Week 4 Discussion: Health Assessment Questions Describe toddler lordosis and is it normal. Lordosis is a pronounced lumbar curve giving the child a swayback appearance. From the side, lordosis is common throughout childhood, appearing more pronounced in children with a protuberant abdomen. As the child continues to walk, the condition will slowly and naturally correct itself. What is a Denver Developmental Screening Test II? This test uses both parent observation and direct observation and has long been the standard for developmental screening. It monitors the development of infants and preschool-aged children. •
Revised from original Denver Developmental Test
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Clinician assess 125 questions
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Requires 20-30 minutes to perform
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Available in English and Spanish
What are the stages of the interview process? There are 3 phases to each interview. They include: •
An Introduction – Address the patient using his or her surname. Introduce yourself and state your role. Give the reason for the interview, if gathering a complete history.
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A Working Phase – This is the data gathering phase. Includes open ended or closed ended (direct) questions, and responses.
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A Termination (or closing) – Should end gracefully. Give the person a final opportunity for self-expression. Provide a summary or recapitulation of what you have learned during the interview. This is the final statement of what you and the patient agree his or her health state to be.
Write an example of an open ended question. When you said you are hurt, what do you mean? Describe each examination technique and the order in which they are normally performed. •
Inspection – This is the close careful scrutiny, first the person as a whole and then of each body system. Should learn how to use each person as a control and compare the right and left sides of the body for symmetry. Requires good lighting, adequate exposure, and occasional use of instruments to enlarge your view. Page 1 of 3
Week 4 Discussion: Health Assessment Questions •
Palpation – This follows and often confirms points you noted during inspection. Applies your sense of touch to asses texture, temperature, moisture, and organ location and size, as well as swelling, vibration or pulsation, rigidity or spasticity, crepitation, presence of lumps or masses, and presence of tenderness or pain. Should be slow and systematic.
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Percussion – Involves trapping the person’s skin with short, sharp strokes to assess underlying structures.
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Auscultation – Listening to sounds produced by the body, such as the heart, blood vessels, lungs, and abdomen, through a stethoscope. Should use a stethoscope with two end pieces – a diaphragm and a bell.
Where are the only areas of the body that lymph nodes are accessible for examination? These include: Cervical nodes, Axillary nodes, Epitrochlear node, Inguinal nodes Is it normal to have enlarged lymph nodes? No. Lymph nodes in healthy adults are normally not palpable. What does a normal tympanic membrane look like and where should you see the light reflex? The tympanic membrane (eardrum) separates the external and middle ear. It is translucent, with a pearly gray color and a prominent cone of light in the anteroinferior quadrant, which is the reflection of the otoscope light. The parts of the malleus show through the translucent drum; these are the umbo, the manubrium, and the short process. The cone-shaped light reflex is prominent in the anterior inferior quadrant (at the 5 – o’clock position in the right drum and the 7 – o’clock position in the left drum). This is the reflection of the otoscope light. Describe how you would perform visual acuity using a Snellen Chart. Position the person on a mark exactly 20 feet from the chart. If the person wears glasses or contact lenses, leave them on. Shield one eye at a time during the test. Ask the person to read through the chart to the smallest line of letters possible. Record the results using the numeric fraction at the end of the last successful line read. Indicate whether any letters were missed and whether corrective lenses were worn. Describe what a finding of 20/15 O.D. means? Normal visual acuity is 20/20. The top number (numerator) indicates the distance the person is standing from the chart; the denominator gives the distance at which a normal eye can read a particular line. The larger the denominator, the poorer the vision. 20/15
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Week 4 Discussion: Health Assessment Questions O.D. means: a person could be at 20 feet to see an object whereas normal people would have to be at 15 feet to see the same object. O.D. is for the right eye. Is this vision indicative of seeing better or worse than the "normal" eye? This is indicative of better than normal eyesight. Describe the layers of the skin. The skin has 2 layers: •
Epidermis – outer, highly differentiated
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Dermis – the inner supportive layer Beneath these layers is a third layer – the insulating subcutaneous layer of adipose
tissue. What does ABCDE mean? Abnormal characteristics of pigmented lesions are summarized with the mnemonic or ABCDE: •
Asymmetry of a pigmented lesion.
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Border irregularity.
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Color variation (areas of black, gray, blue, red, white, pink) or dark black color.
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Diameter greater than 6 mm.
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Elevation or enlargement.
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