*NURSING > STUDY GUIDE > Final Exam Study Guide for Health Assessment (All)
Final Exam Study Guide for Health Assessment Know your types of data: Subjective: Subjective data is what the person says about him or herself during history taking. The term ... s reflective and introspective are not used to describe data. (p.2) Objective: Objective data are what the health professional observes by inspecting, percussing, palpating, and auscultating during the physical examination. Parts of a database Together with the patients record and laboratory studies, the objective and subjective data form the data base. The other items are not part of the patients record, laboratory studies, or data. (p.2)7 Know your priorities: First-level priority problems are those that are emergent, life threatening, and immediate (e.g., establishing an airway, supporting breathing, maintaining circulation, monitoring abnormal vital signs) (see Table 1-1). (p.4) Second-level priority problems are those that require prompt intervention to forestall further deterioration (e.g., mental status change, acute pain, Abnormal laboratory values, risks to safety or security) (see Table 1-1). Define culture: Culture has four basic characteristics. Culture adapts to specific conditions related to environmental and technical factors and to the availability of natural resources, and it is dynamic and ever changing. Culture is learned from birth through the process of language acquisition and socialization, but it is not most clearly reflected in one’s language and behavior (p14). The culture that develops in any given society is always specific and distinctive, encompassing all the knowledge, beliefs, customs, and skills acquired by members of the society. Within cultures, groups of people share different beliefs, values, and attitudes. Differences occur because of ethnicity, religion, education, occupation, age, and gender. When such groups function within a large culture, they are referred toas subcultural groups (p.14) How to give culturally sensitive care: the inclusion of cultural considerations in the health assessment is of Paramount importance to gathering data that are accurate and meaningful and to intervening with culturally sensitive and appropriate care (p.8) Culturally competent implies that the caregiver understands And attends to the total context of the individual’s situation. This competency Includes awareness of immigration status, stress factors, other social factors, and cultural similarities and differences. Define spirituality and religion: religion is the belief in a higher power. Religion is defined as an organized system of beliefs concerning the cause, nature, and purpose of the universe, especially belief in or the worship of God or god. Spirituality arises out of each person’s unique life experience and his or her Personal effort to find purpose and meaning in life. (p.15) Know the illness theories: among the biomedical explanations for disease is the germ theory, which states That microscopic organisms such as bacteria and viruses are responsible For specific disease conditions. The naturalistic, or holistic, perspective holds that the forces of nature must Be kept in natural balance. The magicoreligious perspective holds that supernatural forces dominate And cause illness or health (p.18) In addition to seeking help from the biomedical or scientific health care provider, patients may also seek help from folk or religious healers. Some people, such as those of Mexican American or American Indian origins, may believe that the cure incomplete unless the body, mind, and spirit are also healed (although the division of the person into parts is a Western concept). Wide cultural variations exist in the way certain symptoms and disease conditions are perceived, diagnosed, labeled, and treated. Chinese- Americans sometimes convert mental experiences or states into bodily symptoms (e.g. Complaining of cardiac) symptoms because the center of emotion in the Chinese culture is the heart) (p.-17-18) Silent suffering is a potential response to pain in many cultures. The nurses Assessment of pain needs to be embedded in a cultural context. (p22) In addition to expecting variations in pain perception and tolerance, the nurse Should expect variations in the expression of pain. It is well known that Individuals turn to their social environment for validation and comparison (p.22) Know proper techniques in interviewing and the phases What is interpretation and confrontation? Know the types of questions Open ended closed ended interpretation reflection confrontation leading or biased The open-ended question asks for narrative information. It states the topic to Be discussed but only in general terms. The nurse should use it to begin The interview, to introduce a new section of questions, and whenever the person introduces a new topic (p.31) Open-ended questions are used for gathering narrative information When the health care provider uses the response of confrontation, the frame of Reference shifts from the patient’s perspective to the perspective of the health care provider, and the health care provider starts to express his or her own Thoughts and feeling (p.32) Open-ended questions allow for self-expression, build and enhance rapport, and obtain narrative information. These features enhance communication during an interview. (p.31) The nurse should use clarification when the persons word choice is Ambiguous or confusing (e.g., Tell me what you mean by fits.). Clarification Is also used to summarize the persons words or to simplify the words to make Them clearer; the nurse should then ask if he or she is on the right track. (p.33) Best way to ask patient about his or her pain A final summary of any symptom the person has should include, along with seven other critical characteristics, Location: specific. The person is asked to point to the location (p.50) The symptom of pain is difficult to quantify because of individual interpretation. With pain, adjectives should be avoided and the patient should be asked how the pain affects his or her daily activities Best response if patient has allergies - Describe what happens to you Note both the allergen (medication, food, or contact agent, such as fabric or environmental agent) and the reaction (rash, itching, runny nose, watery eyes, or difficulty breathing). With a drug, this symptom should not be a side effect but a true allergic reaction (p.52) Know health promotion activities How toddlers might show pain With a very young child, the parent is asked, how do you know the child Is in pain? A young child pulling at his or her ears should alert parents To the child’s ear pain. Statements about teething and questioning whether The child is really having pain do not explore the symptoms, which should Be done before a physical examination. What is a genogram -A genogram (or pedigree) is a graphic family tree That uses symbols to depict the gender, relationship, and age of immediate blood relatives in at least three generations (parents, grandparents, siblings) Graphic family tree that uses symbols to depict the gender, relationship, and Age of immediate family members (p,52-53) How to assess mental status with the elderly After 5 minutes ask for the recall of the four words. To test the duration of memory, ask for a recall at 10 minutes and at 30 minutes. The normal response for people younger than 60 years is an accurate three- or four-word recall after a 5-, 10-, and 30-minute delay.33a People with Alzheimer dementia score a zero- or one-word recall. Impaired new learning ability also occurs with anxiety (because of inattention and distractibility) and depression (because of lack of effort mobilized to remember). (Jarvis, 022015, p. 71) .........Continued......... [Show More]
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