Test 2

transfer of heat from the surface of one object to the surface of another without contact btwn the 2 objects, mostly in the form of infrared radiation

transfer of heat from one molecule to a molecule of lower temp with contace

dispersion of heat by air currents

continuous vaporization of moisture from the respiratory tract and from the musosa of the mouth and from the skin

body temp alternates at regular intervals btwn periods of dever and periods of normal or submoral temperatures

ex. malaria

a wide range of temperature fluctuations occurs over a 24 hr period all of which are above normal (more than 3.6 deg)

short febrile periods of a few days are interspered with periods of 1 or 2 days of mormal temperature.

the body temp fluctuates minimally but always remains above normal

ex typhoid fever

• increased heart rate
• increased resp rate and depth
• shivering
• pallid, cold skin
• complaints of feeling cold
• cyanotic nail beds
• gooseflesh appearance of skin
• cessation of sweating

• absence of chills
• skin that feels wam
• photosensitivity
• glassy eyed appearance
• increased pulse and resp rates
• increased thirst
• mild to severe dehydration
• drowsiness, restlessness, delirium, or convulsions
• herpetic lesions of the mouth
• loss of appetitie (if the fever is prolonged)
• malaise, weakness, and aching muscles

• skin that appears flushed and feels warm
• sweating
• dcreased shivering
• possible dehydration

• monitor vitals signs
• assess skin color and temp
• monitor white blood cell count, HCT value, and other pertinent laboratory reports for indications of infection or dehydration
• measure intake and output
• reduce physical activity to limit heat production especially during the flush phase
• antipyretics as ordered
• provide oral hygiene to keep mucous membranes moist
• tepid sponge bath to increase heat loss through conduction
• provide dry clothing and bed linens

• decreased body temp less than 95 deg
• severe shivering at onset
• feelings of cold and chills
• pale, cool, waxy skin
• frostbite (discolored, blistered nose, fingers, toes)
• hypotension
• decreased urinary output
• lack of muscle coordination
• disorientation
• drowsiness progressing to coma

• provide warm environment
• dry clothing
• warm blankets
• limbs close to body
• cover scalp with cap or turban
• warm oral or IV fluids
• warming pads

conjunctiva of eyes (lining of eyelids), nail beds, lips, buccal mucosa. Palms and soles of feet in dark skinned people

scelera of eye, nail beds, mucous membranes and skin, posterior hard palate

conjunctiva, oral mucous membranes, nail beds, palms and soles

bruises; bleeding into subcutaneous tissue

accumulation of blood in tissue or organ, note swelling

broken blood vessel, pin point hemorhages

flat, unelevated change in color; ie freckles, measles rash, port wine stain

raised, solid elevation of skin; ie mole, wart, acne

fluid filled, round, thin translucent mass filled with serous fluid or blood; ie chicken pox, burn blisters, poison ivy

vesicule filled with pus; ie acne vulgaris, impetigo

excessive, coarse hair on face and trunk; ovarian dysfunction

age spots

spider veins

nosebleeds

abnormal constriction of pupils

abnormal dialation of pupils

unequal pupils

droopy eyelid

involuntary movement of eye

• liver
• gallbladder
• duodenum
• head of pancreas
• right adrenal gland
• upper lobe of right kidney
• hepatic flexure of colon
• section of ascending colon
• section of transverse colon

• left lobe of liver
• stomach
• spleen
• upper lobe of left kidney
• pancreas
• left adrenal gland
• splenic flesure of colon
• section of transverse colon
• section of descending colon

• lower lobe of right kidney
• cecum
• appendix
• section of ascending colon
• right ovary
• right fallpian tube
• right ureter
• right spermatic cord
• part of uterus

• lower lobe of left kidney
• sigmoid colon
• section of descending colon
• left ovary
• left fallopian tube
• left ureter
• left spermatic cord
• part of uterus

• spontaneous 4
• to verbal command 3
• to pain 2
• no response 1

• To verbal command 6
• to localized pain 5
• flexes and withdrawals 4
• flexes abnormally 3
• extends abnormally 2
• no response 1

• oriented, converses 5
• disoriented, converses 4
• uses approriate words 3
• makes imcomprehensible
• sounds 2
• no response 1

sensory - ask client to close eyes and identify different mild aromas

sensory - read snellen chart, check visual fields by confrontation, and conduct opthalmoscopic exam

motor - assess 6 ocular movements

motor - assess 6 ocular movements

• sensory - while client looks up, lightly touch lateral sclera fo the eye to elicit blink reflex.
• To test light sensation, have client close eyes, wipe a wisp of cotton over clients forehead and paranasal sinuses.
• To test deep sensation, use alternating blunt and sharp ends of a safety pin over same areas.

sensory - assess skin sensation as for ophthalmic branch

motor and sensory - ask client to clench teeth

motor - assess directions of gaze

motor and sensory - ask client to smile, raise the eyebrows, frown, puff out cheeks, close eyes tightly. Ask client to id various tastes placed on tip and sides of tongue: sugar, salt, lemon juice, and quinine (bitter); id areas of taste

sensory - romber test

assess clients ability to hear spoken word and vibrations of tuning fork

motor and sensory - apply tastes on posterior tongue for id. ask client to move tongue from side to side and up and down

motor and sensory - assess with cranial nerve IX; assess clients speech for hoarseness

motor - ask client to shrug shoulders against resistance from your hands and turn head to side against resistance from your hand (repeat on other side)

motor - ask client to protrude tongue at midline, then move it side to side

client turns the head to one side against the resistance of your hand - repeat with the other side

client shrugs the shoulders against the resistance of your hands

client holds arm up and resists while you try to push it down

client fully extends each arm and tries to flex it while you attempt to hold arm in extension

client flexes each arm and then tries to extend it against your attempt to keep arm in flexion

client spreads the fingers and resists as you attempt to push the fingers together

client grasps your index and middle fingers while you try to pull the fingers out

client is supine, both legs extended; client raises one leg at a time while you attempt to hold it down

client is supine, both legs extended. place your hands on the lateral surface of each knee; client spreads the legs apart against your resistance

client is in same position as for hip abduction. place your hands btwn the knees; client brings the legs together against your resistance.

client is supine, both knees bent. client resists while you attempt tp straighten the legs

client is supine, knee partially extended; client resists while you attempt to flex the knee

client resists while you attempt to dorsiflex the foot and again resists while you attempt to flex the foot

• 0:0% of normal strength; complete paralysis
• 1:10% of normal strength; no movement, contraction of muscle is palpable or visible
• 2:25% of normal strength; full muscle movement against gravity, with support
• 3:50% of normal strength; normal movement against gravity
• 4:75% of normal strength; normal full movement agaist gravity and against minimal resistance
• 5:100% of normal strength; normal full movement against gravity and against full resistance

• decreasing the angle of the joint (eg. bending the elbow, nodding head yes)
• move the head from the upright midline position forward so that the chin rests on the chest

Increasing the angle of the joint (eg. straightening the arm at the elbow, nodding head yes)

move the head from the flexed position to the upright position

• movement of the bone toward the midline of the body
• move each arm from a position at the sides across the front of the body as far as possible. the elbow may be straight or bent.
• bring the fingers of hand together
• move thumb back to the palm of hand
• move leg back to the other leg and beyond in front of it

• movement of the bone away from the midline of the body
• move arm laterally from a resting position at the sides to a side position above the hear, palm of the hand either toward or away from the head
• spread the fingers apart
• extend thumb laterally
• move leg out to the side

• movement of the distal part of the bone in a circle while the proximal end remains fixed
• move arm forward, up, back, and down in a full circle
• move leg backward, up, to the side, and down in a circle

moving the bones of the forearm so that the palm of the hand faces upward when held in front of the body

moving the bones of the forearm so that the palm of the hand faces downward when held in front of the body

Some Say Marry Money, But My Brother Says Big Brains Matter Most

• Olfactory
• Optic
• Oculomotor
• Trochlear
• Trigeminal
• Abducens
• Facial
• Acoustic
• Glossopharyngeal
• Vagus
• Accessory
• Hypoglossal

• knowledge
• comprehension
• application
• analysis
• synthesis
• evaluation

attitudes, values and emotion

skills