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Healthcare Pros: Interview & Examination Techniques for Communication & Diagnosis, Exams of Nursing

Essential interviewing and examination techniques for healthcare professionals. It covers various aspects of communication with patients, including open-ended questions, interpreter use, and dealing with crying, angry, or confused patients. The document also discusses subjective and objective data collection, common symptoms, and skin lesions. Furthermore, it outlines the nursing process steps and problem-solving strategies.

Typology: Exams

2023/2024

Available from 04/04/2024

expertee
expertee 🇺🇸

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Download Healthcare Pros: Interview & Examination Techniques for Communication & Diagnosis and more Exams Nursing in PDF only on Docsity! Liberty University NURS 210 Test 1 Exam Questions with Verified Solutions. General appearance to look for in a pt. #1 - ANS Apparent state of health General appearance to look for in a pt. #2 - ANS LOC General appearance to look for in a pt. #3 - ANS Facial Expression General appearance to look for in a pt. #4 - ANS Posture, gait, motor activity and speech General appearance to look for in a pt. #5 - ANS Odor of body/breath General appearance to look for in a pt. #6 - ANS Skin color and obvious lesions General appearance to look for in a pt. #7 - ANS Dress, grooming, and personal hygiene OLD CART - ANS Onset Location Duration Characteristics Associated manifestations Relieving factors Treatment FIFE - ANS Feelings Ideas Function (what can't you do now that you could before) Expectations Phases of interview - ANS pre-interview, introduction, working, termination Pre-interview - ANS Plan: self-reflection, review pt. record, set interview goals, review own clinical behavior/appearance Introduction - ANS put the patient at ease and establish trust (greet pt. and est. rapport) est. agenda for interview Working - ANS obtain pt. info (invite pt. story--ID/respond to emotional cues) (expand/clarify pt. story) (generate and test diagnostic hypotheses) (Negotiate a plan further evil, treatment, education and self-management support and prevention) Termination - ANS summarize important points, discuss plan of care P a g e 1 | 12 Techniques of a skilled interview - ANS Active listening, guided questioning, nonverbal communication, empathetic responses, validation, reassurance, summarizing, transitions, empowering the pt. Guided questioning - ANS Helps to continue the patient's story -moving from open-ended to focused questions -using questions that elicit a graded response -asking a series of questions, ONE at a time -clarifying what the patient means -encouraging with continuers -using echoing -avoid leading questions (has your pain been improving? You don't have any blood in your stool, do you?) (General-->specific) The silent pt. - ANS Reasons: to collect thoughts, remember details, or decide whether you could be trusted with info. (appear attentive--watch for nonverbal cues, encourage to continue when appropriate, silence may be a part of culture, maybe you're asking too many short-answer questions in rapid succession, did you offend patient, did you fail to recognize an overwhelming symptom (pain, nausea, dyspnea)) Quantifying Q's - ANS When For how long How many How often Rate (your pain) Interview basics: open with - ANS What How Tell me about Describe INTERPRETER - ANS Introduction Note goals Transparency Ethics Respect beliefs Patient focus Retain control Explain Thanks Advance Directive - ANS A person makes provision for health care decisions in event that pt. becomes unable to make those decisions (this includes CPR, artificial feeding/hydration, and antibiotics) P a g e 2 | 12 Keloid - ANS secondary lesion; huge scar that extends beyond border of the initiating injury Lichenification - ANS secondary lesion; Visible and palpable thickening of the epidermis (Prolonged, intense scratching eventually thickens the skin and produces tightly packed sets of papules; looks like surface of moss) Vitiligo - ANS depigmentation of skin (extreme lack of melanin; cow) Pale areas are the vitiligo Patient’s perspective on the illness - ANS FIFE Four general goals of examination - ANS Maximize pt.’s comfort Maintain pt. safety Avoid unnecessary changes in position Enhance clinical accuracy and efficiency Tangential Lighting - ANS optimal for inspecting structures such as the jugular venous pulse, thyroid gland, and the apical impulse of the heart (pulse over the apex of the heart) Melanoma - ANS black tumor Pigment-producing melanocytes Lethal--causing 70% of skin cancer deaths Basal Cell carcinoma - ANS Basal level of epidermis Accounts for most skin cancers Sun-exposed areas Pearly white/translucent Grow slow, rarely metastasize Squamous cell carcinoma - ANS arise in upper layer of epidermis Crusty and scaly Red, inflamed, ulcerated Local warmth means - ANS inflammation or cellulitis Dry skin - ANS Hypothyroidism Dehydration - ANS Dry mucous membranes, cracked lips, dry skin, and lack of tears Jaundice suggests - ANS liver disease or Excessive hemolysis of RBCs Cyanosis in congestive heart failure - ANS usually peripheral, reflecting low blood flow; venous obstruction may cause peripheral cyanosis P a g e 5 | 12 Central cyanosis - ANS advanced lung disease, congenital heart disease, and hemoglobinopathies Pallor results from - ANS decreased redness in anemia and decreased blood flow, as occurs in fainting or arterial insufficiency. The nursing process steps - ANS Assessment Diagnosis Planning Implementation Evaluation How one thinks solves problems and makes decisions - ANS developmental level Environmental influences - ANS favorable conditions to promote health Spiritual influences - ANS living peacefully, morally, and ethically Cultural influences - ANS favorable connections to promote health Social well-being - ANS supportive relationships with family and friends Emotional health - ANS Positive outlook and emotions channeled in a healthy manner Physical health - ANS How the body works and adapts Inspection of NEVI (aka moles) - ANS color, shape, size, surface, number, location Size of mole should be - ANS <6 mm (eraser of #2 pencil) Normal number of moles - ANS 10-40 Location of moles - ANS typically above waist, mostly not on breast, butt, or scalp Cyanosis - ANS lack of o2 Pallor - ANS poor circulation Color of skin - ANS jaundice, pallor, cyanosis, erythema, pale and shiny (I lower extremities; smooth and hairless) Unusual Moles ABCD - ANS Asymmetrical (lumpy) Borders (irregular) Color (multicolor or black) Diameter (greater than 6mm) P a g e 6 | 12 Primary lesion - ANS occurs from some pathological process Secondary lesion - ANS time; results from later evolution of external trauma to primary lesion Vascular lesion examples - ANS Petechial (tiny red dots) Purport (flood of bruising not associated with trauma) Ecchymosis Spider anima (vessels) Venous star Telangiectasia Primary Lesion examples - ANS macule (freckle) Papule (not flat; raised) Patch Plaque Wheal Nodule Tumor Vesicle (small clear fluid-filled lesion) Bulla (blister, can be filled like vesicle) Pustule (zit; raised, small, filled with pus) Cyst (nodule filled with liquid or semisolid) Secondary Lesions examples - ANS scale Lichenification Keloid Scar Excoriation (scratched wound) Fissure Erosion Ulcer (compression of skin-->hypoxia of skin tissue death-->stage 1 ulcer) Crust (dried residue of skin exudate) Atrophy Characteristics of lesion to document - ANS size Shape Color Texture Elevation or depression Pedunculation (skin tag; a piece of skin or a stalk) Exudate Café-Au-Laity spot - ANS A slightly but uniformly pigmented macule or patch with a somewhat irregular border P a g e 7 | 12 Facial edema is bad because - ANS airway Palpation of head and face - ANS palpate skull from front to back Hair Temporal arteries Temporomandibular joint (TMJ) Frontal and maxillary sinus Palpation of head and face because - ANS testing to see if they're normal cephalic and traumatic Pain in temporal artery can lead to - ANS blindness Inspection of Neck; have pt. swallow and looks for - ANS bilateral symmetry of neck muscles, alignment of trachea, note any masses, excess skin folds, observe for distension of jugular vein, observe for prominence of carotid arteries, evaluate ROM Trachea should be - ANS upright, vertical, and midline Palpate of neck - ANS Palpate trachea for midline position Carotid pulse (one at a time) Thyroid gland (tenderness, nodules) Auscultate for bruits Abnormalities of head and face - ANS Headaches, myxedema vs. hyperthyroidism, bushings, Bell's palsy, acromegaly, butterfly rash (sign of lupus), Torticollis, FAS, Hydrocephalus Myxedema - ANS associated with thyroid Torticollis - ANS wry neck; sternocleidomastoid shortens and pulls neck, spasm or congenital (born with) Hydrocephalus - ANS Cranium can't infuse; so much fluid in cranium Mobility and feeding issues Goiter - ANS lack of iodized salt Bell's palsy - ANS viral Three categories of eye testing - ANS Pupils (penlight) Eye movement (various cranial nerves) Vision (Near, distant, peripheral) Assessment tests for eyes - ANS visual acuity (far and near vision) Confrontation test (peripheral) P a g e 10 | 12 Pupils (reactive, together, consensual?) Accommodation Convergence (cross-eyed) Extra ocular eye muscles Visual Acuity - ANS CN II Optic Nerve Pt. 20ft for smelling chart Cover one eye and have pt. read lines Recorded as fractions: 20/20 (pt. is always numerator) Extra ocular eye muscles - ANS Three CN involved (III-coulometer, IV-trochlear, and VI- abduces) Six Cardinal Fields of gaze (observe for sustained nystagmus--twitching of eye) Corneal light reflex - ANS test for balance of extra ocular muscles Cover-uncover test - ANS only if pt. has corneal light reflex issues Ophthalmoscopy exam - ANS Examine pt. right eye with your right eye vice versa Have pt. look over shoulder at a distant point Direct the light at the pupil 12in away Visualize for ophthalmoscopy exam: - ANS Clarity of lens Red reflex Retina/fundus Optic disc Retinal vessels (A: V 3:5 to 2:3 ratio) Macula Fovea Centralism (where images you see get shot to the brain) You lose depth perception if - ANS you lose sight in one eye Myopia - ANS nearsighted Hyperopia - ANS farsighted Presbyopia - ANS farsighted; impaired vision as a result of aging Abnormal in eye to know - ANS Exophthalmos (associated with graves; bulging eyes) Band Keratopathy Corneal Ulcer (Keratitis) Strabismus Cataracts (light reflex) Xanthelasma (fat deposits) Ptosis P a g e 11 | 12 Bank Keratopathy - ANS Extra lipid deposits in mucous membranes of the eyes; become blind, but can get transplant Strabismus - ANS "lazy eye" pt. who fails corneal light reflex Corneal Ulcer - ANS Damage to cornea itself; covers the iris as a dome Ptosis - ANS affects palpebral fissure; congenital or acquired (depth perception is affected) Cataracts - ANS light reflex; if light can't get in, images can't get in Ectropion - ANS lash line rolls outward; mucous membrane dried out (wet face, dry eye) Entropies - ANS Lash line rolls inward; rubs cornea all the time Hordeolum - ANS style; affects eyelash not eyeball (Do not squeeze) Chalaza - ANS Infects eyelid Conjunctivitis - ANS pink eye (viral or bacterial) Subconjunctival hemorrhage - ANS conjunctive and cornea don't meet; iris not affected Subconjunctival lymphoma - ANS blood under cornea Pterygium - ANS sclera encroaches the iris and covers cornea Corneal circus senile - ANS ring of lipid deposits around eyes; "washed out" look; covers up color of iris Problems with internal eye - ANS Diabetic retinopathy Papilledema (first sign of hypertension; optic disc puffy/swollen; vessels look weird) Glaucomatous cupping (increase pressure; globe filled with pressure) Hemorrhage (if seen in babies concerned about shaken baby syndrome) P a g e 12 | 12