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health assessment > week 2 > Flashcards

week 2 Flashcards

1
Q

what influences how a nurse applies the nursing process

A

level and time of experience

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2
Q

what guides a novice nurse for the nursing process

A

no experience and use rules to guide them

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3
Q

what guides a proficient nurse for the nursing process

A

more time and experience
understand a patients situation

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4
Q

what guides an expert nurse for the nursing process

A

arrive at a clinical judgement…grasp of a clinical situation and find the solution

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5
Q

significance of assessment in nursing practice

A
  • info abt health state of a person
  • techniques and legal obligations for trust and confidentiality
  • objective and subjective data gathered
  • informs, replenishes or updates a patient’s database
  • diagnostic reasoning
  • foundational to nursing diagnosis
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6
Q

nursing in the context of health models

A

biomedical model
behavioural model
socioenvironmental model
relational approach

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7
Q

what is the biomedical model

A

-assessment and diagnosis focus on treating the pathogen. (disease causing pathogen)

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8
Q

what is the behavioural model

A

assessment and intervention aim at changing human behaviours considered risky

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9
Q

what is the socioenvironmental model

A

-health is looked at broadly as a resource for life
- combines biomedical, behavioural with sociological and environmental factors

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10
Q

what is the relational approach

A

-health is the sum of an individual within their context
- shaped by an interaction of social, cultural, environmental, historical, family and geographical context

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11
Q

systematic health assessments

A
  • comprehensive head-to-toe assessments are done when a patient is admitted at the beginning of each shift
  • brief physical assessments are done as necessary
  • powerful tool for detecting subtle and obvious changed to a patients health
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12
Q

what is episodic assessment

A

-for a limited or short term problem
- concerns one problem, one cue complex or one body system

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13
Q

what is health assessment commonly referred to as

A

health history

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14
Q

what is health history…what are you gathering

A

-overview of the clients current and past health and illness state

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15
Q

what is subjective data provided by

A

-client (primary source)
- clients chart, family members, friends, co-workers, care partners or interpreters (secondary sources)

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16
Q

the nursing process

A

ADPIE
Assessment
Diagnosis
Planning
Implementation
Evaluation

17
Q

A in the nursing process

A

Assessment
-collect data
review of the clinical record
health history
physical examination
risk assessment
review of literature
-document relevant data

18
Q

D in the nursing process

A

Diagnosis
-compare clinical findings with normal and abnormal variations and developmental events
- interpret data
ID clusters of clues
makes hypotheses
test hypotheses
document diagnosis

19
Q

P in nursing process

A

Planning
-establish priorities
-develop outcomes
-set timelines
-document plan of care
- ID intervention

20
Q

I in nursing process

A

Intervention
- implement in a safe and timely manner
- use community resources
- use evidence based interventions
- document implementation and any modification
- coordinate care delivery

21
Q

e in nursing process

A

evaluation
- progress toward outcome
- conduct systematic, ongoing, criteria-based evaluation
- use ongoing assessment to revise diagnoses, outcomes, plan
-disseminate results to patient and family

22
Q

what is the starting point of diagnostic reasoning

A

organized assessment bc all health care diagnoses, decisions and treatments are based on this info

23
Q

evidence informed clinical decision making includes

A

-physical examination and assessment of patient
- clinical expertise
- patient preferences and values
- evidence from research and evidence informed theories

24
Q

what is an influencing factor

A

situational issues that can arise during a subjective data assessment
-CONSIDER factors that may influence how you ask questions
ex. if withholding info…emphasize confidentiality

25
Q

if a client is hyperaware of the situation and asking why you are asking questions about it….

A
  • share with the clients why you are asking these questions
  • normalize sensitive questions
  • encourage the client to ask me questions if they are uncertain as to why this info needs to be shared
26
Q

if a client is downplaying or exaggerating

A

-seek clarification
-reframe the questions i ask
- paraphrase what the client said to make sure you understood it

27
Q

if a client is withholding info bc dont like sharing info, feel judged or have a condition that is often stigmatized

A
  • emphasize confidentiality
  • introduce sensitive questions later in the interview once the therapeutic and trusting relationship is there
28
Q

if clients may not be fully conscious or oriented due to a physical injury, a mental condition, traumatic event or substance use

A

-be patient and give clients time to think and answer the questions
- delay asking some questions until they are recovering
- if appropriate, ask other ppl who ca share info about the client to corroborate it
-remain nonjudgemental and treat them with respect

29
Q

if a client functions at a developmental age

A

-tailor your language and tone of voice to the clients’ developmental age
- use a respectful and professional tone
- create safe for others to be involved and/or invite a care partner to be present

30
Q

some cultural and social considerations in nursing assessment are

A

-rapidly diversifying population
- health inequities are on the rise (rich/poor divide is growing)
- not all citizens access resources for everyday living equally
- some groups are already disadvantaged
-being alert to the intergroup differences is a nursing imperative-prepares adequately and explores ill-health causes

31
Q

health promotion tiers

A

primary prevention-ex sanitation and immunization
secondary prevention- ex early disease detection
tertiary prevention- ex prevention of complications when a condition or dieases has progressed
all these factors impact a nurses ability to understand the natural history of a disease

32
Q

define health promotion

A

the process of enabling people to increase control over and to improve their health

33
Q

examples of social determinants of health and what part of health history it affects

A

-socioeconomic environment…biographical data and functional assessment
- physical environment…functional assessment
- health childhood development…developmental history
- personal health practices…health promotion and harm reduction approaches
- individual capacity and coping skills…functional assessment
- biology and genetics…family history
- health services…most recent examination
- gender…biographical data
- culture and social considerations…biographical data and perception of health

34
Q

what is ethnicity

A

complex concept that implies geographical and national affiliation
-encompasses “race”, origin or ancestry, identity language and religion

35
Q

what is cultural sensitivity

A

health care providers should be aware of and accommodate peoples values, beliefs, customs and practices

36
Q

what is cultural competence

A

application of knowledge, skills, attitudes or personal attributes required by nurses to maximize respectful relationships with diverse populations of clients and co workers

37
Q

how have policies affected indigenous peoples in canada

A

-lack of employment opportunities
- limited access to educatinoal programs
-inadequate and crowded housings
- high levels of poverty

38
Q

relative poverty

A

situation in which individuals are unable to carry out or participate in the activities expected in a wealthy developed nation such as canada
ex. access to food, clothes, other amenities
-womens poverty is very worrying here

39
Q

how is active listening beneficial

A

-establishes trust so that you can obtain a deeper understanding of the explanatory model…assessing pateints culturally based undersatngins
- some of it is cues

health assessment (4 decks)

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