Physical assessment is taking an educated, systematic look at all aspects of an individual’s health status utilizing knowledge, skills and tools of health history and physical exam. To collect data- information about the client’s health, including physiological, psychological, sociocultural and spiritual aspects To establish actual and potential problems To establish the nurse-client relationship Method: The history is done first, then the physical examination focuses on finding data associated with the history. Health History- obtained through interview and record review. Physical exam- accomplished by tools and techniques ** A complete assessment is not necessarily carried out each time. A comprehensive assessment is part of a health screening examination. On admission, you will do an admission assessment (not necessarily including everything presented here) and document it on the admission form. You will do a daily shift assessment (patient systems review). And, if client has a specific problem, you may assess only that part of the body (focused). Data Collection: Information is organized into objective and subjective data: Subjective: Apparent only to person affected; includes client’s perceptions, feelings, thoughts, and expectations. It cannot be directly observed and can be discovered only asking questions. Objective: Detectable by an observer or can be tested against an acceptable standard; tangible, observable facts; includes observation of client behavior, medical records, lab and diagnostic tests, data collected by physical exam. ** To obtain data for the nursing health history, you must utilize good interview techniques and communications skills. Record accurately. DO NOT ASSUME. D. Frameworks for Health Assessment There are two main frameworks utilized in health assessment: Head to Toe- systematic collection of data starting with the head and working downward. Functional Health Assessment- Gordon’s 11 functional health patterns that address the behaviors a person uses to maintain health. PERSON is the ACC-ADN framework for assessment. It is similar to Gordon's functional health patterns.

This is an educational medical video for Medical Students showing how to examine a hernia swelling

Head to Toe Assesment

Friedreich's ataxia is an inherited disease that damages your nervous system. The damage affects your spinal cord and the nerves that control muscle movement in your arms and legs. Symptoms usually begin between the ages of 5 and 15. The main symptom is ataxia, which means trouble coordinating movements. Specific symptoms include Difficulty walking Muscle weakness Speech problems Involuntary eye movements Scoliosis (curving of the spine to one side) Heart palpitations, from the heart disease which can happen along with Friedreich's ataxia People with Friedreich's ataxia usually need a wheelchair 15 to 20 years after symptoms first appear. In severe cases, people become incapacitated. There is no cure. You can treat symptoms with medicines, braces, surgery, and physical therapy.

Barrett's esophagus is a complication of chronic (long lasting) and usually severe gastrointestinal reflux disease (GERD), but occurs in only a small percentage of patients with GERD. Criteria are needed for screening patients with GERD for Barrett's esophagus. Until validated criteria are available, it seems reasonable to do screening endoscopies in GERD patients who cannot be taken off acid suppression therapy after two to three years. The diagnosis of Barrett's esophagus rests upon seeing (at endoscopy) a pink esophageal lining that extends a short distance (usually less than 2.5 inches) up the esophagus from the gastroesophageal junction and finding intestinal type cells (goblet cells) on biopsy of the lining. There is a small but definite increased risk of cancer of the esophagus (adenocarcinoma) in patients with Barrett's esophagus.

Vaginal discharge serves an important housekeeping function in the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection. Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can odor and hue (its color can range from clear to a milky white-ish), depending on the time in your menstrual cycle. For example, there will be more discharge if you are ovulating, breastfeeding, or are sexually aroused. The smell may be different if you are pregnant or you haven't been diligent about your personal hygiene. None of those changes is cause for alarm. However, if the color, smell, or consistency seems significantly unusual, especially if it accompanied by vaginal itching or burning, you could be noticing an infection or other condition. What causes abnormal discharge? Any change in the vagina's balance of normal bacteria can affect the smell, color, or discharge texture. These are a few of the things that can upset that balance:

Local anaesthetic injection prior to tumescence ready for varicose vein surgery

Amenorrhea is the absence of menstrual bleeding.[1] Amenorrhea is a normal feature in prepubertal, pregnant, and postmenopausal females. In females of reproductive age, diagnosing amenorrhea is a matter of first determining whether pregnancy is the etiology. In the absence of pregnancy, the challenge is to determine the exact cause of absent menses.[2] Primary amenorrhea is the failure of menses to occur by age 16 years, in the presence of normal growth and secondary sexual characteristics. If by age 13 menses has not occurred and the onset of puberty, such as breast development, is absent, a workup for primary amenorrhea should start. Secondary amenorrhea is defined as the cessation of menses sometime after menarche has occurred. Oligomenorrhea is defined as menses occurring at intervals longer than 35 days apart. No consensus has been reached regarding the point at which oligomenorrhea becomes amenorrhea. Some authors suggest the absence of menses for 6 months constitutes amenorrhea, but the basis for this recommendation is unclear. For a post-menarchal girl or a reproductive-aged woman to experience a menstrual cycle interval of more than 90 days is statistically unusual. Practically speaking, this should be an indication for an evaluation to seek the cause.

Your Little Finger Reveals What Kind of a Person You Are

Remove of ascaris lumbricoides worms due to intestinal obstruction

Indwelling urinary catheters are commonly used in hospitals and can lead to preventable catheter-associated UTI. How can rates of catheter-associated UTI be reduced in hospitals? New research findings are summarized in a new NEJM Quick Take. Learn more at http://nej.md/1WoeHdF SHOW MORE

AZT Mechanism of Antiviral Activity

In this video, Jenna talks about Braxton Hicks contractions and preparing for labor.

Genital warts are soft growths that appear on the genitals. Genital warts are a sexually transmitted infection (STI) caused by certain strains of the human papillomavirus (HPV). These skin growths can cause pain, discomfort, and itching. They are especially dangerous for women because some types of HPV can also cause cancer of the cervix and vulva.

Symptoms of serotonin syndrome include a classic triad of mental status changes (eg, anxiety, delirium, confusion, restlessness), autonomic dysregulation (eg, diaphoresis, tachycardia, hypertension, hyperthermia, diarrhea, mydriasis), and neuromuscular hyperactivity (eg, hyperreflexia, tremor, rigidity, myoclonus, ocular clonus). Serotonin syndrome is clinically diagnosed and laboratory tests are used to rule out other etiologies. It usually occurs due to inadvertent interactions between drugs, therapeutic use of multiple serotonergic agents, or serotonergic medication overdose. Treatment involves discontinuation of serotonergic drugs, supportive measures, and sedation with benzodiazepines. In severe cases, a serotonin antagonist (cyproheptadine) may be used.

Watch that video of Bodybuilder's Colon Contains 10 lbs of Meat Worms

The Combitube is a twin lumen device designed for use in emergency situations and difficult airways. It can be inserted without the need for visualization into the oropharynx, and usually enters the esophagus. It has a low volume inflatable distal cuff and a much larger proximal cuff designed to occlude the oro- and nasopharynx.

If the tube has entered the trachea, ventilation is achieved through the distal lumen as with a standard ETT. More commonly the device enters the esophagus and ventilation is achieved through multiple proximal apertures situated above the distal cuff. In the latter case the proximal and distal cuffs have to be inflated to prevent air from escaping through the esophagus or back out of the oro- and nasopharynx.

An animation showing vaginal childbirth (delivery)

If the artery were severed, blood would flow out unimpeded, although the artery wall would contract in an effort to stop the bleeding. After losing >30% of one's blood volume blood pressure would start dropping, and with less pressure the rate of bleeding would go down. At this stage if the blood loss wasn't replaced the person could die. Losing halve to two thirds of one's blood volume is considered to be fatal even if later on blood transfusion is attempted. One's total blood volume at 70ml/kg is estimated to be between 5 to 7 liters, so that makes a blood loss of between 2,5 to 4,7 L.