NR 302 Exam 1

NR 302 Exam 1

Student Name

Chamberlain University

NR-302: Health Assessment I

Prof. Name:

Date

Test One Concept Review

Physical vs. Emotional

When responding to a question, it is important to differentiate between objective and communicative answers. Objective answers typically ask for specific information such as “How do you?” “What type of data?” or “What is the name?” These questions often specify physical or emotional aspects of a situation. On the other hand, communicative answers focus on emotional or subjective factors, using prompts like “What factors?” “What approach?” or “How to improve?” In nursing, it’s essential to distinguish between physical and emotional concerns when responding to patients.

Communication and Question Types

In clinical settings, open-ended questions are useful when seeking more detailed or narrative responses from patients, especially when the patient needs to elaborate on their situation. For example, when a nurse needs to understand a patient’s feelings or experiences more deeply, they may ask an open-ended question like “Can you tell me more about how you’ve been feeling?” Conversely, closed-ended questions are appropriate for obtaining specific information and guiding the interview, especially if a patient is drifting off-topic or the nurse needs to conclude the conversation. For instance, “What time did you take your pill?” is a closed question that elicits a direct answer.

Cultural Awareness

Cultural competence is a fundamental aspect of nursing care. Approaching a patient from another culture involves respecting their beliefs and values. In cases where a patient refuses care due to cultural beliefs, the nurse should respect these beliefs and collaborate with the patient to create a care plan that accommodates their cultural practices. The most reliable source of cultural information is the patient themselves, as they can provide insight into their preferences and needs.

Verbal Responses During Interviews

During interviews, nurses can use various verbal techniques to communicate effectively with patients. These include confrontation, where the nurse might clarify discrepancies (e.g., asking about cigarette use when none was reported), interpretation, which involves offering a nurse’s understanding based on the patient’s data, explanation of factual information like lab results, and summarization, where key details are condensed for clarity. These techniques help in ensuring clear communication and patient understanding.

Interviewing Techniques and Traps

To facilitate a successful interview, nurses should create a comfortable environment by ensuring privacy, adjusting room temperature, and using appropriate body language. Conversely, certain traps should be avoided, such as talking too much, using professional jargon, offering false hope, or interrupting the patient. Furthermore, interpretation services should be used if necessary, with certified interpreters available for accurate communication.

Databases for Patient Information

In nursing, various types of databases help gather patient information. The complete database is used for new patients, where a thorough history is collected. Focused databases are used for patients with established conditions and short-term issues, while follow-up databases track ongoing concerns, such as discharge planning. Emergency databases are used in life-threatening situations where immediate action is necessary, and the history is obtained from family or bystanders.

Health History and SBAR

A patient’s medical history is typically documented in charts or through a genogram, which helps identify any familial patterns of illness. The SBAR (Situation, Background, Assessment, and Recommendation) tool is widely used for communication between healthcare providers. It includes the current situation, relevant past background, findings from assessments, and recommendations for further action.

Subjective and Objective Data

Subjective vs. Objective Data

Subjective data refers to what the patient reports, which cannot be directly observed or measured, such as feelings of nausea or dizziness. Objective data, on the other hand, is what the nurse observes, measures, or tests, such as elevated white blood cell count or abnormal vital signs.

Priority Levels in Care

Priority Levels

In nursing, patient care is prioritized based on the severity of the condition. First-level priorities are life-threatening and require immediate attention, such as airway, breathing, and circulation issues. Second-level priorities are urgent but not immediately life-threatening, like acute pain or significant changes in mental status. Third-level priorities are important but can be addressed later, such as patient education or family issues.

Nursing Basics

Hand Hygiene and Stethoscope Use

Hand hygiene is the most effective way to prevent the spread of disease in healthcare settings. Nurses use different parts of the stethoscope for various purposes: the diaphragm for high-pitched sounds, such as heart and lung sounds, and the bell for low-pitched sounds, like murmurs.

Normal Vital Signs

Normal vital signs include a blood pressure of 120/80, heart rate (HR) between 60 and 100 beats per minute, respiratory rate (RR) between 10 and 20 breaths per minute, a temperature range of 96.5°F to 99°F, and oxygen saturation (O2 sat) greater than 90%.

Nursing Process

The Nursing Process

The nursing process includes six steps: Assessment, Diagnosis, Outcome Identification, Planning, Implementation, and Evaluation. The process begins by collecting data from multiple sources to assess the patient’s condition. Based on the assessment, the nurse diagnoses the patient’s health issues, identifies goals, and develops a care plan. Implementation involves carrying out the care plan, and Evaluation measures the effectiveness of the interventions.

Developmental Considerations

Caring for Aging Patients

When caring for aging patients, nurses should ensure their comfort by adjusting the environment, minimizing unnecessary movement, and providing clear, slow directions. It is a common misconception that aging patients have diminished cognitive function, and these patients should not be assumed to have cognitive impairments unless clearly demonstrated.

Adolescent and Toddler Approaches

Adolescents benefit from a trusting, open communication approach, where confidentiality and respect are emphasized. For toddlers, it is important to approach their caregivers first and allow the child to warm up to the nurse. In infants, a calm and soothing voice helps create a comfortable environment.

Level of Consciousness and Mental Status

Mental Status Assessment

To assess a patient’s mental status, nurses ask about orientation to self, time, place, and situation. The different levels of consciousness include alert, lethargic, obtunded, and coma. Delirium refers to a sudden onset of confusion often caused by metabolic disruptions, while chronic confusion is typically associated with conditions like dementia.

Nursing Assessment and Pain Management

Physical Assessment

The order of a physical assessment includes inspection, palpation, percussion, and auscultation. Each of these techniques provides different types of information, such as inspecting the skin, palpating for abnormalities, percussing to assess organ size, and auscultating to listen for sounds like heartbeats or lung function.

Pain Assessment

When assessing pain, the most reliable person to report pain is the patient themselves. Nurses should assess pain using both subjective and objective methods, considering the patient’s reported pain level, vital signs, and physical observations. Nurses must investigate the type of pain, whether it is acute (nociceptive) or chronic (neuropathic), before administering pain medication.

Nutrition

Nutritional Status

A person’s nutritional status can be affected by physical problems, such as illnesses or aging. The Body Mass Index (BMI) is commonly used to assess obesity, and changes in a patient’s nutritional habits can be tracked using food diaries or direct questioning about their diet.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. ANA.

Jarvis, C. (2020). Physical examination and health assessment (9th ed.). Elsevier.

NR 302 Exam 1

Taylor, C., Lillis, C., & LeMone, P. (2019). Fundamentals of nursing (9th ed.). Wolters Kluwer.