5 R's off cultural humility - ANSWERReflection— what did I learn?
Respect—did I treat everyone involved w respect?
Regard—did unconscious bias drive this encounter?
Relevance—how was cultural humility relevant?
Resiliency—how did my personal resilience affect this interaction?
acute pain - ANSWERepisode of pain that lasts from seconds to less than 6 months
Surgery trauma illness
Protective function
Anatomic structures of the chest - ANSWERSupraclavicular—above the clavicles
Infraclavicular—below the clavicles
Interscapular—between the scapulae
Infrascapular—below the scapulae
Apices of the lungs—the uppermost portions
Bases of the lungs—the lowermost portions
Upper, middle, and lower lung fields
Anatomy of the eye - ANSWERIncludes conjunctiva, cornea, sclera, choroid, retina, iris,
lens, aqueous and vitreous humor, ciliary body, optic nerve
Upper eyelid
Lower lid
Palpebral fissure
Anatomy of thorax and lungs - ANSWERRibs (12)
Sternal angle
Costal margins
Scapula
Spinous process
Midsternal, axillary (mid anterior posterior), vertebral, scapular, misclavicukar
Trachea and bronchi
Encases lungs and heart
Diaphragm
Clavicles
,anorexia nervosa - ANSWERAn eating disorder characterized by an obstinate and
willful refusal to eat, a distorted body image, and an intense fear of being fat
assessing abstract thinking - ANSWERask to interpret a proverb
Similarities
Concrete responses to abstract thinking assessment are common in intellectual
disability delirium or dementia and may reflect limited education. Schizophrenias may
answer concrete or with personal and bizarre interpretations
Assessing acute and chronic pain - ANSWERPatient pain history
Assessing severity
Health disparities in pain
Assessment (medical diagnoses) - ANSWERSupports what Dx you are going to use
and helps w plan development
Assessment of eye history and current state - ANSWERStart with general questions
about vision and ocular function: "How is your vision?" and "How are your eyes?" Make
sure to ask whether the symptoms involve one eye or both as well as the onset and
duration of any symptoms. You can then hone in on the area involved with specific
questions. Make sure to ask about inflammatory signs, such as pain, swelling,
erythema, warmth, and/or loss of function.
In addition to previous medical history, always remember to ask about previous ocular
history, including questions about surgery, eye drops, and use of glasses. When asking
about eye medications, ask about over-the-counter medications, vitamins, or
supplements. Family ocular history can be relevant as well.
Breath Sounds: Bronchial - ANSWERVery oud, higher pitch; expiratory sounds longer
than inspiratory; heard over manubrium
Breath Sounds: Bronchovesicular - ANSWERwith inspiratory and expiratory sounds
about equal in length, are at times separated by a silent interval. Detecting differences
in pitch and intensity is often easier during expiration.
breath sounds: tracheal - ANSWERloud and high harsh sounds heard over the trachea
in the neck equal in inspiration and expiration
Breath Sounds: Vesicular - ANSWERSoft andlow pitch, heard over most of lungs
(peripheral lung especially); inspiratory sounds longer than experiaotry
bulimia nervosa - ANSWERan eating disorder characterized by episodes of overeating,
usually of high-calorie foods, followed by vomiting, laxative use, fasting, or excessive
exercise
Challenging Patient Situations and behaviors - ANSWERSilent
Talkative
, With confusing narrative
With altered state or cognition
With emotional lability
Angry or aggressive
Flirtatious
Discriminatory
With hearing loss
With low or impaired vision
With limited intelligence
Burdened by personal problems
Nonadherent
With low literacy
With low health literacy
With limited language proficiency
With terminal illness or dying
chronic pain - ANSWERepisode of pain that lasts for 6 months or longer; may be
intermittent or continuous
Cancer
Recurring in intervals of months to years
Lasting 1 month beyond the course of acute illness
Classifying normal and abnormal blood pressure - ANSWERCorrect cuff size
Comfortably seated
Appropriate cuff position
<120mmhg and <80 mmhg is normal
120-129/<80 elevated
130-139/80-89 stage I HTN
>140/90 stage 2 HTN
Clinically appraising the evidence - ANSWERUsing the approach found in the Users
guide to the medical literature, and ask 3 questions
1. Are the results valid?
——-bias
2. What are the results?
——assess the performance of tx or prevention intervention
3. How can you apply the results to patient care?
—generalizability
Communicating clinical evidence to patients - ANSWERInformation should be
presented to patients in a way that reduces framing effects and encouraged informed
shared decision-making process.
5 A's
FRAMES
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