NUR 216 HEALTH ASSESSMENT FINAL/ 465+ QS & Ans/ . Terms like:
Heat loss - Answer: Conduction: transfer of heat from body directly to another surface
Convection: Dispersion of heat by air currents
Radiation: Transfer of heat from one object to another without contact b/w them.
Evaporation: ...
NUR 216 HEALTH ASSESSMENT FINAL/ 465+ QS
& Ans/ 2024-2025.
Heat loss - Answer: Conduction: transfer of heat from body directly to another
surface
Convection: Dispersion of heat by air currents
Radiation: Transfer of heat from one object to another without contact b/w them.
Evaporation: Dispersion of heat through water (perspiration)
Diaphoresis: Visible perspiration on the skin
Expected Temp Ranges - Answer: Oral: 96.8-100.4
Rectal: 0.5 degree higher than ear and oral temps
Axillary: 0.5 degree lower than oral and axillary
Temporal: 1 degree higher than oral and axillary
Page 1 of 133
,Temperature considerations - Answer: Newborns 36.5-37.5
Older adult clients 36
Hormonal changes can influence temperature and rises with menses, ovulation
and menopause.
Exercise, activity and dehydration add to hyperthermia
Illness and Injury (fever)
Recent food and fluid intake and smoking can interfere with proper reading, wait
20-30 min before measuring oral
Circadian rhythm, stress and environment affect temp
Specials for Thermometers - Answer: Oral: Used for 4 years and don't use for
clients who breathe through mouth
Rectal: Don't use for clients with diarrhea, are on bleeding precautions or have a
rectal disorder and don't use on infants 3 months or less.
Tympanic: Earwax can affect reading
Pulse assessment - Answer: Peripheral arterial vessel or over the apex of the heart
Rate: number of times per min you feel/hear pulse
Rhythm: Regularity of impulses
Page 2 of 133
,Strength (amplitude): Reflects volume of blood ejected against the arterial wall
with each heart contraction and the condition of the arterial vascular system,
graded 0-4
Equality: symmetric in quality and quantity from each side
Pulse Considerations - Answer: Dysrhythmia: Irregular heart rhythm
Puse Deficit: Diff in apical rate and radial rate; two clinicians should measure to
accurately measure
Age: Infants have 120-160 per min, 12-14 is 80-90 min.
Expected Heart Rate range - Answer: 60-100 per min
Process of Respiration - Answer: Ventilation: exchange of oxygen and CO in the
lungs and is measured with rate, rhythm and depth
Diffusion: Exchange of oxygen and CO b/w alveoli and RBC's, measured with pulse
ox
Perfsion: Flow of RBC's to and from pulmonary capillaries, measure with pulse ox.
Respiration Assessment - Answer: Observe rate, depth and rhythm of the chest
wall.
Rate: number of full inspirations and expirations in 1 min, 12-20 per min
Depth: Amount of chest wall expansion that occurs with each breath
Rhythm: Observation of breathing intervals, expect regular rhythm with an
occasional sigh
Page 3 of 133
, Respiration Considerations - Answer: Age (newborns 35-40 min and school aged
kids 20-30 min)
Sex Men and children have more noticeable respirations in their abs and women
have more noticeable respirations in their chest
Pain/Anxiety
Smoking
Body position
Meds (opioids, sedatives, bronchodilators and anesthetics decrease) (cocaine and
meht increase)
Neuro Injury
Illness
Impaired oxygen carrying capacity of blood
INCREASE OR DECREASE IN ANY OF THESE DOES THE SAME TO CO AND BP
Systemic Vascular Resistance SVR - Answer: reflects the amount of constriction or
dilation of the arteries, and diameter of blood vessels.
INCREASE OR DECREASE DOES THE SAME TO BP
BP Classifications - Answer: Normal: less than 120/80
Prehypertension: 120-139/80-89
Page 4 of 133
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Benzo. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.99. You're not tied to anything after your purchase.
