Dr. Paul Langlois – 2-Day: Advanced Assessment Skills: Respond to the Patient’s Clues with Skill and Confidence

Outline

Psychosocial Assessment

• CALM acronym: How to set the person at ease during your assessment
• Three key elements in determining the psychosocial assessment
• Proven ways to assess stress in the patient
• Two ways to quickly identify suicidal ideation
• Is this an accident or abuse or neglect?

General Survey of the Patient: What You See is What You Get…Well Not Always

• Symptom analysis…use the COLDSPA acronym
• What the blood pressure and pulse tell you about the patient…even before the stethoscope
• Four proven ways to differentiate neuropathic and non-neuropathic pain
• Key steps when a patient says that they have a condition you have never heard of
• Are the patient’s medications causing the problem…check the Beers criteria

Look Into My Eyes

• Red-flags you must be aware of regarding the eyes
• How medications affect the eye exam
• Differentiating visual acuity and visual fields…impact of the cranial nerves

Respiratory System…Much More than Breath Sounds

• Three age-related changes in the lungs you must know
• The stethoscope is vital, but so are your hands
• How to differentiate asthma, emphysema, pneumonia, and pleural effusion
• Keys to indicate the patient needs a chest radiograph
• The ABCs of ABGs: Four proven ways to contrast respiratory vs. metabolic acidosis and alkalosis
• Four other laboratory tests to assess lung function
• Medications for pulmonary conditions

Cardiovascular System…Beyond the Heart

• Determine if that adventitious sound is during systole or diastole
• Murmurs, rubs, opening snaps…what do they all mean?
• What does the ECHO cardiogram tell you?
• Identify the location of the ischemia, injury, or infarction based on the 12-lead ECG
• Laboratory tests for heart conditions…Heart failure, myocardial infarction, pericarditis
• Pearls for a thorough peripheral vascular assessment…arteries, veins, and lymph nodes
• Must-know categories of medications that deteriorate the heart

Gastro-intestinal System…Beyond the Large and Small Intestine

• Don’t worry about this prevalent finding…it is age related
• GI laboratory tests that are vital for patient assessment
• Could this be cancer or a normal finding?
• Four most-ordered GI procedures and differential diagnosis
• The effect of medications on the GI tract

Genitourinary System

• Differentiate cystitis, UTI, and pyelonephritis…should medications be prescribed?
• ”There is blood in my urine”; what you need to do right now for your patient
• GU laboratory test and procedures; how to interpret the results
• How contrast dyes affect the kidney…watch out for these signs

Musculoskeletal System

• ”I have this back pain”; what you need to do now before the pain progresses
• Differentiating muscular pain and nerve damage
• Five time-honored tests for the musculoskeletal system
• Medications that facilitate fluidity in the MS system

Neurologic System

• Differentiating two- and three-reflex arcs
• Four pearls when conducting cranial nerve assessment
• Is this a motor or sensory problem?
• Two tests for meningitis which do not require cerebral spinal fluid
• Types of seizures and the latest medication options
• Four deadly infections of the neurologic system
• Does your patient need an MRI, Positron emission tomography, or CT scan?
• Neurologic monitoring: Intraventricular, intraparenchymal, brain oxygen tension

Assessment of the Elderly Patient

• Head to toe differences in the assessment of the elderly patient
• ”I can’t seem to remember…is this normal?” Cognitive alterations occurring as we age
• These laboratory parameters differ in the elderly
• The effect of medications on the elderly

Rapid Assessment of the Decompensating Patient

• AMPLE acronym: A must-know to quickly and accurately gather patient information
• ”I have pain”…the PQRST acronym is vital to help the patient
• Get these labs immediately for a crashing patient