Lessons 1-3 Flashcards Preview

Health Assessment > Lessons 1-3 > Flashcards

Flashcards in Lessons 1-3 Deck (35)
Loading flashcards...
1
Q

Give examples of situations in which a nurse’s ability to assess a client is critical.

A
  • Giving/holding meds
  • Calling for help
  • Communicating
  • Charting
  • Identifying “watchers”
  • Assigning patients
2
Q

Describe how nursing practice and education has evolved starting in the 1970s

A
  • Physical assessments added to nursing curriculum (but in the same format as medical students)
  • Nursing from task to profession
  • Integrated as part of a health care team
3
Q

What are the 3 problems with incorporating physical diagnosis techniques from the medical profession into nursing curriculum in an essential identical format?

A
  • Nursing as a profession: Nursing curriculum is the same as medical curriculum, but nurses training is only 1-2 years whereas physicians are 4+ years training. There is overlap between nurses and doctors.
  • Technology: Technology makes up more than 50% of the assessment. Traditional exams have been rendered obsolete and do not yield accurate results.
  • Evidence based assessment: Compare physical signs with modern diagnostic standards.
4
Q

What are some positive aspects of technology in regards to physical assessment?

A

Measuring the effectiveness of particular physical assessment to determine its accuracy and usefulness..so basically accuracy and usefulness

5
Q

What are some negative aspects to technology in regards to physical assessment?

A

There may be over-reliance on technology for answers when simple physical assessment may bas as accurate and less invasive

6
Q

Evidence-based assessment

A
  • The use of research and theory is used to guide the selection of assessments to be used
  • Decision of assessment based on info and data does not rely on gut instinct
  • Optimize decision-making by emphasizing the use of evidence from well designed and conducted research
7
Q

Begin with the end in mind

A

Determine the goal and develop a plan to get there. Helps keep you heading in the right direction

8
Q

Mind like water

A

Respond to situations accordingly

Be willing and flexible and adapt to changes as they occur

9
Q

Why is it essential to understand the purpose and value of physical examination techniques?

A
  • You should have a purpose for performing the test
  • You should be able to properly interpret the results of a given test and be able to make appropriate decisions
  • If you don’t understand the above, then there is no way to make a proper decision. If you don’t know the meaning or value of the test, why are you even doing it?
10
Q

What are 3 points about physical examination techniques?

A
  • No test is perfect
  • Context always takes precedence
  • Likelihood ratios are the key
11
Q

Sensitive tests

A

Negative results are most meaningful

  • Tends to detect all people with a disease
  • May also identify people as having a disease when they do not
12
Q

What does it mean when a test identifies people as having a disease when really they do not have it?

A

False positive

13
Q

Specific test

A

Positive results are most meaningful

  • Tends to detect all people without disease
  • May also identify people as not having disease when they actually do
14
Q

What does it mean when a test identifies people as not having a disease when they actually do have it?

A

False negative

15
Q

Why is an HIV test a sensitive test?

A

We do not want to MISS SOMEONE THAT MAY POSSIBLY HAVE HIV (and thus risk of infecting others)

16
Q

What is pancreatic cancer a specific test?

A

Pancreatic cancer is a type of cancer that unfortunately does not give you much hope. We do not want to inform someone they have pancreatic cancer when they do not.

17
Q
Likelihood ratios: 
LR value given. What is the interpretation?
10
2
1
0.5
0.1
A
10- diagnostic (rules in) GREAT TEST
2- Useful
1- No value
0.5- Useful
0.1- diagnostic (rules in) GREAT TEST
18
Q

What is the chief complaint?

A

Part of the doctors history and physical; what brings them in today?
-In a patients own words

19
Q

What is the HPI?

A

Part of doctors history and physical; History of present illness
-Clients story of what is going on

20
Q

What is PMH

A

Part of doctors history and physical; Past medical history

-Overview of client’s health prior to the present illness

21
Q

Family history

A

Part of doctors history and physical; age, health/death of family

22
Q

Psychosocial history

A

Part of doctors history and physical; clients birthplace, education, employment, religion, use of alcohol, tobacco, diets, exercise, hobbies, living accommodations, client’s sexual history, etc

23
Q

What is the ROS?

A

Part of doctors history and physical; Review of systems
-SUBJECTIVE data
-Thorough review of each body system based on what the patient is describing so the doctor as an idea of what is going on..It narrows down so during the physical assessment the doctors has an idea of what to look for.
EX: I have this weird mole on my back…

24
Q

What is the physical exam?

A

Part of doctors history and physical
-OBJECTIVE data
-Thorough assessment of different systems to see what findings they may have
-Measurable
EX: This mole is discolored and abnormally shaped. We should run a test on this.

25
Q

What are the 3 other parts of the doctors history and physical?

A

Lab and radiographic studies
Differential diagnosis
Assessment/plan

26
Q

What is the most important tool doctors use to determine a diagnosis?

A

History

-Listening to the patient’s story

27
Q

What is the role of diagnostic tests?

A

-Labs are used to confirm/disprove the suspected diagnosis

28
Q

Are diagnostic tests used for “hunting expeditions”?

A

No. We do the labs to confirm/disprove the suspected diagnosis…not to run a bunch of random labs to find the problem.

29
Q

What are some tools a nurse needs for a typical bedside assessment?

A
Stethoscope
Penlight
BP cuff
Thermometer
Watch with a second hand
30
Q

What’s the difference between a medical diagnosis and a nursing diagnosis?

A

Medical diagnosis, the assessment is used to supply and underlying cause. More abstract

Nursing diagnosis: Assessment is more holistic, focusing on the client’s experience of the medical problem. More concrete

31
Q

What is the daily routine of a bedside nurse?

A

Daily routine:

  • Beginning report
  • Bedside assessment
  • Fluid intake and output every 2 hours
  • Mid-day focused assessment
  • Final report
32
Q

When is health history done?

A

Health history

33
Q

What is the difference between a head to toe assessment and focused assessment?

A

Head to toe: Whole/body comprehensive

Focuses: Specific/focusing on the system affected by their diagnosis

34
Q

Nursing surveillance (as it relates to health assessment)

A

The thing nurses can do that no one else can do

  • Our main role in the healthcare team
  • Keeping a close eye on the patient the whole-time they are in the hospital (ongoing surveillance)
35
Q

Quote: What does surveillance involve?

A

Surveillance involves frequent patient assessment and recognizing subtle and overt cues