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nursing 125 midterm Exam 2024/2025 Questions With Completed & Verified Solutions.
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nursing 125 midterm Exam 2024/2025 Questions With Completed & Verified Solutions.
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nursing 125 midtermsubjective data - ANS information given by the patient during health history about themselves
objective data - ANS information observed by the nurse during physical assessment
primary data source - ANS patient
secondary data source - ANS data derived from charts, family members, anything other than the
patient
emergent health history - ANS reason for seeking care, current health concerns, medications,
allergies. no details until patient is stable
focused health history - ANS questions related to current situation, ie chief concern
comprehensive health history - ANS demographic data, full description of the reason for seeking
care (chief concern), history of present illness (symptom analysis), past health history, current
medications, family history, personal and social history, growth and development info for
children and infants, review of systems.
demographic data - ANS patient's name and personal info, often filled out in a form. also
includes info abt recent disease exposure, travel, contact w pollution and allergens. may assess
living arrangements for hospital patients to determine level of independence needed for
discharge.
chief concern - ANS reason for seeking care
history of present illness (symptom analysis) - ANS location, quality, severity/quantity, timing
(onset, duration, constancy, patterns), aggravating factors, alleviating factors, associated signs
and symptoms, environmental factors, significance to patient, patient perspective
past health history - ANS medical/surgical conditions, treatments given, injuries, chronic
conditions, OB GYN history (first period, last period, menopause? pregnancies?), immunization
history, childhood illnesses, routine screening test dates and results, last physical exam date
current medications - ANS note name, dose, route and purpose. note allergies, don't confuse
side effects w allergy.
family history - ANS identify areas of familial concern and areas for health promotion. identify
history of cancer, heart disease, diabetes, etc.
,personal and social history - ANS marital status, children, significant life experiences,
occupation, housing, safety, mental health issues, memory and cognition, culture, language,
recreation and hobbies, spiritual beliefs
growth and development info - ANS for babies and young children, identify genetic background,
motor skills, speech, developmental milestones
review of systems - ANS review history and subjective data of each body system. use common
language and do health promo
primary reason patients access healthcare - ANS pain
pain is - ANS what the patient says it is
acute pain - ANS result of tissue damage with an easily identifiable cause. it is intense,
localized, and has a protective function
recurrent acute pain - ANS brief pain episodes that occur at intervals. protective, result of injury
or inflammation. ex: migraines
chronic pain - ANS lasts 3+ months. not always protective. may start as acute, may continue for
life. starts slow, builds gradually. may not have identifiable cause. can become more severe due
to changes in how the body transmits the pain signal
signs and symptoms of acute pain - ANS elevated resp rate, elevated heart rate, high blood
pressure, diaphoresis (sweating), nausea and vomiting, muscle spasms, guarding the site,
restlessness, anxiety and distress, seeking help
signs and symptoms of chronic pain - ANS normal vitals, no diaphoresis, reduced functional
abilities, sleep and appetite changes, depression, suicidal, apathy, lethargy, decreased
concentration, decreased libido, social withdrawal, excessive diagnosis/cure seeking
neuropathic pain - ANS caused by nerve damage. very painful and difficult to treat. can be acute
or chronic
nociceptive pain - ANS pain from a normal process that results in noxious stimuli being
perceived as painful
referred pain - ANS travels along a dermatome
visceral pain - ANS felt in abdominal organs
somatic pain - ANS originates in skin, muscles, bones and joints
, cutaneous pain - ANS derives from the dermis, epidermis, and subcutaneous tissues
phantom pain - ANS felt in an amputated limb
one dimensional pain scale - ANS patient self reports pain intensity on a scale of 1-10
multidimensional pain scale - ANS Mcgill scale, brief pain inventory. often used in chronic pain
patients. includes many aspects of pain assessment
faces pain scale - ANS used in children or nonverbal patients
FLACC pain scale - ANS F: Faces.
L: Legs.
A: Activity.
C: Cry
C: Consolability
used in babies 0-3 years
older adult pain - ANS pain viewed as natural component of aging process, may be ignored and
undertreating by healthcare providers. pain may also be underreported and patients may not
take meds
PAINAID scale - ANS used for patients with dementia. breathing, negative vocalization, facial
expression, body language, consolability
vital signs - ANS temperature, pulse, respirations, blood pressure. sometimes O2 saturation.
informally includes pain.
when are vital signs taken - ANS on admission, routinely in acute care, when patients
deteriorate, before and after invasive procedures, before and after certain medications, when
required
acute general survey findings - ANS anxiety, acute distress, pallor, cyanosis, change in mental
status
acute vital signs findings - ANS acute change, stridor, resp <10 or >32, increased effort to
breathe, O2 sats <92, pulse <55 or >120, systolic BP <100 or >170, temperature <35 or >39.5,
new chest pain, agitation, restlessness
general survey - ANS overall appearance, hygiene and grooming, skin colour and lesions, body
structure and age development, facial expressions, loc, speech, range of motion, gait
vital signs trends - ANS trends in vital signs are more important than a single value
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