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NSG 6020 MIDTERM EXAM STUDY GUIDE / NSG6020 MIDTERM EXAM STUDY GUIDE (LATEST-2022): SOUTH UNIVERSITY
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NSG 6020 MIDTERM EXAM STUDY GUIDE / NSG6020 MIDTERM EXAM STUDY GUIDE (LATEST-2022): SOUTH UNIVERSITY
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NSG 6020 MIDTERM EXAM STUDY GUIDE1. Be familiar with s/s of Bronchitis, Pneumonia, Tuberculosis, and Pulmonary
Edema.
Bronchitis
Cough, may be dry or productive. Acute, often viral, illness generally without
fever or dyspnea; at times with burning retrosternal discomfort
Pneumonia
Sputum is mucoid or purulent; may be blood-streaked, diffusely pinkish, or
rusty. Acute illness with chills, often high fever, dyspnea, and chest pain.
Commonly from streptococcus pneumonia, haemophilus influenza, moraella
catarrhails, klebsiella in alcoholism, especially if underlying smoking, chronic
bronchitis and copd, cardiovascular disease, diabetes.
Tuberculosis
Cough, dry, or with mucoid or purulent sputum, may be blood-streaked or
bloody. Early= no symptoms. Later= anorexia, weight loss, fatigue, fever, and
night sweats.
Pulmonary Edema
Pink frothy sputum, dyspnea, orthopnea, difficulty breathing when laying down,
waking up at night breathless, rapid weight gain in lower extremities.
2. S/S of Dyspnea
Subjective sense of discomfort or difficulty breathing. Pt’s c/o SOB, chest
tightness, or simply difficulty breathing or trying to catch their breath.
3. Changes in Gastrointestinal system in aging adult
During the middle and later years, the abdominal muscles tend to weaken, there
is decreased activity of lipoprotein lipase, and fat may accumulate in the lower
abdomen and near the hips even when the weight is stable. These changes often
produce a softer, more protruding, abdomen which patients may interpret as fluid
or evidence of disease. The change in abdominal fat distribution increases the
risk of cardiovascular disease.
,Aging can blunt the manifestations of acute abdominal disease. Pain may be less
severe, fever is often less pronounced, and signs of peritoneal inflammation,
such as guarding and rebound tenderness, may be diminished or even absent.
4. Best technique to assess skin temperature
Skin temperature is best assessed by the dorsal aspects of the hand and fingers.
Situations that increase skin temperature include increased blood flow to the skin
or underlying structures; thermal or chemical burns; local infections; and
generalized, systemic infections and fever. Decreased skin temperature may
result from atherosclerosis and shock
5. Assessment of Thyroid Gland in pregnant patients
During pregnancy the thyroid is hyperstimulated.
Thyroid function changes include an increase in thyroid-binding globulin
due to rising levels of estrogen and stimulation of thyroid-stimulating hormone
(TSH) receptors by HCG. This results in a slight increase, usually in the normal
range, in serum concentrations of free T3 and T4, while serum TSH
concentrations appropriately decrease. This transient apparent “hyperthyroidism”
should be considered physiologic
6. Proper methods of auscultation of heart sounds
Listen at the 2nd right and left interspaces, down the
left sternal border to the 4th and 5th interspaces, and across to the apex the six
listening areas with the diaphragm, then the bell (see p. 391). As indicated, listen
at the lower right sternal border for right-sided murmurs and sounds, often
accentuated with inspiration, with the diaphragm and bell.
*** In a quiet room, auscultate the heart with your stethoscope with the
patient’s head and upper chest elevated to 30°. Start at either the base or apex,
listening first with the diaphragm, then with the bell ***
7. Phases of physical assessment
8. Use of Snellen Chart
Testing near vision with a hand-held card can help identify the need for reading
glasses or bifocals in patients older than 45 years. You can also use this card to
, test visual acuity at the bedside. Held 14 inches from the patient’s eyes, the card
simulates a Snellen chart
9. Familiar with thyroid gland, parotid gland, & adrenal gland
Parotid Gland
Salivary gland that lies near the mandible, superficial to and behind the
mandible, is both visible and palpable when enlarged. The opening to the gland
can be seen in the oral cavity. Opens near the upper second molar.
Thyroid gland
The thyroid gland is usually located above the suprasternal notch. The thyroid
isthmus spans the second, third, and fourth tracheal rings just below the cricoid
cartilage. The lateral lobes of the thyroid curve posteriorly around the sides of
the trachea and the esophagus; each is about 4 cm to 5 cm in length. Except in
the midline, the thyroid gland is covered by thin straplike muscles anchored to
the hyoid bone and more laterally by the sternocleidomastoids, which are readily
visible.
The thyroid also regulates the brain and nerve function and development, plus the
function of the skin, hair, eyes, heart and intestines. The thyroid works in
conjunction with the pituitary gland.
Adrenal Gland
The adrenal glands are endocrine glands that produce a variety of hormones
including adrenaline and the steroids aldosterone and cortisol. They are found
above the kidneys. Each gland has an outer cortex which produces steroid
hormones and an inner medulla
10. Familiar with the different types of lymph nodes and how to examine them
The lymph nodes of the head and neck are variably classified. One classification
is shown in Figure 7-76, together with the directions of lymphatic drainage. The
deep cervical chain is largely obscured by the overlying sternocleidomastoid
muscle, but at its two extremes, the tonsillar node and supraclavicular nodes may
be palpable. The submandibular nodes lie superficial to the submandibular gland,
and should be differentiated. Nodes are normally round or ovoid, smooth, and
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