treatment. Next in order of severity are a group of congenital origin which, given early and full ortho- dontic treatment, respond well without the need of surgery. This group includes a few of the early-cases of prognathism, of congenital open bite, and of recession of the jaw. Almost every case with these deformities can be improved by early orthodontic treatment. But all the more severe cases of prognathism, of recession, and the jaw deformities seen in patients with cleft palate, need surgical intervention if the correction is to be a complete one. -
CASE REPORT 48-Year-Old Man
THE PATIENT CASE REPORT 48-year-old man SIGNS & SYMPTOMS – Acute hearing loss, tinnitus, and fullness in the left ear Dennerd Ovando, MD; J. Walter Kutz, MD; Weber test lateralized to the – Sergio Huerta, MD right ear Department of Surgery (Drs. Ovando and Huerta) – Positive Rinne test and and Department of normal tympanometry Otolaryngology (Dr. Kutz), UT Southwestern Medical Center, Dallas; VA North Texas Health Care System, Dallas (Dr. Huerta) Sergio.Huerta@ THE CASE UTSouthwestern.edu The authors reported no A healthy 48-year-old man presented to our otolaryngology clinic with a 2-hour history of potential conflict of interest hearing loss, tinnitus, and fullness in the left ear. He denied any vertigo, nausea, vomiting, relevant to this article. otalgia, or otorrhea. He had noticed signs of a possible upper respiratory infection, including a sore throat and headache, the day before his symptoms started. His medical history was unremarkable. He denied any history of otologic surgery, trauma, or vision problems, and he was not taking any medications. The patient was afebrile on physical examination with a heart rate of 48 beats/min and blood pressure of 117/68 mm Hg. A Weber test performed using a 512-Hz tuning fork lateral- ized to the right ear. A Rinne test showed air conduction was louder than bone conduction in the affected left ear—a normal finding. Tympanometry and otoscopic examination showed the bilateral tympanic membranes were normal. THE DIAGNOSIS Pure tone audiometry showed severe sensorineural hearing loss in the left ear and a poor speech discrimination score. The Weber test confirmed the hearing loss was sensorineu- ral and not conductive, ruling out a middle ear effusion. -
Cardiovascular Assessment
Cardiovascular Assessment A Home study Course Offered by Nurses Research Publications P.O. Box 480 Hayward CA 94543-0480 Office: 510-888-9070 Fax: 510-537-3434 No unauthorized duplication photocopying of this course is permitted Editor: Nurses Research 1 HOW TO USE THIS COURSE Thank you for choosing Nurses Research Publication home study for your continuing education. This course may be completed as rapidly as you desire. However there is a one-year maximum time limit. If you have downloaded this course from our website you will need to log back on to pay and complete your test. After you submit your test for grading you will be asked to complete a course evaluation and then your certificate of completion will appear on your screen for you to print and keep for your records. Satisfactory completion of the examination requires a passing score of at least 70%. No part of this course may be copied or circulated under copyright law. Instructions: 1. Read the course objectives. 2. Read and study the course. 3. Log back onto our website to pay and take the test. If you have already paid for the course you will be asked to login using the username and password you selected when you registered for the course. 4. When you are satisfied that the answers are correct click grade test. 5. Complete the evaluation. 6. Print your certificate of completion. If you have a procedural question or “nursing” question regarding the materials, call (510) 888-9070 for assistance. Only instructors or our director may answer a nursing question about the test. -
Bates' Pocket Guide to Physical Examination and History Taking
Lynn S. Bickley, MD, FACP Clinical Professor of Internal Medicine School of Medicine University of New Mexico Albuquerque, New Mexico Peter G. Szilagyi, MD, MPH Professor of Pediatrics Chief, Division of General Pediatrics University of Rochester School of Medicine and Dentistry Rochester, New York Acquisitions Editor: Elizabeth Nieginski/Susan Rhyner Product Manager: Annette Ferran Editorial Assistant: Ashley Fischer Design Coordinator: Joan Wendt Art Director, Illustration: Brett MacNaughton Manufacturing Coordinator: Karin Duffield Indexer: Angie Allen Prepress Vendor: Aptara, Inc. 7th Edition Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2009 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2007, 2004, 2000 by Lippincott Williams & Wilkins. Copyright © 1995, 1991 by J. B. Lippincott Company. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appear- ing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia PA 19103, via email at [email protected] or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Library of Congress Cataloging-in-Publication Data Bickley, Lynn S. Bates’ pocket guide to physical examination and history taking / Lynn S. -
The Pupillary Light Reflex in the Critically Ill Patient
light must be high for the iris to be seen, which reduces Editorials the step increase induced by the penlight).6 If the pupillary light reflex amplitude is less than 0.3 mm and the maximum constriction velocity is less than 1 mm/s, the reflex is unable to be detected using a The pupillary light reflex in penlight.6 In conscious patients with Holmes-Adie and Argyll-Robertson pupils with ‘absent’ pupillary light the critically ill patient reflexes, small light reflexes have been detected using infrared pupillometry.7 Also in post-resuscitation non- brain dead critically ill patients with ‘absent’ pupillary The pupillary response to light is controlled by the reflexes, the reflex has been demonstrated using a autonomic nervous system. The direct pupillary light portable infrared pupillometer.6 reflex refers to miosis that occurs in the stimulated eye; In this issue of Critical Care and Resuscitation, the consensual pupillary light reflex refers to miosis that Thomas8 describes a case of Guillain Barré syndrome occurs in the other eye. The reflex has a latent period presenting with weakness and fixed dilated pupils who with length of the period, amplitude of the response, and subsequently became ‘locked in’ with absence of any the speed of the pupillary constriction dependent on the clinical response to external stimuli. A positive brain intensity of the stimulus employed.1 For the reflex to be stem auditory evoked response was used to indicate truly tested, an intense stimulus and close observation normal brain stem function. In another recent report, a are required. The reflex has afferent, efferent and central case of ‘reversible fixed dilated pupils’ was associated connections; therefore non-response to light (i.e. -
What's the Connection?
WHAT’S THE CONNECTION? Sharon Winter Lake Washington High School Directions for Teachers 12033 NE 80th Street Kirkland, WA 98033 SYNOPSIS Students elicit and observe reflex responses and distinguish between types STUDENT PRIOR KNOWL- of reflexes. They then design and conduct experiments to learn more about EDGE reflexes and their control by the nervous system. Before participating in this LEVEL activity students should be able to: Exploration, Concept/Term Introduction Phases ■ Describe the parts of a Application Phase neuron and explain their functions. ■ Distinguish between sensory and motor neurons. Getting Ready ■ Describe briefly the See sidebars for additional information regarding preparation of this lab. organization of the nervous system. Directions for Setting Up the Lab General: INTEGRATION Into the Biology Curriculum ■ Make an “X” on the chalkboard for the teacher-led introduction. ■ Health ■ Photocopy the Directions for Students pages. ■ Biology I, II ■ Human Anatomy and Teacher Background Physiology A reflex is an involuntary neural response to a specific sensory stimulus ■ AP Biology that threatens the survival or homeostatic state of an organism. Reflexes Across the Curriculum exist in the most primitive of species, usually with a protective function for ■ Mathematics animals when they encounter external and internal stimuli. A primitive ■ Physics ■ example of this protective reflex is the gill withdrawal reflex of the sea slug Psychology Aplysia. In humans and other vertebrates, protective reflexes have been OBJECTIVES maintained and expanded in number. Examples are the gag reflex that At the end of this activity, occurs when objects touch the sides students will be able to: or the back of the throat, and the carotid sinus reflex that restores blood ■ Identify common reflexes pressure to normal when baroreceptors detect an increase in blood pressure. -
A Model of Accommodative-Pupillary Dynamics Stanley Gordon Day Iowa State University
Iowa State University Capstones, Theses and Retrospective Theses and Dissertations Dissertations 1969 A model of accommodative-pupillary dynamics Stanley Gordon Day Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/rtd Part of the Electrical and Electronics Commons Recommended Citation Day, Stanley Gordon, "A model of accommodative-pupillary dynamics " (1969). Retrospective Theses and Dissertations. 4649. https://lib.dr.iastate.edu/rtd/4649 This Dissertation is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Retrospective Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. This dissertation has been microâhned exactly as received 69-15,607 DAY, Stanley Gordon, 1939- A MODEL OF ACCOMMODATIVE-PUPILLARY DYNAMICS. Iowa State University, Ph.D., 1969 Engineering, electrical University Microfilms, Inc., Ann Arbor, Michigan ®Copyright by STANLEY GORDON DAY 1969 A MODEL OF ACCOMMODATIVE-PUPILLARY DYNAMICS by Stanley Gordon Day A Dissertation Submitted to the Graduate Faculty in Partial Fulfillment of The Requirements for the Degree of DOCTOR OF PHILOSOPHY Major Subject : Electrical Engineering Approved: Signature was redacted for privacy. In Charge of Major Work Signature was redacted for privacy. Head of Major Department Signature was redacted for privacy. Dea^ of Gradulate College Iowa State University Of Science and Technology Ames, Iowa 1969 il TABLE OF CONTENTS Page DEDICATION iii INTRODUCTION 1 REVIEW OF LITERATURE 4 EQUIPMENT AND METHODS 22 RESULTS AND DISCUSSION 47 SUÎ4MARY AND CONCLUSIONS 60 BIBLIOGRAPHY 62 ACKNOWLEDGEMENTS 68 APPENDIX 69 i iii DEDICATION This dissertation is dedicated to Sandra R. -
Gender Reassignment Surgery Policy Number: PG0311 ADVANTAGE | ELITE | HMO Last Review: 07/01/2021
Gender Reassignment Surgery Policy Number: PG0311 ADVANTAGE | ELITE | HMO Last Review: 07/01/2021 INDIVIDUAL MARKETPLACE | PROMEDICA MEDICARE PLAN | PPO GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated by each individual policyholder terms, conditions, exclusions and limitations contract. It does not constitute a contract or guarantee regarding coverage or reimbursement/payment. Self-Insured group specific policy will supersede this general policy when group supplementary plan document or individual plan decision directs otherwise. Paramount applies coding edits to all medical claims through coding logic software to evaluate the accuracy and adherence to accepted national standards. This medical policy is solely for guiding medical necessity and explaining correct procedure reporting used to assist in making coverage decisions and administering benefits. SCOPE X Professional X Facility DESCRIPTION Transgender is a broad term that can be used to describe people whose gender identity is different from the gender they were thought to be when they were born. Gender dysphoria (GD) or gender identity disorder is defined as evidence of a strong and persistent cross-gender identification, which is the desire to be, or the insistence that one is of the other gender. Persons with this disorder experience a sense of discomfort and inappropriateness regarding their anatomic or genetic sexual characteristics. Individuals with GD have persistent feelings of gender discomfort and inappropriateness of their anatomical sex, strong and ongoing cross-gender identification, and a desire to live and be accepted as a member of the opposite sex. Gender Dysphoria (GD) is defined by the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition, DSM-5™ as a condition characterized by the "distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender" also known as “natal gender”, which is the individual’s sex determined at birth.