Health Assessment Flashcards
What concept of health is currently used in Canada and which previous concepts has it surpassed
The socioenvironmental approach has been used since the mid-1980s. It surpassed the biomedical approach and the behavioural approach
biomedical approach
A concept of health that deemed medical interventions as the key
Health = absence of disease
(20th century)
behavioural approach
Lalonde Report
Put the responsibility of health on the individual as opposed to being solely the physician’s responsibility. Aimed to improve behavioural determinants of health: reduce smoking, exercise, diet
(not everyone has the means to change their lifestyle)
socioenvironmental approach (also describe the Ottawa charter)
recognized that one's environment is essential to health Ottawa charter (expansion of lalonde report) - identified 9 prerequisites for health & recognized health as a human right
what are the 9 prerequisites for health?
peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice, and equity
What is health? (WHO)
The extent to which an individual is able to realize aspirations and satisfy needs and to cope with the environment. A resource for everyday life, not the objective of living; it is a positive concept.
What is health assessment
The collection of data (subj + obj) about an individual’s health state
What’s the difference between subjective data and objective data
subj = symptoms
- anything the patient says about themselves
obj = signs
- all data gathered during the physical assessment
What are the 4 types of assessments?
Complete - full head-to-toe + complete health history (i.e. upon admission to hospital or yearly check-up)
Focused - short duration, directed at one concern (i.e. chest infection)
Follow-up - a re-evaluation of a previously assessed problem
Emergency - a rapid assessment of lifesaving data while emergency treatment is being given
Why is HA important (4)
Collected data informs your txt decisions/clinical judgments
Other clinicians also gather info for decisions based on HA
It is a part of the nursing process
For patient safety
What are the components of the complete health history (subjective assessment)
Biographical data - name, address, phone #, pronouns, significant others
Source of history - who is answering the questions?
Reason for seeking care - “in patient’s own words”
History of Current Illness - PQRSTU AAA
Past Health (illnesses, injuries, hospitali, operations, etc.)
Family History (anything inheritable)
Review of Systems (head-to-toe)
Functional Assessment (ADLs, IADLs, coping, violence at home, etc.)
What does PQRSTU AAA stand for
Provoke Quality/quantity Region/radiation Severity Timing Understanding the patient's perception Associated factors Alleviating factors Aggravating factors
What are the components of a physical assessment (objective data) - IPPA
inspection
palpation
percussion
auscultation
Inspection
“concentrated watching”
Compare: side to side for what is expected vs unexpected
Palpation
Feeling for Texture, temp, moisture, organ location/size, vibrations/pulsations on chest wall, lumps/mass, elicit pain
Always palpate tender areas last
What are each of the following used for in palpation:
a) fingertips
b) fingers and thumb
c) back of hands
d) ulnar surface of hand
a) texture, swelling, pulse
b) detecting the position/shape/consistency
c) temperature
d) vibrations on chest wall
Percussion
A method of tapping on a surface to:
- determine the density of the underlying structure
- map out the location/size of a structure
- elicit pain
- elicit tendon reflexes
What are the 2 common percussion notes?
Resonant- hollow, air-filled sound
Dullness- muffled thud (something other than air there)
Auscultation
listening to sounds produced by the body
note: it can be hard to hear if there is shivering, extra room noise, hair, poor quality stethoscope etc.
What are some things you can do to be respectful to a client’s social and cultural background?
build trust
listen
convey respect
promote client comfort, dignity, and safety
What is a general survey?
A survey of the overall impression or appearance of the client
Should occur each time you meet the client
What are the 4 components of a general survey?
physical appearance
body structure
mobility
behaviour
General Survey: Physical Appearance
LOC = alertness and responsiveness
Skin condition – paleness, redness, excessive sweat
Facial features – symmetry/drooping (stroke), grimacing (pain)
Acute signs of distress - anxious
General Survey: Body Structure
They are sitting or standing comfortably and are stable when doing so
