1
HISTORY/MODULE 9 Manila 1892 - Rizal returned to establish La
Reform- changes in the manner of
governance.
- idea of assimilation.
- could achieve it through peaceful
means through the power of words and pen.
Assimilation - idea of PH being
transformed as a province of spain.
Middle Class
- mestizos and former principalias.
- Able to afford education.
January 1889 - Hispano-Filipino
Association (composed of filipino students
in spain and spanish allies) (today as
Propaganda Movement)
La Solidaridad
- newspaper for advocacy.
- to collect, gather, libertarian ideas.
- First editor; Graciano Lopez Jaena
later on gave it to Marcelo H. Del Pilar.
- published its last issue in 1895.
February 15 1889 - members stated the
aims of the newspaper.
Pseudonyms:
Rizal - Laong Laan/Dimas Alang
Antonio Luna - Taga-Ilo
Marciano Poncy -
Tikbalang/Naning/Kalipulako
Marcelo H. Del Pilar - Plaridel
La Liga Filipina (1892) - to continue the
reformists started in spain.
Andres Bonifacio - KKK
Filipino Nationalism - national unity.
Reform Movement - pushed the people to
fight further for their rights and freedoms
(through revolution).
Look for the Activity 6.
HISTORY/MODULE 11
Propaganda Movement - eager for reforms.
(Rizal, Jaena,Del Pilar). Better state of living
Liga Filipina organization to continue the
Propaganda Movement.
La Liga - key to implementing changes to
the country, prominent members were
Bonifacio and Mabini.
July 7,1892 - bonifacio met secretly in
No.72 Azcarraga Street.
KKK - secret society to overthrow spain
rule.
Vital Goals.
- Political, Moral, Civic.
Propaganda Movement - Filipino elites
who wanted reform.
Lowest Level - Sangguniang balangay
followed by Sangguning bayan.
Top body - Kataas-taasang Sanggunian.
(president, secretary, oo)
Andres Bonifacio - notable founder of
katipunan.
Katipon - new members
Kawal - if he recruits more members.
Top member - bayani.
Kartilya ng Katipunan - set of 13
teachings.
Katipuneros - lowerclass of PH society are
students, laborers, artists, vendors and
factory employees.
1892 - 1896 - around 300
Mid 1896 - 20,000 - 30,000.
1896 - became more popular around Manila
and the province of Central Luzon.
August 19, 1896 - Teodoro Patino divulged
the details of the katipunan to a spanish friar
August 23,1896 - in pugad lawin they took
their cedulas and tore it as symbol of their
separation from spanish colonial regime (cry
of pugad lawin).
Revolution of 1896 - katipuneros started to
attack military garrisons of spanish forces.
Emilio Aguinaldo - successful military
exploits.
Magdiwang - group led by Bonifacio.
Magdalo - led by Emilio Aguinaldo

Tejeros Convention - to elect new officials
for the revolution.
- turning point not only for the PH
revolution of 1896 but of the country's entire
history.
- first election in PH.
Bonifacio - Director of the Interior.
Daniel Tirona - insult bonifacio.
May 10,1897 - bonifacio executed.
1897 - Biak na Bato in Bulacan.
- Biak na bato agreement proof of
their willingness to negotiate and
abandon the katipunan.
Pedro Paterno - former reformists and ally
of Aguinaldo.
December 1897 - signed the agreement.
HISTORY/MODULE 12
Cuba - another colony of spain.
Read the M12 and the Activity.
HISTORY/MODULE 13
PAWCI - to gather information regarding the
war.
1900 - elites formed the Association de Paz
( to support the Americans in defeating
fellow Filipinos).
Partido Federal - to promote the
annexation of the PH as one of the states of
the US.
Filipino Elites - advocate only for reforms
under spain.
Genuine Leaders - reward of their
cooperation.
Influential Revolutionaries - Miguel Malvar
and Macario Sakay.
General Miguel Malvar - control the
government for a short time.
Macario Sakay - Republika ng
Katagalugan.
2
- earliest member of katipunan.
- close friend of bonifacio
- notable resistance fighter.
- seen as a new bonifacio.
1902-1906 - he established a base in the
laguna and guerilla campaign.
Tulisanes - American accused Sakay and
his forces.
Party Switching/Turncoatism - politicians
transfer from one political party.
HISTORY/MODULE 14
1901 - the first governor general was
William H. Taft.
Sergio Osmena - young politician from
cebu.
Jones Law of 1916 - independence to the
filipinos.
Philippine Legislature - to create laws for
the country.
PH Senate - served the upper house.
House Representative - lower house.
Manuel L. Quezon - President of the
senate.
Sergio Osmena - speaker of the house.
Independence missions - Filipino
politicians who were sent to the US to
convince america.
Three prominent politicians - Roxas,
Osmena, and Quezon.
OsRox - Law Hare Hawes Cutting Act.
QuAquAl - Benigno Aquino r, Rafael
Alunan, Quezon (the passage of Tydings
Mcduffie Law/PH Independence Act.)
National Assembly - legislature to make
laws known as Commonwealth Acts.
Commonwealth of the PH - to learn how to
manage an independent and functional
government.
Sept 16 - national elections were organized.
Social Justice Program - to address the
land and labor issues.

HISTORY/MODULE 16
USAFFE - United States Armed Forces Far
East led by General Douglas MacArthur to
respond to the looming threat of Japanese.
Pearl Harbor - Military base in the pacific.
General Douglas MacArthur - I shall
Return.
KALIBAPI - Kapisan ng Paglilingkod sa
Bagong Pilipinas.
- political party composed of
Filipinos supporting japanese.
June 16, 1943 - Japanese prime Minister
Hideki Tojo gave the PH promise of
Independence.
Second Republic - puppet regime.
Comfort Women - non existent to the
public eye.
Maria Rosa Henson 1927-1997 - first one
to share her experience.
Victim blaming - Instead of condemning
the perpetrators, people tend to blame the
victims.
HISTORY/MODULE 17
Guerilla Welfare - irregular in fast moving
or unconventional military strategy.
- intelligence gathering (guerilla)
HUKBALAHAP - Hukbo ng Bayan Laban
sa mga Hapon.
Alejandrino - his right hand man.
Huks - member
- policy of continuous attack.
Balutans - squad of unarmed guerillas.
Hunters ROTC - PMA
Josefa Llanes Escoda - Girl Scout of the
PH
- women on the 1,000 bill.
McArthurs first Republic - People of the
PH, I have returned.
February 3, 1945 - second world war.
- Battle of manila.
3
Liberation - not so called independence.
August 15 - Japan declared surrender
Sept 2 - sign the terms of surrender.
CONTEMPORARY: LESSON 7
Global Governance - a movement towards
political cooperation.
Global Interstate System - The whole
system of human interactions.
Institutions of Global governance
● United Nations - maintenance of
international peace and security.
● World Bank - promoting and
supplementing private foreign
investment.
● International Criminal Court of
Justice (ICC) - to prosecute
individuals for the international
crimes of genocide.
● World Trade Organization - global
rules of trade.
● North American Free Trade
Agreement - reduce trading cost,
increase business investment.
● International Monetary Fund - to
foster global monetary cooperation.
● World Health Organization - to
direct and coordinate health.
● North Atlantic Treaty Organization
(NATO) - to defend each other from
the possibility of the communist
Soviet Union.
CONTEMPORARY: LESSON 8
Foreign Direct Investment (FDI) -
purchase of an interest.
Types of Foreign Direct Investment
● Horizontal direct investment -
company establishes the same type
of business operation.
● Vertical investment -
complementary business.

● Conglomerate - a foreign business
unrelated to its core business.
Foreign portfolio investment (FPI) - an
institutional investor such as a pension fund.
CONTEMPORARY: LESSON 9
Technological Innovation - source of
Innovation.
TYPES OF INNOVATION
● Incremental Innovation - small but
important improvements in a
product, process or service.
● Architectural Innovation - built not
on new technological breakthroughs.
● Radical Innovation - These
innovations are revolutionary.
CONTEMPORARY: LESSON 10
Risks of Globalization - economic gains
and comfortable living.
Equity Distribution - unfairly skewed
towards rich nations.
Interdependence - when two or more
actors affect and rely on each other.
National Sovereignty - The supreme,
absolute, and uncontrollable power.
CONTEMPORARY: LESSON 11
Economic System - A system of
production, resource allocation, and
distribution of goods and services.
FOUR BASIC ECONOMIC QUESTIONS
- What to produce?
- How to create/produce?
- In what quantities?
- Who receives the production output?
Four main types of Economic Systems
● Traditional Economic System -
most basic of all the economic types.
4
● Command Economic System -
more advanced economic system.
● Market Economic System - a type
of economic system where supply
and demand regulate the economy.
● Mixed Economic System - an
economic system combining private
and public enterprises.
CONTEMPORARY: LESSON 12
Sustainable world - outcome of the
different development strategies.
Sustainability - to minimize humans'
negative impact.
Sustainable development - Development
that meets the needs of the present.
- is an increase in quality of life within
a community.
Climate change - contributes to global
warming.
Energy consumption - curve our energy
consumption.
Sustainable sourcing - sourcing local and
buying local.
Waste production must be kept to a
minimal environmental footprint - focus
on recycling.
Ways to Achieve Sustainable
Development.
Technological Development - the creation
or enhancement of systems.
Human Development - is the identification
and removal.
STS: LESSON 8
Science and Technology - part of human
activities.
Homo Erectus - fire to cook.
Stone Age - tools from stone and flints.
Homo Sapiens and humans - sharpen
stones and one would use a knife (wedge).
 5

Notable Comparison ● Wittiness - virtue of a good sense

1. Mortality Rate - children die during of humor. ( buffoonery and
birth. boorishness)
2. Average Lifespan - to prolong lives ● Friendliness - friendship is a vital
by enhancing living status. part of a life.
3. Literacy Rate - to education. - Virtue lies between
4. Gross Domestic Product - to not being friendly at
determine the value of a country. all and being too
Modern Humans - good life. friendly towards many
people.)
STS: LESSON 9 ● Justice - virtue of dealing
Aristotle - How to find the highest good in fairly with others.
life?
Nicomachean Ethics - nature of the good STS: LESSON 11
life for a human being.
- supreme good is happiness 4 DEVICES
- written by Aristotle named for ● Mobile Phone - 89%
nicomachus. - Subscription is at 119 million.
Virtue - traits and tendencies. - 3.2 hours.
- becomes a habit. ● Smartphone - 53%
Temperate - temperance. ● Tablet - 14%
Courageous - courage. ● Desktop - 39%
11 Virtues - 5.2 hours
● Courage - cowardice and ● Laptop/Netbooks - 37%
recklessness. ● Smart TV - 4%
● Temperance - between Facebook - 47 million active.
overindulgence and insensitivity. Children - lazy and unhealthy.
● Generosity - virtue of charity. Alienation - will get mad or annoyed.
- Golden (miserliness and
giving more than you can afford). STS: LESSON 12
● Magnificence - virtue of living Information Age - period starting in the last
extravagantly. (between stinginess quarter of the 20th century.
and vulgarity) - also called the Digital Age and New
● Magnanimity - virtue of relating to Media Age.
pride. (between not giving yourself a Symbolic Information - writing, math, other
credit and having delusions of codes.
grandeur) James R. Messenger - theory of
● Right Ambition - between empty information age in 1982
vanity and undue humility. - The new age is a true age based
● Patience - virtue that controls your upon the interconnection of
temper. computers.
● Truthfulness - virtue of honesty. Mechanical Machines - Galileo and
Newton's time (before).
Computer - Now.

STS: LESSON 13
5% - completely automated.
60% - jobs.
800 - occupations.
46 - countries.
90% - world GDP.
STS: LESSON 13
Advantages of Automation - higher
production rates.
Disadvantages - worker displacement.
HEALTH EDU/MODULE 9
Fry readability Graph - first grade.
SMOG Formula - 4th grade.
COMPREHENSION TESTS
Cloze Procedures - assessing
medical literature with 6th grade
level or above.
Listening Test - instructional
materials written at 5th grade level.
READING SKILLS AND HEALTH
LITERACY TESTS.
WRAT - Wide Range Achievement Test
- ability to correctly pronounce
words.
REALM - Rapid Estimate of Adult Literacy
in Medicine.
- Read and pronounce.
TOFLA - Test of Functional Health literacy
in Adults.
- Reading comprehension and
numeracy.
NVS - Newest Vital Sign
- Risk for low health literacy.
eHEALS - eHEalth Literacy Scale
- To find and navigate electronic
health information.
LAD - Literacy Assessment for Diabetes
6
- To measure word recognition in
adults.
SAM - Suitability Assessment of Materials
- Suitability of instructional materials
for a given group of learners.
- Print material, illustrations and
videotape.
HEALTH EDU/MODULE 10
Verbal Ability - girls learn to talk.
Mathematical Ability - boys show signs of
excelling in mathematical reasoning.
Spatial Ability - problem solving, creativity,
analytic skill and cognitive styles.
School Achievement - girls get better
grades on average than boys.
Aggression - males are more aggressive
than females.
Conformity & Dependence - females more
conforming and more influenced by
suggestion.
Emotional Adjustment - emotional
stability.
Values and Life Goals - to think about
themselves.
Achievement Orientation - to express
achievement motivation in social skills and
social relations.
LGBTQ - over 8 million in the US.
SES - Socioeconomic status - most
important determinant of physical and
mental.
VARIABLES - Educational level,
family income, occupation and family
structure.
Acculturation - to modify one’s own
culture.
Assimilation - person emigrating to a new
culture.
Cultural Awareness - external sins of
diversity.

Cultural Competence - process of
demonstrating knowledge and
understanding the client’s culture.
Cultural Relativism - groups assigned to
its conventions arise out of its own.
Tripp Reimer - define ethnocentrism and
cultural relativism.
Culture - integral part of a person's life.
Purnell and Paulanka (1998) - totality of
socially transmitted behavior patterns.
Ethnic Group - subculture; people who
have experiences different from those
dominant cultures.
Ethnocentrism - to think about their ways
of thinking.
Ideology - thoughts, attitudes and beliefs
that reflect social needs.
Subculture - experience different from
those of the dominant culture by virtue.
Transcultural - comparison for similarities
and differences between cultures.
World View - way of people to look at the
universe.
PRIMARY CHARACTERISTICS
● Nationality
● Race
● Color
● Gender
● Age
● Religious Affiliation
SECONDARY CHARACTERISTICS
1. Global Society - outermost sphere.
2. Community - second.
3. Family - third.
4. Individual - innermost.
Interior Level - 12 cultural domains.
Model basis - 19 assumptions.
Giger & Davidhizar’s Transcultural
Assessment Model (6 cultural
phenomena)
1. Communication - verbal, primary
language, nonverbal.
2. Personal pace - action speaks
louder than words.
7
3. Social Organization - learned
behaviors, culture specific.
4. Time - how time is viewed.
5. Environmental Control - how the
health system is evaluated.
6. Biological variations - body
structure, genetics.
Nurse/Client Model - recognize differences
in cultures of both nurse and patient.
Learn Model - improvement of cross
cultural.
HEALTH EDU/MODULE 11
Hispanic/Latino Culture
● Largest/fastest growing subculture
● Less like to receive preventive care
● Economically disadvantaged
● Strong family ties
● Information from mass media.
● Spanish/ English may be the primary
language.
● Categorize into hot and cold
disease.
Teaching Strategies
1. Identify Subgroup
2. Consider age
3. Encourage involvement in
teaching/learning
4. Provide space for extended family.
5. Incorporate religious
6. Display warmth
Black/American Culture
- Second largest US ethnic group
● Way of life
● Disadvantage due to poverty and
lack of education.
● Extended family
● Strong religious values
● Believe in voodoo, witchcraft.
● Believe in all animate and inanimate
objects.
● Some use folk remedies.

Asian/Pacific Islander Culture
4 Philosophies
1. Buddhism
2. Confucianism
3. Taoism
4. Phi
- Majors barrier to health care are
language, cultural beliefs, health
literacy
- Male authority and dominance
- Saving face
- Strong family ties
- Respect for parents, elders,
teachers.
Teaching strategies
● Friendly
● Give permission to ask a question
● Consider language barriers
● Learning style is passive, by
repetition and rote memorization.
● Males need to make decisions
● Need reassurance
● Asking in different ways to assure
understanding.
American Indian/Alaska Native Culture
● Spiritual attachment to the land
● Intimacy of religion and medicine
● Strong ties to family/tribe
● Children an asset not liability
● Supernatural powers exist
● Avoid acculturation
● Lack materialism
● Witchcraft cause of illness
● Shaman and ceremonies in healing
● Don't feel they have control of their
destiny.
● Looking into another's eye reveals
and may steal someone's soul.
Teaching Strategies
- Giving info about diseases
- Emphasize changes in diet
- Help patients build positing coping
mechanisms
8
- Tribes unique customs and
language.
HEALTH EDU/MODULE 12
15% - live with disability.
Moral Model - view disability as a sin
- Experience guilt, shame and denial
of care.
The Medical and Rehabilitation models -
disabilities as problems requiring
intervention to cure.
Social/Disabilities
Model - disability as a normal part of life.
- Social discrimination rather than the
disability itself.
- Most influential on current thinking.
Disability - a complex phenomenon.
ADA - American with Disabilities Act
- Disability as a physical and mental
impairment.
- Enacted in 1990.
Language and Disabilities - puts the
person before the disability.
HEALTH EDU/MODULE 13
Types of Disabilities
1. Sensory
➔ Hearing Impairments -
total/partial auditory loss
(type,degree, configuration)
➔ Type:
Conductive: Correctable
Sensorineural: Permanent
Mixed
➔ Visual Impairments
2. Learning
➔ Disorder include: Dyslexia,
Auditory, Dyscalculia
➔ Heterogenous group of
disorders of listening,
speaking, reading,writing,

reasoning, or mathematical
disabilities.
3. Developmental - a severe chronic
state before 22 years old caused by
mental/physical impairment.
➔ Attention deficit/hyperactivity
disorder, intellectual
disabilities, asperger
syndrome/autism spectrum
disorder.
4. Mental Illness - 20% of adult
americans.
5. Physical
➔ Traumatic Brain Injury -
falls are leading cause
➔ Treatments: Acute care,
Acute Rehabilitation, and
Long-term rehabilitation.
➔ Memory Disorders - short
term or long term memory
deficits.
6. Communication disorders - affect
perception/language production
abilities.
● Global Aphasia, Expressive
Aphasia, Receptive Aphasia,
Anomic Aphasia, and
Dysarthria.
7. Chronic illness - leading cause of
death in the U.S.
- Permanent condition lasting
3 months, often a lifetime.
Assistive Technologies - technological
tools ( computers, communication devices)
available to people to live more
independently.
State of the Evidence - growing awareness
of rising cost of healthcare.
HEALTH EDU/MODULE 14
Goal - final outcome to be achieved at the
end of the teaching and learning process.
9
Objective - specific, single, concrete, one
dimensional behavior.
Subobjectives - aspect of a main
objective.
Goals and Objectives - before a goal can
be reached.
- Observable, Measurable
- Consistent with the goal.
3 Important Characteristic
➢ Performance - expected to be able
to do.
➢ Condition - behavior will be
observed.
➢ Criterion - to perform to be
competent.
ABCD RULE
➢ Audience (who) - who the learner.
➢ Behavior (what) - what the learner
will perform.
➢ Condition (under which
circumstances) - testing situation.
➢ Degree - reflecting quality/quantity
of mastery.
4 PART METHOD - cabd.
SMART OBJECTIVES
● SMART - to be achieved.
● MEASURABLE -
quantifying/qualifying objectives.
● ACHIEVABLE - attainable.
● REALISTIC - available resources.
● TIMELY - when the objectives will be
achieved.
HEALTH EDU/MODULE 15
Learning Domain - interdependent.
Behavior - domain category.
Level of complexity - simple to complex.
3 TYPES OF LEARNING DOMAIN
● Cognitive - thinking.
- learners' intellectual abilities.
- Traditional focus of most teaching.
● Lecture
● Group discussion

● One to one Instruction
● Self Instruction
Cognitive Knowledge - learning affective
and psychomotor skills.
● Affective - feelings.
- Commitment to feelings
expressed as emotions.
Affective Learning - degree of a person’s
depth.
Method: Group Discussion, Role
Playing, Role Modeling and Gaming.
● Psychomotor - doing/skills.
- Acquiring dine and gross
motor abilities
Method: Demonstrationand
instructional materials, return demo,
simulation, and self instruction.
Mental Imaging - mental practice.
Intrinsic - within the learner.
Augmented - external to learner,
Bloom Taxonomy - Taxonomy of
Educational Objectives.
- K12 teachers and college
instructors.
6 Major Categories
● Knowledge
● Comprehension
● Application
● Analysis
● Synthesis
● Evaluation
Bloom's Taxonomy
● Create - produce
● Evaluate - Justify
● Analyze - Draw
● Apply - Use
● Understand - Explain
● Remember -Recali facts.
Basic Elements of Teaching Plan
1. Purpose
2. Goal Statement
3. Objectives list
4. Content outline
5. Methods of teaching
10
6. Time allotment
7. Resources for instruction
8. Learning evaluation methods
Internal Consistency - answer yes
Written - formal
Verbal - informal
Components of Learning Contract
● Content - behavioral objectives
● Performance expectations - will be
facilitated
● Evaluation - be judged.
● Time Frame - length of time.
Concept of Learning Curve - changes in
psychomotor performance.
HEALTH EDU/MODULE 16
Teaching Methods - the way information is
taught.
Instructional Materials - objects or
vehicles used to transmit information.
TEACHING METHODS:
● Lecture - educator verbally
transmits information directly to a
group of learners.
● Group Discussion - learners get
together.
● One to One Instruction - ftof
delivery of information.
➔ Precontemplation - provide
information.
➔ Contemplation - support
decision making for change.
➔ Preparation - support a
move to action.
➔ Action - encourage constant
practice.
➔ Maintenance - continue
encouragement.
● Demonstration - educator is done
to show the learner how to perform.
● Return Demonstration - learner
attempts to perform a skill.

● Gaming - learner to participate in a
competition.
● Simulation - trial and error.
TYPES: written, clinical,
model,computer.
● Role Play - unrehearsed
dramatization.
● Role Modeling - identification and
emanation.
● Self Instruction - to provide or
design activities.
Instructional Materials
● Audience response system (ARS)
● Books
● Printed handouts
● Videos
● Podcasts
● Posters
HEALTH ASSES LEC/MODULE 9
Type of History Interview
● Eye History
● Family History
● Lifestyle Habits
Vision Test - peripheral inspection
Extraocular movements - cardinal fields.
Visual Acuity - expressed as two numbers
● Numerator (20) - distance of the
patient
● Denominator - normal eye can read
the line of letters.
Near Vision - special hand held card.
Rosenbaum Chart - reading
glasses/bifocal in patients older than 45 y/o.
Snellen Chart - 14 inches from the patient's
eye.
Ophthalmic Examination - eyes without
dilating the pupils (mydriatic drops).
Extraocular Muscles - normal conjugate
movements.
Nystagmus - fine rhythmic oscillation.
Lid Lag - eyes move from up and down.
11
Nasolacrimal Duct Obstruction - cause of
excessive tearing.
Vision Screening - vision shifts with age.
➔ Amblyopia - lazy eye.
➔ Strabismus - eye misalignment.
Variation and Abnormalities of the
Eyelids
● Ptosis - drooping of the upper lid.
- congenital.
Myasthenia - damage to the
oculomotor nerve and sympathetic
nerve (Horner Syndrome).
Senile Ptosis - weakened muscle.
● Entropion - common in the elders.
● Ectropion - margin of the lower lid is
turned outward.
● Lid Retraction and Exophthalmos
- wide eyed stare suggests retracted
eyelids.
Hyperthyroidism - retracted lids
and a lid lag.
Exophthalmos - eyeball protrudes
forward.
Graves Hyperthyroidism - bilateral.
Opacities of the Cornea and Lens
● Corneal Arcus - thin grayish white.
● Corneal Scar - superficial grayish
white.
● Pterygium - triangular thickening of
bulbar conjunctiva.
● Cataracts - lenses visible to the
pupil.
Nuclear Cataract - gray when seen
by a flashlight.
Peripheral Cataract - spoke like
shadows that point inward.
HEALTH ASSES LEC/MODULE 10
Common symptoms of the ears
● Hearing loss - can be congenital.
Hearing Impairment
➔ Conductive loss - problems
in the external or middle ear.

➔ Sensorineural - problems in
the inner ear.
- have particular
trouble understanding the
speech.
SYMPTOMS : Earache, Vertigo.
● Earache - pain in the ear.
External Ear - otitis externa.
Respiratory Infection - otitis media
2 ( mouth, throat, neck).
● Discharge - softwax.
● Tinnitus - has no external stimulus
Meniere's Disease - hearing loss
and vertigo.
● Vertigo - patient/environment is
rotating or spinning.
Rhinorrhea - drainage from the nose and
associated with nasal congestion.
- sense of stuffiness or obstruction.
Rhinitis Medicamentosa -
decongestants can worsen symptoms.
Congestion - sensitivity and specificity.
Acute Bacterial Sinusitis - upper
respiratory infection.
Epistaxis - bleeding from the nose.
Sore Throat - frequent complaint.
Streptococcal Pharyngitis/Strep Throat -
absence of cough.
Hoarseness - altered quality of voice
Gingivitis - bleeding from the gums.
Dysphagia - difficulty of swallowing.
HEALTH ASSES LEC/MODULE 11
Dyspnea - air hunger. Shortness of breath.
Cough - reflex responds to stimuli.
Mucoid Sputum - translucent.
Purulent Sputum - yellowish/greenish.
Chest pain - caused by cardiac, respiratory,
gastrointestinal.
➔ Examination: Percussion.
Pleural effu-sion - serous fluid.
Hemothorax - blood.
Empyema - pus.
12
Hyperresonance - heard over hyperinflated
lungs/COPD/Asthma.
BREATH SOUND
● Vesicular - soft and low pitched.
● Bronchovesicular - inspiratory and
expiratory sound.
● Bronchial - louder and higher pitch.
ADVENTITIOUS SOUND
● Crackles - rales.
- Abnormalities of lungs.
- Non musical crackling
sounds.
● Wheezes - high pitched sounds.
● Rhonchi - low pitched, snoring,
rattling sounds.
● Stridor - loud, high pitched crowing
sound.
DEFORMITIES
● Normal Adult - wider than its deep.
● Funnel Chest - depression in the
lower portion of the sternum.
● Barrel Chest - increased
anteroposterior diameter,
● Pigeon Chest - Pectus carinatum.
Sternum is displaced
anteriorly.
● Traumatic Flail Chest - multiple rib
fractures.
● Thoracic Kyphoscoliosis -
abnormal spinal curvatures.
HEALTH ASSES LEC/MODULE 12
Cardiovascular System - made up of heart
and blood vessels.
- delivering oxygen and nutrients to
the cells, removing waste and maintaining
perfusion.
Heart - pump that drives circulation.
- hollow muscular organ.
Blood vessels - pathway
Precordium - exterior chest.
Apex - tapered inferior tip
- produces the apical impulse.

Precordium - point of maximal impulse
(PMI).
PMI - 1 to 2.5 cm.
Sinus Node - cardiac cells located in the
right atrium near the junction of vena cava.
Atrioventricular Node - located low in the
atrial septum.
Cardiac Output - blood ejected from each
ventricle.
Stroke Volume - ejected with each
heartbeat.
Preload - load that stretches the cardiac
muscle before contraction.
Myocardial Contractility - ability of cardiac
muscle to contract/shorten.
Afterload - vascular resistance to
ventricular contraction.
Arterial System - arterial pulse.
Pulse pressure - difference between
systole and diastole.
Jugular Vein Undulations - visible in the
internal jugular.
HEALTH ASSES LEC/MODULE 13
Carotid artery pulse - provides valuable
information about cardiac function.
Contour of the pulse wave - speed of the
upstroke.
Brisk - normal stroke.
Summit - smooth, rounded and roughly
midsystolic.
Thrills - the throat of a purring cat.
Hepatojugular Reflux - if JVP is elevated.
- Supine position.
Heart - cardiac examination.
- Supine position.
S1 - first sound.
- Lub
- Louder than S2 at apex.
S2 - second sound
- Dub
- Louder than S1 at base.
13
Cardiac Examination - inspect and palpate
precordium
Dextrocardia - heart situated on the right
side.
Pulmonic Area - left 2nd intercostal space.
- overlies the pulmonary
artery.
Aortic Area - right 2nd intercostal space.
- overlies the aortic outflow
tract.
Pulmonary Hypertension - increased
pressure in s2 pulmonary artery.
HEALTH ASSES LEC/MODULE 14
Heart Murmurs
Midsystolic Murmur - begins after S1 and
stops before S2.
- Gaps are audible between the
murmur and heart sounds.
Pansystolic Murmur - starts at S1 and
stops at S2 without a gap.
Late systolic Murmur - starts in mid- or
late systole and persists up to S2.
Early diastolic Murmur - start after S2
without a discernible gap.
Mid Diastolic Murmur - start a short time
after S2, may fade away.
Late Diastolic (Presystolic) Murmur - start
late in diastole and typically continue up to
s1.
Shape - most difficult for a novice to
determine.
Crescendo Murmur - grows louder.
Mitral stenosis - late diastolic murmur.
Decrescendo Murmur - grows softer.
Aortic Regurgitation - early diastolic.
Crescendo-Decrescendo Murmur - first
rises in intensity, then falls.
Aortic Stenosis - innocent flow murmurs.
Plateau Murmur - same intensity.
Mitral Regurgitation - pansystolic murmur.
Intensity - 6 point scale and expressed as
fraction.

Numerator - intensity of loudest
murmur.
Denominator - scale.
GRADE OF MURMURS.
➔ G1 - very faint.
➔ G2 - Quiet.
➔ G3 - Moderately loud.
➔ G4 - loud with palpable thrill.
➔ G5 - Very loud.partly off the chest.
➔ G6 - Very loud. Entirely off the chest.
Abdominal Obesity - large waist
circumference.
➔ Men - 40 inches and more.
➔ Women - 35 inc and more.
HEALTH ASSES LAB/MODULE 9
Rhinorrhea - drainage.
Congestion - difficulty breathing through
nose.
Epistaxis - bleeding changes in sense of
smell.
Nose - sensory organ of smell.
Weber Test - lateralization of vibration.
- tuning fork in the middle of the
scalp, near the forehead.
Rinne Test - air and bone conduction.
- mastoid process
HEALTH ASSES LAB/MODULE 11
Chest pain - most serious and
important signals coronary heart
disease.
Palpitations - unpleasant awareness.
- skipping, racing, fluttering,
pounding/stopping of the heart.
Shortness of breath - common patient
concern representing dyspnea,
orthopnea.
Cough - fluid leaking into the lungs.
Edema - excessive fluid in extravascular
interstitial space.
14
Nocturia - urination at night.
Fatigue - sense of exhaustion.
Cyanosis - poor oxygenation of the
body.
Diaphragm - high pitched sounds of S1
and S2.
Bell - sensitive to the low pitched
sounds of S3 and S4 and murmur of
mitral stenosis.
HEALTH ASSES LAB/MODULE 12
Health History - to identify symptoms of
peripheral arterial and venous disease.
HEALTH ASSES LAB/MODULE 13
Visceral pain - hollow abdominal organs;
intestine/biliary tree.
- forcefully or are distended or
stretched.
- varies in quality and may be
gnawing, burning, crampling, aching.
- if it becomes severe it may be
associated with sweating.
Parietal Pain - inflammation in the parietal
peritoneum.
- steady, aching pain that is more
severe than visceral pain.
Referred Pain - felt in more distant sites.
Dyspepsia - pain centered in the upper
abdomen.
- recurrent discomfort.
Discomfort - nonpainful.
Bloating - nausea/belching can occur
alone.
Functional/Nonulcer/Dyspepsia - 3 month
history of nonspecific upper abdomen
discomfort.
Heartburn - rising retrosternal burning pain.
GERD - cough, wheezing and aspiration
pneumonia.
 15

Alarm symptoms - difficulty swallowing Palpation

(dysphagia), pain with swallowing ➔ Light Palpation - abdominal
(odynophagia) tenderness.
Acute lower Abdominal pain - localized at ➔ Deep palpation - delineate
right lower quadrant. abdominal masses.
- sharp, continuous, intermittent, and Percussion - measure the ventricle span of
cramping. liver dullness in the midclavicular line.
Chronic Lower Abdominal Pain - bowel EXAMINATION IN KIDNEYS - palpation
habits and alternating diarrhea and and percussion.
constipation.
Suprapubic Pain - bladder disorder. HEALTH ASSES LAB/MODULE 14
Dysuria - burning sensation/ pain during
urination. Female/male breast examination -
Urgency - unusually intense. inspection and palpation.
Frequency - abnormally frequent voiding, Special Techniques
Polyuria - 24 hour urine volume. ● Assessment of nipple discharge.
Nocturia - urinary frequency at night. ● Examination of mastectomy
Urinary incontinence - involuntary loss of ● Self awareness and instruction of
urine. BSE.
Gross Hematuria - blood in urine is visible
to the naked eye. HEALTH ASSES LAB/MODULE 15
Microscopic Hematuria - blood detected
during microscopic urinalysis.
Kidney pain - flank pain. Joint Pain - extra articular involving bones,
- visceral pain. muscles and tissues.
Ureteral pain - severe and colicky. Myalgias - aches and pains in muscle.
EXAMINATION - IAPP Arthralgias - aches and pain in joints.
Inspection EXAMINATION:
➔ Skin Ass Inspection:
- Scars ➔ Symmetry
- Striae ➔ Alignment
- Dilated Veins ➔ Bony deformities
- Rashes/lesions ➔ Skin changes
- Ecchymosis ➔ Nodules
- Umbilicus ➔ Muscle atrophy
- Contour of abdomen. ➔ Crepitus
- Increased peristaltic wave. Normal Findings - no swelling, redness,
- Increased pulsations. deformities.
Auscultation - provide important Abnormal Findings - swelling caused bt
information about bowel motility. excess of fluid (effusion).
- abdominal bruits Deformities
- friction rubs. 1. Dislocation
Percussion - tympany and dulness 2. Subluxation
3. Contracture
 16

4. ankylosis ➔ Motor - temporal and

Palpation: masseter muscles (Jaw
➔ Palpate each joint, skin for Crunching), Lateral
temperature, muscles, bony Pterygoids (Lateral Jaw
articulation and area of joint Movement)
articulation. ➔ Sensory - facial.
➔ Heat, tenderness, swelling/masses. 1. Ophthalmic
Normal Findings - no heat, tenderness, 2. Maxillary
swelling. 3. Mandibular
- Not tender to palpation, 6. Facial
- Synovial membrane not palpable. ➔ Motor - facial
Abnormal Findings - heat, tenderness, movements.
swelling, palpable fluid is abnormal. ➔ Sensory - taste.
Crepitation - audible and palpable 7. Abducens - lateral deviation of eye;
crunching or grating. motor.
Temporomandibular joint (Jaws) ➔ Acoustic - hearing
Normal Finding - audible and palpable and balance;sensory.
snap. 8. Glossopharyngeal
Abnormal Findings - swelling (round ➔ Motor - pharynx
bulge), crepitus and pain. ➔ Sensory - posterior
Cervical Spine (Neck) portion of eardrum
Normal Findings - spine is straight and the and ear canal.
head erect, tenderness. 9. Vagus
Abnormal Findings - head tilted in one ➔ Motor - palate,
side,asymmetry of muscle and tenderness pharynx and larynx.
and hard muscles with spasm. ➔ Sensory - pharynx
Spine - standing with gown on, open at the and larynx.
back. 10. Spinal Accessory - Motor;
sternomastoid and upper portion of
HEALTH ASSES LAB/MODULE 16 trapezius.
11. Hypoglossal - motor; tongue.
Cranial Nerves PERRLA
1. Olfactory - sense of smell;sensory. ➔ Pupils
Anosmia - loss of sense with ➔ Equally
tobacco smoking. ➔ Round and
Papilledema - choked disc ➔ Reactive to
2. Optic - vision; sensory. ➔ Light and
3. Oculomotor - pupillary ➔ accomodation
constriction;motor. Nystagmus - back and forth rolling of eyes.
Anisocoria - difference of >0.4 mm. Lid Lag - occurs w/ hyperthyroidism.
4. Trochlear - downward, rotation of Ptosis - eyelid drooping.
eye;motor. Strabismus - limited eye movement.
5. Trigeminal Muscle weakness - flattening of a
nasolabial fold.

Ageusia - loss of sense of taste
Fasciculations - rapid, continuous,
twitching.
FUNDA LEC/MODULE 9
Nursing process - critical thinking process.
- continuous and dynamic.
Clinical judgment - patient’s response to
health problems.
5 Nursing Process
➔ Assess - gather information.
➔ Diagnoses - identify the problem.
➔ Plan - set goals.
➔ Implement - perform the nursing
actions.
➔ Evaluate - achieved.
Assessment - collecting information.
STAGES:
➔ Collection and verification of data.
➔ Analysis of data.
Developing the Nurse Patient
Relationship for Data Collection
➔ Sources of Data:
Patient - interview, observation,
physical examination.
Family and significant others.
Health care team.
Medical Records
Scientific literature
➔ Database
Type of Assessment
➔ Patient centered care.
➔ Physical examination.
➔ Periodic Assessment.
Cue - data obtained by use of senses.
Inference - judgment/interpretation of cues.
Type of Data:
1. Subjective
- Patients' verbal descriptions.
2. Objective
- Observation/measurements.
Patient Centered Interview
● Orientation and setting an agenda.
17
● Working Phase
● Termination
Interview Techniques
● Observation
● Open ended questions
● Leading questions
● Back channeling
● Direct closed ended questions.
Components of Nursing Health History
1. Biographical Information
2. Reason for seeking health care.
3. Health History
4. Psychosocial history.
5. Patient Expectations
6. Present illness/Health Concerns
7. Family History
8. Spiritual Health
Nursing Diagnosis - clinical judgment.
- first introduced in 1950.
1953 - fry proposed
1973 - first national conference.
1980/1995 - ANA publication of A social
Policy Statement.
1982 - National American Nursing
Diagnosis Association (NANDA) founded.
Types of Nursing Diagnoses
● Problem focused
● Risk
● Health Promotion
Data Cluster - set of cues/signs/symptoms.
Clinical Criterion - objective/subjective
sign/symptom/risk factor.
Data Interpretation - to select the correct
diagnostic label of a patient.
Three part nursing diagnostic label
● Problem
● Etiology
● Symptoms.
Concept Map - helps you critically think
about a patient's diagnosis.
Sources of Diagnostic Error
● Data Collection
● Interpretation and analysis of data,
● Clustering
 18

● Diagnostic statement
EHR - Electronic health information records.
High - Emergent.
Intermediate - non life threatening.
Low - affect the well being.
Priority setting - begins at holistic level.
Goal - broad statement.
Expected Outcome - to reach a goal.
Nurse Initiated
● Independent - actions that a nurse
initiates.
Health care provider initiated
● Dependent - require order form.
Collaborative
● Interdependent - require combined
knowledge/skill/expertise.
NIC
● Lowa Intervention Project - to
enhance communication of nursing
care across health care settings.
NIC 3 LEVELS
● Domain
● Classes
● Interventions

FUNDA LEC/MODULE 10

Nursing Intervention - any treatment based

on clinical judgment and knowledge.
Direct Care Intervention - treatment
performed through interaction.
Indirect Care Intervention - treatment
performed away from a patient.
Standardized Interventions - set a level of
clinical excellence for practice.