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Instructions for conducting various health assessments, including testing for visual acuity using a snellen eye chart, assessing hearing with the rinne test, and performing physical exams to identify conditions such as bradypnea, orthopnea, and tachypnea. It also covers techniques for auscultating the lungs and abdomen, identifying different types of breath sounds, and assessing for edema.
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How to test for visual acuity - ANS>> Snellin eye chart (Stand 20 feet away from the chart) how to test for hearing - ANS>> Use the Rinne test Do a physical exam Bruit - ANS>> abnormal blowing or swishing sound heard during auscultation of an artery or organ How to auscultate lungs - ANS>> side to side (zig-zag movement, have pt. take a full breath while you are listening - start C7 to T10 COMPARING ) How to auscultate abdomen - ANS>> perform auscultation prior to palpation or percussion. Listen in a clockwise manner starting in the lower right quadrant, listen for 5 minutes in each quadrent normal bowel sounds - ANS>> 5-30 per minute, high pitched hypoactive bowel sounds - ANS>> follow abdominal surgery or with inflammation of the peritoneum, 5-15 per minute, could be bowel obstruction hyperactive bowel sounds - ANS>> loud, high-pitched, rushing, tinkling sounds that signal increased motility (diarrhea, laxative use, gurgling) ABCDEs of melanoma - ANS>> asymmetry, border, color, diameter, evolution Skin assessment on dark skinned patient - ANS>> Pallor: yellowish brown, ashen gray Erythema: purplish tinge difficult to see Cyanosis: dull and lifeless Jaundice: check for yellowness of palms of hands bronchial breath sounds - ANS>> higher pitch, louder, inspiration and expiration are equal and there is a pause between inspiration and expiration. (heard in the front) bronchovescicular breath sounds - ANS>> moderate, high pitched, ( inspiration = to expiration) vesicular breath sounds - ANS>> low pitched, soft, expiration, alveoli
Crackles (fine) - ANS>> discontinuous, high-pitched, short crackling, (popping sounds heard during inspiration that are not cleared by coughing) Crackles (coarse) - ANS>> Loud, low-pitched, bubbling and gurgling sounds that start in early inspiration and may be present in expiration. (May decrease somewhat by suctioning or coughing but will reappear shortly. Sounds like opening a velcro fastener) Stridor - ANS>> strained high-pitched sound (heard on inspiration caused by obstruction in the pharynx or larynx) How to assess edema - ANS>> 1+ Barely detectable impression when finger is presssed into skin. 2+ Slight indentation. 15 seconds to rebound 3+ Deeper indentation. 30 seconds to rebound. 4+ > 30 seconds to rebound. S1 heart sound - ANS>> Start of systolic (the first heart sound heard)
Osteoporosis s/s - ANS>> early shows no s/s age 30-40, over 55 F>M (Lupus, RA, inflammatory bowel, celiac disease Heberden's nodes - ANS>> Swelling of distal interphalangeal finger joints, characteristic of osteoarthritis How might you elicit the Babinski response? - ANS>> Stroke the lateral aspect of the sole of the foot from heel to across the ball TMJ (temporal mandibular joint) - ANS>> chewing, popping, and grinding of teeth, jaw popping, should open and close, slide up and down, and side to side Function Assestments - ANS>> Test to be able to tell if elderly patients can perform regular tasks Passive Range of Motion (PROM) - ANS>> therapist putting a patient's joints through available range of motion without assistance from the patient (anything your physically doing for the patient yourself) Romberg test - ANS>> - ask client to stand with feet at comfortable distance apart, arms at sides, and eyes closed (expected finding: client should be able to stand with minimal swaying for at least 20 seconds other could be multiple sclerosis, alcohol intoxication, shows loss of proprioception and vestiubular function) Olfactory 1 - ANS>> smell optic 2 - ANS>> vision facial 7 - ANS>> eye brows, puff face, smile,(CNS lesions, stroke) CN 8 (Acoustic) - ANS>> equilibrium and hearing Range of Motion (ROM) - ANS>> - active, passive, voluntary
osteoporosis risk factors - ANS>> post-menopause- reduction of estrogen levels; calcium intake; activity level Vertigo - ANS>> spinning caused by inner ear disorder
Crepitus - ANS>> a grating sound or sensation produced by friction between bone and cartilage or the fractured parts of a bone.
general changes in geriatric populations - ANS>> - skin changes