Chapter 12 health assessment
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what is a classic migraine?
- usually preceded by an aura during which the client may feel depressed, restless, or irritable.
- see spots or flashes of light; feel nauseated or experience numbing or tingling in the face or extremities. the pain of the migraine itself may be mild or debilitating, requiring the client to lie down in the darkness in silence. it is usually a pulstating pain that is localized to the side, front, or back of the head and may be accompanied by nausea, vertigo, tremors, and other symptoms. The acute phase lasts from 4 to 6 hours.
enlargement of lymph nodes is called
lymphadenopathy which can be due to infection. allergies or a tumor.
the presence of bruit is normal or abnormal?
it is an abnormal finding and is an indication of increased blood flow.
what is Grave's disease? It is a common type of hyperthyroidism or hypothyroidism?
- an autoimmune disorder that causes increased production of thyroid hormones.
is enlarged thyroid normal in pregnant women?
yes it is normal, most pathologic hyperthyroidism in pregnancy is caused by Graves' disease.
an enlarged thyroid gland may be due to
a metabolic disorder such as hyperthyroidism or hypothyroidism. palpable masses of 5mm or larger are alterations in health.
Normally when palpating the thyroid gland from behind the client would you feel the thyroid gland?
No, you may be able to feel the isthmus and fullness of the thyroid as it moves up upon swallowing.
If the client has any enlargement of the thyroid or masses near the thyroid they appear as .......
bulges when the client swallows.
the thyroid gland is not observable normally until the client?
what is abnormal while palpating the trachea?
tracheal displacement is the result of masses in the neck or mediastinum, peumothorax, or pulmonary fibrosis.
What is Goiter?
enlarged thyroid. common in areas where there is limited iodine. significant problem in china and india.
-It can be caused by either hypo or hyper thyroid function.
What is plagiocephaly?
flat occipital prominence it results from putting infants on their back
while observing the movements of head, face and eyes: Jerky movements or tics can be the result of???
Neurologic or psychologic disorders
While palpating the head and scalp consider what abnormalities?
swelling, edema, any tenderness or masses which will require further evaluation.
While confirming the skin and tissue integrity what should be noted as abnormals?
any alteration in skin or tissue integrity related to ulcerations, rashes, discolorations, or swelling.
While auscultating the temporal artery what should be considered abnormal?
A bruit is indicative of stenosis (narrowing) of the vessel
While testing the range of motion what should be considered abnormal?
any limitation of movement or tenderness on movement requires further evaluation. Crepitation would be abnormal.
what is crepitation?
a crackling sound on movement may indicate a joint problems.
what is normal range of motion?
you should feel slight indentation of the joint. soft clicking noises on movement are heard and are considered normal.
while inspecting a face what is normal?
symmetry, the top of the pinae of the ear should be at the level of the outer canthi of the eyes.
while palpating the head and scalp what is normal?
no tenderness with palpation
while confirming the skin and tissue integrity what is normal?
the skin should be intact
while palpating the temporal artery what is normal?
the artery should feel smooth.
an alternate method for assesing an obese patient for the neck includes using a
doppler stethoscope to assess the pulses
what is normal while inspecting the neck for the skin color, integrity, shape and symmetry?
neck held erect with no tremors
what is abnormal while inspecting the neck for the skin color, integrity, shape and symmetry?
- rigid neck which indicates arthritis.
- -Inability to hold the neck erect may be due to muscle spasms.
- -Swelling of the lymph nodes indicates infection and requires further assessment.
what is normal while testing the range of motion of the neck?
no pain and no limitation of the movement
what is abnormal while testing the range of motion of the neck?
any pain or limitation of movement could indicate arthritis, muscle spasm, or inflammation. rapid movement and compression of the cerebral vertebrae may cause dizziness.
what are the abnormals while observing the juglar veins and carotid arteries ?
any distention or prominence may indicate a vascular disorder
What is normal while palpating the trachea?
- trachea should be midline and the distance to the sternocleidomastoid muscles on each side should be equal.
- -Confirm that the hyoid bone and tracheal cartilaes move when the client swallows.
What is cluster headache?
numerous episodes occure over a period of days or even months and then are followed by a period of remission during which no headaches occur. it has no aura. The onset is sudden and may be associated with alcohol consumption, stress, or emotional distress. It often begins suddenly at night with an excruciating pain on one side of the face spreading upward behind one eye. The nose and affected eye water and nasal congestion is common. It lasts for few hours or few minutes.
What is a tension Headache?
it is a muscle contraction headache due to sustained contraction of the muscles in the head, neck or upper back. the onset is gradual not sudden and the pain is steady, it can be either unilateral or bilateral and typiccally ranges from the cervical region to the top of the head. It can be associated with stress, work, position, dental problems, premenstraual syndrome, sinus inflammation.
What is Hydrocephalus?
-Enlargement of the head caused by inadequate drainage of cerebrospinal fluid resulting in abnormal growth of the head.
what is Crainiosynotosis?
- Early closure of sutures.
- -With early closure of the sagital sutures, the head elongates.
- -with early closure of the coronal sutures, the head, face and orbits are altered.
What is acromegaly?
enlargement of the bones, facial features, hands and feet due to increased growth hormone.
What is Bell's Palsy?
a temporary disorder affecting cranial nerve VII and producing a unilateral facial paralysis. It may be cause by a virus. Its onset is sudden and it resolves spontaneously in a few weeks.
What is a Cushing's Syndrome?
Increased adrenal hormone production that leads to rounded moon face, ruddy cheeks, prominent jowls and excess facial hair.
What is a parkinson's disease?
A masklike expression occurs in parkinson's disease. The disease is the result of a decrease in dopamine, a neurotrasnmitter.
what is a brain attack?
a stroke or cerebrovascular accident. it occurs because of clotting in the brain.
Results in neurologic deficits that include facial paralysis and garbled speech.
What is Fetal Alcohol Syndrome?
It is a disorder characterized by epicanthal folds, narrow palpebral fissures, a deformed upper lip below the septum of the nose and some degree of mental retardation. It is seen in infants of mothers whose intake alcohol during pregnancy was significant.
What is torticollis?
Wry neck..a spasm of the muscle supplied by the spinal accessory nerve, causing lateral flexion contracture of the cervical spine musculature.
It may be result of birth trauma (cogenital), scars, disease of the cervical vertebrae, abscesses, TMJ, tumors, or other problems in the cervical area.
-If left untreated the muscle becomes fibrotic and permanently shortened.
Hyperthyroidism is caused by
excessive thyroid hormones.
what happens when a person has hyperthyroidism?
his thyroid is enlarged because of the gland, exophthalmos (bulging eye), fine hair, weight loss, diarrhea, and other alterations.
Symptoms of hyperthyroidism include?
- irritibility/ nervousness
- muscle weakness or tremors
- weight loss
- enlarged thyroid
- heat sensitivity
- visual disturbances
What is thyroid adenoma?
It refers to benign thyroid nodules that occur most frequently in older adults. There isn't any known cause for this.
What is thyroid carcinoma?
- It occurs following radiation of the thyroid, chronic goiter, or as a result of hereditary factors.
- -They are malignant tumors in hormone-producing cells or supporting cells. excess thyroid hormone is produced in the tumors.
Hyperthyroidism and Medication: sometimes excessive amount of iodine may cause?
oversecretion of thyroid hormones. the decrease in thyroid hormones result in lowered basal metabolism.
Hypothyroidism occurs most frequently in females or males? and what age group?
it occurs in females ages 30 and 50.
Symptoms of hypothyroidism includes:
- weight gain
- memory impairment
- intolerance to cold
What is cogenital hypothyroidism?
the thyroid is nonfunctioning at birth. If untreated it results in retardation of physical and mental growth.
What is Myxedema?
- It is a severe form of hypothyroidism.
- It causes nonpitting edema throughout the body and thickening of facial features.
- It affects major organ systems
Myxedema coma results in
cardiovascular collapse, electrolyte disturbances, respiratory depression and cerebral hypoxia
What is thyroiditis?
an inflammation of the thyroid gland. this inflammation cause release of stored hormones, resulting in temporary hyperthyroidism of weeks or months.
What is postpartum thyroiditis?
a temporary condition occuring in 5% to 9% of females postpartum.
what is hashimoto's thyroiditis?
an autoimmune disease that results in primary hypothyroidism. this form of thyroiditis occurs most frequently in females and tends to be familial.
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