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HA exam 4
Terms in this set (47)
swelling in legs or arms, an accumulation of fluid in interstitial spaces
i. Caused when lymph nodes are taken out
ii. Unilateral and non-pitting
when the nipple is pulled in another direction
a dimple on skin
a woman who has never given birth
a. inflammation of the breast usually caused by bacterial infection
i. Inflammation, chills, fever, redness
ii. Post-partum and breast-feeding mothers most at risk
a. enlargement in breast tissue of males
i. Any age
1. Hormone changes
3. Old age
What is the preferred position for a female patient during a gynecological/rectal exam?
Lithotomy position, supine and knees bent and apart
What is the preferred position for a female patient during a breast exam? Why?
a. Lying down with arms up
i. Beast tissue against chest wall
What position(s) could you place a male patient in during a rectal exam?
a. Left lateral (sims)
b. Knee chest position, butt in air, bend over a table
i. Caused by HPV
ii. Most common symptom is abnormal vaginal bleeding, sch as bleeding between normal menstrual periods, bleeding after intercourse, or menstrual bleeding that is heavier or lasts longer than normal
iii. Upon examination a lesion may be visible
1. Usually has a hard granular surface that bleeds easily and has irregular borders
i. Most common gynecological malignancy
ii. Occurs most often in postmenopausal women
1. Especially those taking estrogen
iii. Abnormal uterine bleeding or spotting
iv. A watery, vaginal discharge is frequently noted several weeks to months before bleeding begins
i. Highest mortality rate "whispering disease"
ii. Most commonly in white women over the age of 50
iii. There are usually no symptoms until advanced stages of the disease. The most common symptom of ovarian cancer is abdominal distention or fullness
1. By time ovarian malignancies are palpable the disease is usually advanced
i. ages 20-49
ii. usually bilateral
iii. multiple or single
v. soft to firm; tense
vii. retraction signs: absent
viii. usually tender
ix. well defined boarders
x. variations with menses
ii. Usually bilateral
iii. Single; may be multiple
iv. Rounded or discoid
v. Firm, rubbery
vii. Retraction signs: absent
viii. Usually nontender
ix. Well defined boarders
x. No variation with menses
ii. Usually unilateral
iv. Irregular or stellate
v. Hard, stonelike
vii. Retraction signs: often present
viii. Usually nontender
ix. Poorly defined, irregular
x. No variation with menses
How do you perform a breast assessment on a patient who has had a mastectomy? What area is at risk for possible malignancy recurrence?
a. The same way as any other patient
b. The scar line
Why is it important to assess the axillary area during a breast exam?
a. This is where a lot of our lymph nodes are
What characteristics of a breast mass need to be noted and documented?
i. Discrete or poorly defined?
i. Which breast? Which quadrant?
i. Estimate width, length, and thickness in cm
i. Oval, round, lobed, irregularly shaped, indistinct?
i. Tender or nontender during palpitation?
i. Hard, soft, firm, rubbery?
i. Mobile or nonmobile during palpitation
i. Any dimpling of tissue around mass?
What breast changes occur during the menstrual cycle?
b. Size (fullness, enlargement)
c. Fibrocystic lumps
How would the nurse describe an anal abnormality? What are the anatomical locations of the clock-face?
a. As a clock face
b. 12 is toward pelvic bone
c. 6 sacrococcygeal area
What assessment is performed as a screening measure for colorectal cancer?
a. Occult blood
What are expected findings when palpating the penis?
a. The dorsal vein should be apparent on the dorsal surface of the shaft of the penis
b. skin is usually dark and hairless with a wrinkled surface infrequently apparent vascularity
c. in uncircumcised men the prepuce is present in folded over the glans
d. then circumcised men the amount of prepuce there is
e. the foreskin should retract easily and completely over the glans
f. Glans should be smooth, pink and bulbous
g. the previous bold is wrinkled and loosely attached to the underlying glan it is darker than the glans
What are the expected findings when palpating the scrotum?
a. the scrotal skin has a coarse appearing surface and should be without lesions
b. small bumps on the scrotal skin are known as sebaceous cysts or sebaceous glands they are considered a normal finding
c. the underside of the scrotum is deeply pigmented, hairless , and has a rugous surface
d. temperature effects the appearance of the scrotum
i. when cold the testes retract slightly upward causing the screen to become smaller and tighter and appearance
ii. when temperature is hot the testes extend downward and hang loosely
muscle wasting, bones are prominent
What are the risk factors for obesity?
a. Sedentary lifestyle
c. High fat diet
d. Lack of exercise
What are the risk factors for an eating disorder?
a. Teenage girls
b. Self-esteem issues
c. Peer pressure
d. Preoccupation ___________
i. Family history
What laboratory findings indicate dehydration? What physical assessment findings indicate dehydration?
a. Dark urine
b. Dry mucus membranes (especially mouth)
c. Turgor (nonelastic, tenting)
i. High hemoglobin and hematocrit
e. Urine labs
iii. Specific gravity
How is the waist-to-hip ratio calculated? What does it tell us?
b. Women less than 0.8
c. Males less than 1
d. Tells us fat distribution
How is the desired body weight calculated?
a. Females: 100 for the first five ft + 5lbs per inch for every inch over 5ft
b. Males: 106 for the first five ft + 6lbs per inch for every inch over 5ft
How do you calculate percentage change in weight? (pg. 90) What does this tell us?
a. Current body weight/usual body weight then *100
b. Tells us how severe weight loss is
What questions would you ask a patient if they complain of weight gain or weight loss?
a. Is it intentional or unintentional?
b. Is it sudden or gradual?
What do triceps skin fold measurements assess?
a. Total body fat
How is alcohol related to nutrition?
a. Empty calories, suppress appetite
b. Inhibits nutrient absorption (malabsorption)
What physical exam findings would you expect in a patient with a riboflavin deficiency?
a. Purple or magenta tongue
What physical exam findings would you expect in a patient with a Vitamin B deficiency?
a. Cracks on mouth and lips
b. Excessively red tongue
What physical exam findings would you expect in a patient with an iron deficiency?
a. Spooning of the nails
b. Pale skin (pallor skin or conjunctiva of eye)
What conditions/disease processes require increased fluid intake?
a. Hot climates
d. GI losses
e. Respiratory status
f. Wounds draining
a. thinking that your own culture is the standard, and that anyone or anything different from that standard is below it or less than
widespread and fixed preconceived thoughts about a certain group
lifelong process of self-critique
What questions could you ask to assess a patient's spiritual and religious preferences?
a. Avoid asking too specific of questions (don't want to assume or push any beliefs on them)
b. Do you have any specific spiritual practices or beliefs?
What characteristics make up race?
a. Skin color
b. Hair color
c. Hair texture
d. Body size
e. Eye color
f. Genetic makeup
What characteristics make up culture?
e. Set of values and beliefs
What are examples of culturally competent care?
c. Asking about and providing food that fits within a culture or beliefs
d. Avoid stereotyping
e. Ask about specific ceremony's (especially birth and death)
What is the first step towards cultural awareness?
a. Develop cultural competency
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