Health Assessment

Question 1

What concept of health is currently used in Canada and which previous concepts has it surpassed

Answer 1

The socioenvironmental approach has been used since the mid-1980s. It surpassed the biomedical approach and the behavioural approach

Question 2

biomedical approach

Answer 2

A concept of health that deemed medical interventions as the key
Health = absence of disease
(20th century)

Question 3

behavioural approach

Answer 3

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)

Question 4

socioenvironmental approach (also describe the Ottawa charter)

Answer 4

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

Question 5

what are the 9 prerequisites for health?

Answer 5

peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice, and equity

Question 6

What is health? (WHO)

Answer 6

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.

Question 7

What is health assessment

Answer 7

The collection of data (subj + obj) about an individual’s health state

Question 8

What’s the difference between subjective data and objective data

Answer 8

subj = symptoms
- anything the patient says about themselves
obj = signs
- all data gathered during the physical assessment

Question 9

What are the 4 types of assessments?

Answer 9

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

Question 10

Why is HA important (4)

Answer 10

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

Question 11

What are the components of the complete health history (subjective assessment)

Answer 11

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.)

Question 12

What does PQRSTU AAA stand for

Answer 12

Provoke
Quality/quantity
Region/radiation
Severity
Timing
Understanding the patient's perception
Associated factors
Alleviating factors
Aggravating factors

Question 13

What are the components of a physical assessment (objective data) - IPPA

Answer 13

inspection
palpation
percussion
auscultation

Question 14

Inspection

Answer 14

“concentrated watching”

Compare: side to side for what is expected vs unexpected

Question 15

Palpation

Answer 15

Feeling for Texture, temp, moisture, organ location/size, vibrations/pulsations on chest wall, lumps/mass, elicit pain
Always palpate tender areas last

Question 16

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

Answer 16

a) texture, swelling, pulse
b) detecting the position/shape/consistency
c) temperature
d) vibrations on chest wall

Question 17

Percussion

Answer 17

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

Question 18

What are the 2 common percussion notes?

Answer 18

Resonant- hollow, air-filled sound

Dullness- muffled thud (something other than air there)

Question 19

Auscultation

Answer 19

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.

Question 20

What are some things you can do to be respectful to a client’s social and cultural background?

Answer 20

build trust
listen
convey respect
promote client comfort, dignity, and safety

Question 21

What is a general survey?

Answer 21

A survey of the overall impression or appearance of the client
Should occur each time you meet the client

Question 22

What are the 4 components of a general survey?

Answer 22

physical appearance
body structure
mobility
behaviour

Question 23

General Survey: Physical Appearance

Answer 23

LOC = alertness and responsiveness
Skin condition – paleness, redness, excessive sweat
Facial features – symmetry/drooping (stroke), grimacing (pain)
Acute signs of distress - anxious

Question 24

General Survey: Body Structure

Answer 24

They are sitting or standing comfortably and are stable when doing so

Question 25

General Survey: Mobility

Answer 25

Normal gait

Normal ROM and movement coordination

Question 26

General Survey: Behaviour

Answer 26

facial expressions
mood/affect
speech
dress
personal hygiene

Question 27

What are the components of a mental health assessment? ABCT

Answer 27

Appearance 
- general presentation
Behaviour 
- speech, mood/affect
Cognition
- LOC
- orientation
- attention/concentration
- memory
- comprehension and reasoning
Thinking
- process
- content
- insight and judgment about their condition
- perception of themselves and their environment