NSG 500 - Advanced Health Assessment Exam 2 Question: Symptoms of tympanic membrane rupture Answer: Bloody/yellow discharge from ear, pain, hearing loss, tinnitus Question: Laryngeal obstruction Answer: Stridor Question: How to examine the ear in children vs. adults, and considerations in geriatrics Answer: Children/infant: Below 3 years old, down and back Adults: 3+ older, UP and back. Question: Risk factors for cataract development Answer: -#1 risk factor: diabetes -old age, -tobacco use, -obesity, -prolonged exposure to sunlight/uv light -long term corticosteroid use (chrohn's disease and prednisone) Question: Indicators of hypertensive retinopathy during eye exam Answer: -Cotton wool bodies, AV nicking (most common) -Disc edema, narrowing -flame shaped hemorrhages Question: Evaluation of hearing in pediatrics: at what age can an infant turn their head to their parent's voice? (Also known as the moro reflex) Answer: 4-6 mon ths Question: Nasal exam findings for drug abuse (like snorting cocaine) Answer: deviation or septal perforation, nasal damage, chronic congestion, chronic sniffing, nose bleeds Question: (Respiratory - 23:44) Diaphragmatic excursion and normal findings Answer: You're assessing for symmetry and how far lungs are able to expand; in normal findings; 5 -6 cm If this number is increased that would be concern for a pleural effusion. Question: Normal respiratory r ate to HR ratio Answer: 1:4 Question: How to perform percussion; how should the patient be placed? -What would give you dull sounds? Answer: The patient should be placed sitting up, and you want them, ideally, their arms folded and leaning forward and overtop something like a bedside table or chair and leaning forward. This is to help increase the surface area of lung fields. -Dull sounds wou ld indicate pleural effusion/pneumonia Question: Lung exams on infants; what should you NOT do? Answer: -No percussion! -Auscultate lungs first, because they'll scream! Question: As you age/older adult, what happens to your diaphragmatic excursion? Answer: -As you age, you have decreased diaphragmatic excursion due to decreased elasticity in the lungs
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