WEEK 3 - Assessment Flashcards
purpose of health assessment
- includes all body systems
- identifies the deteriorating and clinically ill patients to intervene rapidly
- the main focus is to stabilize the patient
components of a health assessment
primary assessment - secondary assessment - focused assessment
primary assessment- go through it
DRSABCDE
airwar and c spine
ensure the airway is patient
- head tilt and chin lift manoeuvre
- jaw thrust - spinal injury
- airway compromise
danger
identify any dangers to you, the patient or any other healthcare professionals
- stop and remove danger if safe to do so
response
can you elicit any verbal or motor response
- failure to respond is clear indication of illness
breathing
- effective respirations
- air entry into the lungs
- skin and mucous membrane colour
- chest wall movement
circulation
check signs for impending cardiovascular collapse
- pulse rate and quality
- skin colour and warmth
- capillary refill
- internal and external haemorrhage
- auscultate to hear the S1 + S2 heart sounds
disability
assessment of central nervous system function
- AVPU
- pupil response
- limb assessment
- pain
exposure and environment
assessment for clues to the cause of the patient condition
- remove clothing as required
- maintain body temperature during exposure
- assess for signs of injury, trauma or illness
reversible causes of reduced consciousness
medications - blood glucose level - overdose - anaphylaxis - hemorrhagic shock and hypotension
components of secondary assessment
- Biographical data
- Reason for seeking care
- Perception of present state of health
- Past health and medical history
- Family history
- General overall health and wellbeing
- Health and lifestyle management
- physical examination
focused assessment
a thorough assessment of a particular clinical manifestation related to a particular body system
- completed throughout each shift and at handover to review patient progress
- using skills of inspection, auscultation, palpation and percussion
