Focused Exam: Abdominal Pain Results | Turned In
Health Assess - Spring 1 2020, 322301
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Overview
Objective Data Collection: 21 of 21 (100%)
m
Transcript
er as
Subjective Data Collection Correct Incorrect
co
eH w
Partially correct Missed
Objective Data Collection
o.
Education & Empathy
Inspected head and face
Documentation
rs e 1 of 1 point
ou urc
Care Plan Skull Symmetry (1/3 point) Facial Feature Symmetry (1/3 point)
Symmetric Symmetric
Asymmetric Asymmetric
o
Appearance (1/3 point)
aC s
No visible abnormal findings
vi y re
Flushed appearance
Rash or lesion
Skin growths (freckles, moles, or birth mark)
Excessive hair growth
Evidence of skin trauma (scar, laceration, or bruising)
ed d
ar stu
Appearance (1/3 point)
No visible abnormal findings
Rash
Striae
https://www.coursehero.com/file/54630935/Esther-Parks-Abdominal-Pain-ObjectiveData-Shadow-Healthpdf/
Bulging around umbilicus
, Distension
Visible masses (warts, cysts, or tumors)
Freckles, birthmark, or discoloration
Excessive hair growth
Scarring
Laceration, lesion, or wound
Bruising
Redness
Jaundice
Prominent veins
Inspected for edema in lower extremities 1 of 1 point
Right: Edema (1/4 point) Right: Severity Of Edema (1/4 point)
No edema No edema
Pitting 1+ Slight pitting
Non-pitting 2+ Deeper pit, disappears in 10 to 15 seconds
3+ Noticeably deep pit that lasts more than a minute
4+ Very deep pit that lasts 2 to 5 minutes
m
Left: Edema (1/4 point) Left: Severity Of Edema (1/4 point)
er as
No edema No edema
co
Pitting 1+ Slight pitting
eH w
Non-pitting 2+ Deeper pit, disappears in 10 to 15 seconds
3+ Noticeably deep pit that lasts more than a minute
o.
4+ Very deep pit that lasts 2 to 5 minutes
rs e
ou urc
Auscultated heart sounds 1 of 1 point
Heart Sounds (1/2 point) Extra Heart Sounds (1/2 point)
o
S1 and S2 audible No extra sounds
aC s
S1, S2, and S3 audible Gallops
S1, S2, and S4 audible Murmur
vi y re
S1, S2, S3, and S4 audible Friction rub
Valve clicks
ed d
Auscultated breath sounds 1 of 1 point
ar stu
Breath Sounds (1/3 point) Adventitious Sounds (1/3 point)
Present in all areas No adventitious sounds
Diminished in some areas Wheezing
sh is
Absent in some areas Fine crackles
Stridor
Th
Rhonchi
Rales
Location (1/3 point)
All areas clear
Adventitious sounds in anterior right upper lobe
Adventitious sounds in anterior right middle lobe
Adventitious sounds in anterior right lower lobe
Adventitious sounds in anterior left upper lobe
Adventitious sounds in anterior left lower lobe
Adventitious sounds in posterior right upper lobe
Adventitious sounds in posterior right lower lobe
Adventitious sounds in posterior left upper lobe
Adventitious sounds in posterior left lower lobe
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