Lippincott Manual of Nursing Practice Series: Assessment by Springhouse

By Springhouse

This full-color quick-reference guide covers all features of the sufferer background and actual exam to aid nurses interpret evaluate findings, realize sufferer wishes, and supply targeted care. details is gifted in a succinct, hugely bulleted structure, with lists, tables, and flowcharts to spotlight key evidence. ordinary image icons contain Skill Check (tips for acting actual exam techniques), Culture Cue and Age Alert (specific diversifications in evaluate findings and methods concerning age, tradition, or ethnicity), Alert (life- or limb-threatening situations), and Clinical Picture (quick-scan charts visually evaluating clusters of irregular findings and differentiating between attainable causes).

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However, it may also result from oropharyngeal, respiratory, neurologic, and collagen disorders and the effects of toxins and treatments. Dysphagia increases the risk of choking and aspiration and may lead to malnutrition and dehydration. Dysphagia may suggest achalasia, most common in patients ages 20 to 40. Here the disorder involves difficulty with solids and liquids. The dysphagia develps gradually and may be precipitated or exacerbated by stress. Occasionally, it’s preceded by esophageal colic.

To take an effective history, establish rapport with the patient. Ask open-ended questions and listen carefully to responses. Closely observe the patient’s nonverbal behavior. 42 CHIEF COMPLAINT A patient with a cardiovascular problem typically cites specific complaints, such as: ● chest pain ● irregular heartbeat or palpitations ● shortness of breath on exertion, lying down, or at night ● cough ● cyanosis or pallor ● weakness ● fatigue ● unexplained weight change ● swelling of the extremities ● dizziness ● headache ● high or low blood pressure ● peripheral skin changes, such as decreased hair distribution, skin color changes, or a thin, shiny appearance to the skin ● pain in the extremities, such as leg pain or cramps.

Ask these questions: ● Where and how is your food prepared? ● Do you have access to adequate storage and refrigeration? ● Do you receive welfare payments, Social Security payments, Supplemental Security Income, food stamps, or assistance from Special Supplemental Food Program for Women, Infants, and Children? If the patient doesn’t cook his own food, his nutritional health depends on whether others are available to help him. Inadequate food storage and refrigeration can lead to nutritional problems.

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