HEALTH ASSESSMENT
Help!
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| show | to promote health
to prevent illness
to treat human responses to health or illness
to advocate for individuals, families, communities, and population
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| show | Gather information
analyzing and synthesizing
making judgments about nursing interventions
evaluating patient care outcomes
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| primary prevention | show 🗑
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| show | early identification of illness
exams, blood test
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| tertiary prevention | show 🗑
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| show | what the patient tells you
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| objective and signs | show 🗑
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| show | Emergency
Focused
Comprehensive
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| show | short, life threatening
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| show | based on patients problem
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| long term care assessment | show 🗑
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| intensive care assessment | show 🗑
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| show | functional assessment
head to toe assessment
body system assessment
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| general survey | show 🗑
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| show | temp
pulse
res rate
bp
O2
pain
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| BP | show 🗑
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| show | age
gender
race
diurnal
medication
personal habits
pain
emotions
obesity
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| show | phase 1: sharp thuds, start of systolic bp
phase 2: blowing sound
phase 3: crisp thud
phase 4: sounds become muffled
phase 5: end of sound, ends at diastolic bp
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| show | arm above heart level
loose cuff
narrow cuff
deflating very slow
re-inflating without deflating completely
not waiting 1-2 min before repeat
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| false low BP measurement | show 🗑
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| show | normal 120/80
prehypertensive 120-139/80-89
stage 1 hypertension 140-159/ 90-99
stage 2 hypertension more than 160/100
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| show | regulated by hypothalamus
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| show | age
diurnal variation: decrease in morning, increase in late afternoon and evening
menstrual cycle: decrease
exercise: increase
stress: increase
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| sites of temp | show 🗑
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| show | adult: 60-100
newborn: 120-170
1 yr: 80-160
3 yr: 80-120
6 yr: 75-115
10 yr: 70-110
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| show | drop in BP as you stand
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| show | HA
flushing
ringing in the ear
nose bleed
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| sign and symptoms of hypotension | show 🗑
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| show | very high fever
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| show | very low fever
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| febrile | show 🗑
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| show | without fever
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| factor affect pulse | show 🗑
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| show | slow pulse
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| tachycardia | show 🗑
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| respiration | show 🗑
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| show | fast respiration
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| show | slow respiration
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| apnea | show 🗑
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| dyspnea | show 🗑
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| orthopnea | show 🗑
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| show | review of medical record before interviewing the patient
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| show | physical setting
nurse behaviors
type of questions and how they are asked
personality and behavior of clients
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| show | concentrate on clients response
don't formulate next question
don't make assumptions
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| facilitation | show 🗑
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| clarification | show 🗑
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| show | repeating what client says using different words
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| reflection | show 🗑
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| confrontation | show 🗑
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| interpretation | show 🗑
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| summary | show 🗑
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| show | using medical terminology
expressing value judgments
interrupting the client or changing the subject
being authoritarian
using why question
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| show | C: characteristics
O: onset
L: location
D: duration
S: severity
P: precipitating factor
A: alleviating/ aggravating factors
T: treatment
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| pruritus | show 🗑
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| show | skin elasticity
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| show | accumulation of fluid in intracellular spaces
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| show | flat/slightly rounded(convex)
nail base angle 160
capillary refill 1-2 sec
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| show | blue
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| pallor | show 🗑
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| jaundice | show 🗑
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| erythema | show 🗑
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| show | bruising
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| telangiectasia | show 🗑
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| show | benign tumor, small slightly raised bright red area on face, neck, and trunk
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| purpura | show 🗑
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| show | flat reddish purple, non blancheable
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| show | port wine stain, stork bite
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| vascular spider | show 🗑
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| venous star | show 🗑
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| assessment of mole melanoma | show 🗑
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| show | macule or patch
papule or plaque
nodule or tumor
vesicle or bulla
wheal
pustule
cyst
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| show | clubbing
hypertrophy
thinning/brittleness
koilonychia
inflammation
pitting
leukonychia
beau's lines
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| show | migraine
cluster
tension
post traumatic
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| migraine headaches | show 🗑
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| show | painful
30-40 yrs
common in men
1/2 to 1 hr repeat daily
behind one eye
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| show | 20-40 yrs
bilateral to specific area
last for days
skeletal muscle of face and jaw
tight band around head
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| show | secondary to head injury
common cause motor vehicle accident
days to weeks after injury
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| show | graves disease most common cause
20-40 females
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| show | autoimmune
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| hydrocephalus | show 🗑
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| show | head is too small
genetic, chromosomal, toxic stimuli
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| macrocephaly | show 🗑
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| nasal discharge color | show 🗑
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| infant mouth | show 🗑
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| children mouth | show 🗑
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| show | inflammation of nasal mucosa
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| show | nosebleed
cause by un-control hypertension
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| candidiasis/thrush | show 🗑
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| shape ribs | show 🗑
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| fine rales/crackles | show 🗑
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| coarse rales/crackles | show 🗑
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| show | high-pitched
blocked airway due to inflammation
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| show | low-pitched, snoring, rattling
blocked airway due to inflammation plus fluid
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| stridor | show 🗑
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| friction rub | show 🗑
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| show | round thorax
nose breathers until 3 months
10-15 sec apnea
seesaw breathing
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| grunting | show 🗑
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| show | inflammation of bronchial tree caused by viruses or bacteria
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| show | inflammation of bronchial tree
productive cough
3 months of 2 successive years
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| pneumonia | show 🗑
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| show | bacterial infectious disease
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| show | fluid in the pleural linning
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| empyema | show 🗑
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| asthma | show 🗑
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| emphysema | show 🗑
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| pneumothorax | show 🗑
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| show | blood in plural space
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| atelectasis | show 🗑
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| s1 | show 🗑
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| s2 | show 🗑
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| show | lub dub
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| show | take deoxygenated blood to lungs
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| show | bring oxygenated blood back to the heart
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| apical pulse | show 🗑
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| homan's sign | show 🗑
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| s3 | show 🗑
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| s4 | show 🗑
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| show | swishing or blowing sound heard at beginning, middle, pr end of the systolic or diastolic phase
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| show | 0: absent, not palpable
1+: pulse diminished, barely palpable
2+: easily palpable, normal
3+: full pulse
4+: strong, bounding pulse
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| left side HF | show 🗑
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| show | cell necrosis from infarction
blood backs up in right atrium
systolic murmur
dependent peripheral edema
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| show | color: normal or cyanotic
temp: normal
pulse: normal
edema: often marked
skin: brown pigmentation around ankles
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| arterial insufficiency | show 🗑
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| show | accumulation of fluids
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| peptic ulcer disease | show 🗑
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| crohn's disease | show 🗑
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| show | chronic IBD starts in rectum and progresses through large intestine
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| show | inflammation of diverticula, herniations through muscular wall in colon
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| show | inflammation of liver
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| show | chronic degenerative liver disease, diffuse destruction/regeneration of hepatic parenchymal cell
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| cholecystitis with cholelithiasis | show 🗑
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| pancreatitis | show 🗑
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| cystitis | show 🗑
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| urethritis | show 🗑
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| pyelonephritis | show 🗑
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| glomerulonephritis | show 🗑
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| nephrolithiasis | show 🗑
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| Barlow-Ortolani maneuver | show 🗑
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| osteoporosis | show 🗑
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| rheumatoid arthritis | show 🗑
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| show | degenerating cartilage
joint deformities
heberden's bouchard's nodes
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| show | increase in serum uric acid
tophi: round pea-like deposits
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| show | for carpal tunnel syndrome
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| show | 1 olfactory
2 optic
3 oculomotor
4. trochlear
5. trigeminal
6. abducens
7. facial
8. auditory
9. glossopharyngeal
10. vagus
11. spinal accessory
12. hypoglossal
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| show | to assess Babinski response
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| Glasgow coma scale | show 🗑
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| show | pupils equal round reactive to light and accommodation
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| show | dropping
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| consensual and direct to light | show 🗑
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| rosenbaum test | show 🗑
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| show | peripheral vision developed at birth, central vision at 9-12 month
1 month: can fixate, follow light
2-3 month: tears, may see strabismus
3-4 month: fixate, follow n reach for toy
6-12 month: follow a toy in all direction
8 month: distinguish color
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| show | 2.5 to 3 yrs
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| show | 3 to 6 yrs
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| show | 7 to 8
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| presbyopia | show 🗑
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| cataract | show 🗑
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| show | caused by diabetes mellitus
common in 20 to 75
dark spot in vision
2 types background and proliferative
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| show | damage retina by intraocular pressure
leading cause of blindness in USA
center is okay and peripheral is bad
2 types: open and closed angle
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| Macular degeneration | show 🗑
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| tinnitus | show 🗑
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| vertigo | show 🗑
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| dizziness | show 🗑
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| ear is called what | show 🗑
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| show | the hard part of ear
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| cauliflower ear are called what | show 🗑
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| normal tympanic membrane | show 🗑
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| ear assessment | show 🗑
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Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
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To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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Created by:
anuali
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