natural, 2, gooseneck
About the Lighting:
1) Lighting with ____ daylight is BEST, although it is often not available.
2) artificial light from ____ sources will suffice and will prevent shadows.
3) A wall-mounted or ____ stand lamp is needed for high-INTENSITY lighting.
The table should be at a height at which you can stand without stooping and should be equipped to raise the person's head up to ____ degrees.
For the Ototscope; Choose the _____ SPECULA one that will fit comfortably into the person's ear canal.
Clean your stethoscope endpiece with an alcohol wipe BEFORE and AFTER ____ patient contact. The best routine is to combine stethoscope rubbing with every hand hygiene.
wash your hands
The single MOST important step to decrease risk of microorganism transmission is to _____ _____ ____ promptly and thoroughly.
Wash your HANDS;
(1) before and after every ___ patient encounter;
(2) after ___ with blood, body fluids, secretions, and excretions;
Use the mechanical action of SOAP AND WATER handwashing when hands are ____ soiled and when patients are INFECTED with ____ -forming organisms
Wear GLOVES when the POTENTIAL exists for contact with any____ ____ (e.g., blood, mucous membranes, body fluids, drainage, open skin lesions).
Wear a gown, mask, and protective eyewear when the POTENTIAL exists for any blood or body fluid ____ (e.g., suctioning, arterial puncture).
Patient Anxiety is NORMAL and can be reduced by an examiner who is ___ and self-assured, as well as considerate and ____ .
Begin the exam by assessing VITALS plus what measurements?
Ask the patient to change into an examining gown, leaving his or her underpants ___. This will feel more comfortable.
As you reenter the room, WASH YOUR HANDS in the person's ____ . This indicates you are protective of this person and are starting fresh for him or her.
Explain each step in the examination and how the person can cooperate. Encourage the person to ask questions. Keep your own movements ____, methodical, and deliberate.
Begin the physical portion by touching the person's ____, checking SKIN COLOR,NAIL BEDS, and metacarpophalangeal joints
Organize the steps so the person does not change ____ too often. Although proper exposure is necessary, use additional _____ to maintain the person's privacy and to prevent chilling.
Do not hesitate to WRITE OUT the examination SEQUENCE and ____ to it as you proceed. The patient will accept this as quite natural if you explain you are making brief notations to ensure accuracy.
If you forget a step in the examination; perform the maneuver in the ____ ____ place in the sequence.
As you proceed through the examination, occasionally offer SOME BRIEF ___ about the person's body.
you want to linger in one location
This phrase is used when?
-"I always listen to heart sounds on a number of places on the chest. Just because I am listening a long time does not necessarily mean anything is wrong with you."
explain to patient and have another examiner come double check
If you discover an ABNORMAL FINDING, what do you do next?
This phrase is used when?
-"I do not have a complete assessment of your heart sounds. I want Ms. Wright to listen to you too."
BEFORE you leave a hospitalized person, LOWER the bed to avoid risk for falls; make the person _____ and ____ ; and return the bedside table, television, or any equipment to the way it was originally, with the call button available.
Teens; The major task of adolescence is developing a ______ ____ . Peer group values and acceptance are important.
•The adolescent should be ____ on the examination table.
•Examine the adolescent ____ , without parent or sibling present.
feedback, wide variation
• During the examination, the adolescent needs ___ that his or her own body is HEALTHY and developing NORMALLY.
•The adolescent has keen awareness of body image, often comparing himself or herself to peers. Apprise/Inform the adolescent of the ____ _____ among teenagers on the rate of growth and development.
care, teaching, wellness
•Communicate with some ____. Do not treat the teenager like a child, but do not overestimate and treat him or her like an adult either.
•Because the person is idealistic at this age, the adolescent is ripe for health _____. Positive attitudes developed now may last through adult life. Focus your teaching on ways the adolescent can promote _____.
head to toe
• Teens, Adults, and Older adults all follow what sequence?
Teens; Examine _____ LAST , and do it QUICKLY.
meaning, physical strength
Aging Adults; During later years, the tasks are developing the ____ of life and one's own existence and adjusting to changes in _____ _____ and health.
•The older adult should be ____on the examination table; a FRAIL older adult may need to be ____.
position changes, rest periods
•Arrange the sequence to allow as FEW _____ ____ as possible.
•Allow _____ _____ when needed.
•Adjust examination _____ to meet the possible slowed pace of the aging person. It is better to break the complete examination into a ____ visits than to rush through the examination and turn off the person.
short, attention span, emotions
Confusion of sudden onset may signify a disease state. It is noted by ____-term memory loss, diminished thought process, diminished _____ ____, and labile/unstable _____
•Be aware that aging years contain MORE of life's ____. How the person adapts to losses significantly affects health assessment.
The Ill Person; For the person in some distress, alter the _____ during the examination. For example, a person with shortness of breath or ear pain may want to sit up, whereas a person with faintness or overwhelming fatigue may want to be supine.
The Ill Person; Initially it may be necessary just to examine the body areas appropriate to the ____, collecting a mini-database. You may return to finish a complete assessment after the initial distress is resolved.
Position the examination table so that ____ sides of the person are easily accessible.
With older adults; •Use _____ ______ . This is especially important with the aging person because other senses, such as vision and hearing, may be diminished.
Wash Your Hands;
(3) after contact with any ____ contaminated with body fluids; and
(4) after removing ____
* Wearing gloves is NOT A PROTECTIVE SUBSTITUTE for ___ _____ .
For the older adult; •Do NOT MISTAKE diminished vision or hearing for ____ .
What is the ONLY time we use "Direct" percussion?
When do we use "Fist" percussion?