Nr 509 Mid Term Study Guide Advanced Physical Assessment

This study source was downloaded by 100000857300661 from CourseHero.com on 11-17-2022 01:34:18 GMT -06:00https://www.coursehero.com/file/65116085/NR509-Mid-Term-Study-Guidedocx/ Week 3: Preparing for Exam 1ChptTopics 1 Basic and Advanced Interviewing Techniques: steps for identifying problems and making a dx:1. Identify abnormal findings2. Localize findings anatomically3. Cluster the clinical findings4. Search for probable causes of the findings5. Cluster the clinical data6. Generate hypotheses about the causes of the problems7. Test the hypothesis and establish a working dx Components of the Health History: this is the identifying data & source of history; reliability factors include age, gender, mental status Chief complaint CC is the concern & symptoms in pts own words; Present illness HPI amplifies the CC & describes how the sx developed, = complete, clear, chronologic description of problems prompting the visit, including 7 attributes: OLD CARTS1. location2. quality3. quantity/severity4. timing: onset, duration, frequency5. setting in which it occurs6. alleviating/aggravating factors7. associated manifestationsAlso includes pertinent + and - from the ROS relevant to CC to generate a differential dx. Meds noted here along with allergies and tobacco use. Past hx = immunizations, screenings, lifestyle issues/choices, sexual partner, surgical & OB hx Psych info = dx, hospitalizations, tx, illness time frame Family hx = presence/absence of family