Test 3 Study GuideChapter 11 (Nutritional Assessment): 1. Review what is recommended for an infant’s nutritional intake.2. Review the nutritional advantages of breastfeeding.3. The reason(s) nutritional assessment is performed and what specific measurements need to be taken with all nutritional assessments.4. Review concerns about the elderly and their nutritional intake.5. What aging factors may affect the nutritional status of the elderly (i.e. environmental concerns, such as financial hardships, and physiological, such as diminished taste and smell, decreased GI motility)?6. Review nutritional concerns concerning the pediatric population.7. Review nutritional history questions (subjective data) that need to be asked of the parents of the pediatric population, pregnant women and the elderly population.8. What can affect the nutritional intake/needs of the geriatric population?9. Know the most common anthropometric measurements and how to measure them (skinfold thickness, BMI, mid-arm circumference, frame size and arm span).10. Review the significance of body weight, body mass index and waist-to-hip ratio.11. Review common lab studies pertaining to nutrition: hemoglobin and hematocrit, serum albumin, prealbumin, cholesterol, fasting glucose and triglycerides and creatinine height index and nitrogen balance.12. What is optimal nutritional status?Chapter 21: Abdomen Review the following from the text and class lecture:1. Sequence of abdominal assessment2. Terminology: melena, aortic aneurysm, ascites, hernia, tympany, light versus deep palpation, hepatomegaly3. Assessment of the liver border and how to assess the span (width) of the liver in the midclavicular line4. Review the assessment for renal inflammation: CVA tenderness5. Abnormal versus normal bowel sounds6. Detection of pulsations above umbilicus and below xiphoid process: abdominal aorta. Review signs of possible aneurysmand the significance of this condition.7. How would the nurse assess for urinary retention? What sound(s) on percussion can be expected if the bladder was full?8. What is a hernia? What is the difference between a direct hernia versus an indirect hernia? Know which one typically affects the younger population (indirect) versus the type that affects older males (direct). How would you explain a hernia of a infant to the child’s mother?9. Review abdominal abnormalities: abdominal aortic aneurysm,peptic ulcer disease, hepatitis, cholecystitis, hernia10. What would be important to assess in a patient suspected of having a gastric ulcer?Chapters 12: Skin,Review the following from the text and class lecture:1. Importance of skin assessment2. Skin changes seen with aging, including the changes associated with pregnancy3. Skin assessment in both fair-skinned and dark-skinned patients for petechia, bruising, pressure sores, pallor and jaundice. How would use assess for shock in either fair-skinned or dark-skinned patients?4. Effects of chronic disease (COPD, peripheral vascular disease, diabetes) on skin and nails5. Assessment of skin turgor and its significance in determination of the patient’s hydration status6. Danger signs of skin cancer (ABCDE’s)7. Types (3) of skin cancer and characteristics of each8. The effects of chronic disease, such as diabetes, on the skin9. Common skin terminology: patch, macule, papule, wheal, pustule, bulla, cyst, vesicle, ulcer, fissure and excoriation10. Review the essential documentation for a skin lesionChapter 17 (Breasts and Regional Lymphatics): 1. Review techniques and sequence of breast examination and the areas of the breast and axillary that are assessed.2. What abnormal findings could be found with the inspection of the breasts? with palpation of the breasts?3. Review signs and symptoms of lymph nodes as far as infection versus cancer. In other words, what alterations would the nurse expect to see with breast cancer? breast infection?4. Review the signs and symptoms of various breast lumps and which ones may suggest malignancy.5. What breast changes occur in pregnancy?6. Review the American Cancer Society (ACS) guidelines on routine evaluations of the breast:a. Annual mammograms beginning at age 40;b. Clinical breast exam beginning in the 20’s and 30’s, preferably every 3 years; after age 40 every year by a health professional;c. Breast self exam (BSE) is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changesto their health professional right away. d. Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year.7. Be able to provide patient instruction on self-breast examination8. Review breast abnormalities: mastitis, breast cancer, plugged milk duct, ecstasia, Paget’s disease and peau d’orange.9. What is mammography? What patient education is involved?10. Review documentation needed to record the discovery of a breast mass11. HPV Vaccine Chapters 24 & 26 (Male and Female Genitourinary Systems):1. Review changes seen with aging in both male and female genitalia, including signs and symptoms of menopause.2. How may the genitalia appear on a female neonate? (engorged due to lingering effects of maternal hormones) 3. Know the correct sequence of female genitalia assessment: palpation, speculum examination and bimanual examination.4. Review normal versus abnormal findings of breast, cervical, uterine, prostate, rectal, scrotal and testical palpation assessments.5. Review the palpation techniques of each of the above.6. Know the presenting signs of urinary disorders: incontinence (stress, urge and reflex), dysuria, hematuria, nocturia and polyuria.7. What questions would be appropriate to ask during the health history segment of the genitourinary assessment?8. When should parents consider toilet training of their children? Why is it not recommended to toilet train a child before then?9. Know that normal vaginal discharge is small, clear or cloudy and always nonirritating. It varies due to hormonal changes during the monthly cycle. 10. Review common signs and symptoms of other infections: urinary tract infections, vaginitis, candidiasis, bacterial vaginosis.11. Review signs and symptoms of female reproductive tract abnormalities: endometriosis, PID, ectopic pregnancy and ovarian cancer (usually the symptoms are “quiet” initially, but patient may experience bloating, weight gain and feelings of