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Ysabella Shared "Client assessment exam 1" - 31 Picmonics

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Client assessment exam 1

I-SBAR-R
Identify
Situation
Background
Assessment
Recommendation
Readback
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1 min
Glasgow Coma Scale
LOC Assessment
Score of 3 to 15
8 or Less = Coma
Eye Opening
Verbal Response
Motor Response
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1 min
ABCDEs of Melanoma
Asymmetry
Border
Color
Diameter
Evolving
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1 min
Age 2 Months - Developmental Milestones
Gross Motor
Holds Head Up, But Unsteady
Moves Both Arms and Both Legs
Fine Motor
Opens Hands Briefly
Tracks Objects to the Midline
Language/Communication
Produces Sounds Aside from Crying
Reacts to Loud Noise
Social / Cognitive
Social Smile
Recognizes Parents
Soothed When Spoken to or Picked Up
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2 mins
Age 2 Years - Developmental Milestones
Gross Motor
Kicks a Ball
Runs
Walks Up Stairs With Help
Fine Motor
Stacks Six Blocks
Feeds Self With a Spoon
Language / Communication
Two-Word Phrases
Points to Book Items as Prompted
Demonstrates Varied Gestures
Identifies Body Parts When Prompted
Social / Cognitive
Shows Empathy
Holds and Manipulates Objects Simultaneously
Engages With Multiple Toys
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2 mins
Age 9 Months - Developmental Milestones
Gross Motor
Sits Up Independently
Fine Motor
Transfers Objects Between Hands
Uses Fingers to Pull Food Toward Self
Language/Communication
Produces Various Sounds Like "mamamama" and "bababababa"
Raises Arms to be Lifted Up
Social / Cognitive
Separation Anxiety
Shows Facial Expressions
Looks When Calling Name
Smiles or Laughs at Peek-a-boo
Looks for Dropped Objects Out of Sight
Bangs Two Items Together
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2 mins
Age 4 Years - Developmental Milestones
Gross Motor
Unbuttons Some Buttons
Catches a Large Ball
Serves Food or Pours Water With Help
Fine Motor
Copies Line, Circle, Stick Figure
Language / Communication
100% Speech Understandable
Identifies Colors
Social/ Cognitive
Cooperative Play
Imaginary Friends
Likes Being a “Helper”
Avoids Danger
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2 mins
Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)
Changes in Mood
Poor Hygiene
Odd Sleep Patterns
Frequent Injuries
Relationship or Job Difficulty
Poor Performance
Anorexia OR Weight Loss
Social Isolation
Financial Problems
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2 mins
Alcohol Use Disorder Assessment (Formerly Alcohol Abuse Assessment)
Intoxication
CNS Depression
Withdrawal
Wernicke-Korsakoff Syndrome
Medical Complications
GI Distress
Cardiomyopathy
Pancreatitis
Cirrhosis
Immunosuppression
Sexual Dysfunction
Considerations
Screening (Assessments)
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3 mins
Benign Prostatic Hyperplasia (BPH) Assessment
Assessment
Men Over 50
Enlarged Prostate Gland
Urinary Retention
Weak Urine Stream
Frequency
Urgency
Nocturia
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1 min
Child and Elder Physical Abuse Assessment
Physical Abuse
Inconsistent Injuries
Delay in Treatment
Various Stages of Healing
Child Abuse
Symmetrical Burns
Sexually Transmitted Infection
Bloody/Torn Undergarments
Shaken Baby Syndrome
Elder Abuse
Poor Hygiene
Overmedication
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2 mins
Cranial Nerve Function
Sensory
CN I
CN II
CN VIII
Motor
CN III
CN IV
CN VI
CN XI
CN XII
Both
CN V
CN VII
CN IX
CN X
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1 min
Erikson’s Theory Of Psychosocial Development - Stage 5 (Adolescence)
Age
Adolescent (12-18 Years)
Basic Conflict
Identity vs. Role Confusion
Important Events
Social Relationships
Virtue
Fidelity
Freud Stage
Genital
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2 mins
Erikson’s Theory Of Psychosocial Development - Stage 4 (School Age)
Age
School Age (6-12 Years)
Basic Conflict
Industry vs. Inferiority
Important Events
School
Virtue
Competence
Freud Stage
Latency
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2 mins
Erikson’s Theory Of Psychosocial Development - Stage 8 (Older Adult)
Age
Older Adult (65+ to Death)
Basic Conflict
Integrity vs. Despair
Important Events
Reflection on Life
Virtue
Wisdom
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1 min
Lab and Diagnostic Tests During Pregnancy (1st Visit)
Diagnosis
Complete Blood Count (CBC)
Blood Typing and Rh
Rubella
HIV
Hepatitis B
Tuberculosis Skin Mantoux Test (PPD)
Sexually Transmitted Infections
Chlamydia
Neisseria gonorrhoeae
Syphilis
Pap Smears
Urinalysis
Sickle Cell Screening (If Indicated)
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2 mins
Level of Consciousness: Descriptive guide for Glasgow Coma Scale
Conscious
Confused
Delirious
Somnolent
Obtunded
Stuporous
Comatose
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3 mins
Low Blood Pressure Response
Characteristics
Posterior Pituitary Releases Vasopressin
Vasoconstriction
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
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1 min
Lung Sounds - Crackles
Location
Lower Lobes
Description
Fine/Coarse
Sounds Like
Fine: Twisting Hair through Fingers
Coarse: Velcro
Cause
Collapsed Small Airways and Alveoli "Popping Open"
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1 min
Neurovascular Assessment 6 P's
Pain
Paresthesia
Pulse
Pallor
Pressure
Paralysis
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1 min

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