NUR 2092 SECTION 03 HEALTH ASSESSMENT TEST 1

NUR 2092 SECTION 03 HEALTH ASSESSMENT TEST 1

NUR 2092 Health Assessment Exam 1 Study Guide

HEALTH ASSESSMENT EXAM 1

CHAPTER 2

• FOUR TYPES OF ASSESSMENT DATABASES

O COMPLETE (TOTAL HEALTH)

▪ COMPLETE HEALTH HISTORY AND FULL PHYSICAL EXAMINATION

• DESCRIBES CURRENT AND PAST HEALTH STATE

• FORMS A BASELINE AGAINST WHICH ALL FUTURE CHANGES CAN BE

MEASURED

▪ THIS WOULD BE DONE IN A PHYSICIAN’S OFFICE/FIRST PATIENT

▪ TAKES ABOUT HALF AN HOUR TO GET ALL THIS INFO

O FOCUSED OR PROBLEM-CENTERED DATABASE

▪ USED FOR A LIMITED OR SHORT-TERM PROBLEM

▪ COLLECT A MINI DATABASE

• SMALLER IN SCOPE AND MORE TARGETED

▪ COLLECT INFORMATION REGARDING THAT ACUTE INCIDENT

O FOLLOW-UP DATABASE

▪ COMPLICATIONS?

▪ ARE MEDICATIONS WORKING?

▪ BLEEDING? STILL HURT? ANY BETTER?

O EMERGENCY DATABASE

▪ URGENT, RAPID COLLECTION OF CRUCIAL INFORMATION

▪ NAME?

▪ AS MUCH INFO AS YOU CAN?

• CAB

O CIRCULATION – MOST IMPORTANT

O AIRWAY

O BREATHING

O WHAT’S HAPPENING?

▪ CALL 911 AND EXPLAIN

• EVIDENCE-BASED ASSESSMENT

O CLINICAL DECISION MAKING DEPENDS ON ALL FOUR FACTORS

▪ BEST EVIDENCE FROM A CRITICAL REVIEW OF RESEARCH LITERATURE

▪ THE PATIENT’S OWN PREFERENCES

▪ THE CLINICIAN’S OWN EXPERIENCE AND EXPERTISE

▪ PHYSICAL EXAMINATION AND ASSESSMENT

• ASSESSMENT SKILLS MUST BE PRACTICED WITH HANDS ON

EXPERIENCE AND REFINED TO A HIGH LEVEL

• CULTURAL COMPETENCY QUESTIONS

O WHEN MEETING A PATIENT FOR THE FIRST TIME

• HEALTH

▪ WHERE DOES THE PATIENT COME FROM?

▪ WHAT IS HIS/HER HERITAGE?

▪ WHAT IS HIS/HER CULTURAL BACKGROUND?

▪ WHAT LANGUAGE IS THE PATIENT FAMILIAR WITH?

▪ WHAT ARE HIS/HER HEALTH AND ILLNESS BELIEFS AND PRACTICES?

O BALANCE OF A PERSON IS A COMPLEX, INTERRELATED PHENOMENON

▪ WITH ONE’S BEING: PHYSICAL, MENTAL, AND SPIRITUAL

▪ IN OUTSIDE WORLD: NATURAL, COMMUNAL, AND METAPHYSICAL

• ILLNESS

O LOSS OF A PERSON’S BALANCE

• ALMOST 40% OF US RESIDENTS IDENTIFY AS OTHER THAN NON-HISPANIC WHITES

• EMERGING MINORITY GROUPS

O YOUNGER WITH LOWER MEDIAN AGES

O HIGHER PROPORTIONS UNDER 18 YEARS OLD

O HOUSEHOLDS WITH MULTIPLE GENERATIONS

O POVERTY LEVEL

▪ TRANSPORTATION

▪ ACCESS TO CARE

▪ LITERACY

• IMMIGRATION AND HEALTH CARE CONCERNS

O MANY NEW IMMIGRANTS HAVE ONLY MINIMAL UNDERSTANDING OF THE

FOLLOWING

▪ MODERN HEALTH CARE DELIVERY SYSTEM

▪ MODERN MEDICAL AND NURSING PRACTICES AND INTERVENTIONS

▪ ENGLISH LANGUAGE

O IMPERATIVE THAT THE NURSE’S CARE IS TAILORED TO MEET THE PERSON’S

PERCEIVED NEEDS

• NATIONAL CULTURAL AND LINGUISTIC STANDARDS

O FIRST AND LANDMARK STANDARD

▪ HEALTH CARE ORGANIZATIONS ARE LEGALLY REQUIRED TO ENSURE THAT

PATIENTS RECEIVE EFFECTIVE, UNDERSTANDABLE, AND RESPECTFUL CARE

THAT IS PROVIDED IN A MANNER COMPATIBLE WITH THEIR CULTURAL

HEALTH BELIEFS AND PRACTICES AND PREFERRED LANGUAGE

O EFFECTIVE CARE

▪ POSITIVE OUTCOMES AND SATISFACTION FOR PATIENT

O RESPECTFUL CARE

▪ CONSIDERS VALUES, PREFERENCES, AND EXPRESSED NEEDS OF PATIENT

O CULTURAL AND LINGUISTIC COMPETENCE

▪ CONGRUENT BEHAVIORS, ATTITUDES, AND POLICIES THAT COME TOGETHER

IN A SYSTEM AMONG PROFESSIONALS THAT ENABLES WORK IN CROSS-

CULTURAL SITUATIONS

• LINGUISTIC COMPETENCE

O TITLE VI OF CIVIL RIGHTS ACT OF 1964

▪ SERVICES CANNOT BE DENIED TO PEOPLE OF LIMITED ENGLISH

PROFICIENCY

O MOST COMMON NON-ENGLISH LANGUAGE IS SPANISH

O PATIENTS WHO HAVE LIMITED ENGLISH PROFICIENCY (LEP) ARE AT RISK FOR

POOR HEALTH CARE OUTCOMES DUE TO THE BARRIER THAT LANGUAGE PRESENTS

DURING HEALTH CARE DELIVERY INTERACTIONS

• CULTURAL COMPETENCE

O CULTURALLY SENSITIVE

▪ POSSESSING BASIC KNOWLEDGE OF AND CONSTRUCTIVE ATTITUDES

TOWARD DIVERSE CULTURAL POPULATIONS

O CULTURALLY APPROPRIATE

▪ APPLYING UNDERLYING BACKGROUND KNOWLEDGE NECESSARY TO

PROVIDE THE BEST POSSIBLE HEALTH CARE

O CULTURALLY COMPETENT

▪ UNDERSTANDING AND ATTENDING TO TOTAL CONTEXT OF PATIENTS

SITUATION INCLUDING THE FOLLOWING

• IMMIGRATION STATUS

• STRESS AND SOCIAL FACTORS

• CULTURAL SIMILARITIES AND DIFFERENCES

• STEPS TO CULTURAL COMPETENCE

O UNDERSTAND ONE’S OWN HERITAGE-BASED VALUES, BELIEFS, ATTITUDES, AND

PRACTICES

O IDENTIFY MEANING OF “HEALTH” TO PATIENT

O ACQUIRE KNOWLEDGE ABOUT SOCIAL BACKGROUNDS OF PATIENTS

O BECOME FAMILIAR WITH LANGUAGES, INTERPRETIVE SERVICES, AND COMMUNITY

RESOURCES AVAILABLE TO NURSES AND PATIENTS

• FOUR BASIC CONCEPTS OF CULTURE

O LEARNED

O SHARED

O ADAPTED

O DYNAMIC

• RACE AND ETHNICITY

O SELF-IDENTIFICATION

O SOCIAL GROUP

• ACCULTURATION

O ASSIMILATION IS ONE DIMENSIONAL

O BICULTURALISM/INTEGRATION IS DIMENSIONAL

• CULTURE

O THOUGHTS, COMMUNICATIONS, ACTIONS, BELIEFS, VALUES, AND INSTITUTIONS OF

RACIAL, ETHNIC, RELIGIOUS, OR SOCIAL GROUPS

• RELIGION

O BELIEF IN DIVINE OR SUPERHUMAN POWER, OR POWERS TO BE OBEYED AND

WORSHIPPED AS CREATOR/RULER OF UNIVERSE

O SYSTEM OF BELIEFS, PRACTICES, AND ETHICAL VALUES

O SHARED EXPERIENCE OF SPIRITUALITY

O PEOPLE HOLD RELIGION VERY DEAR

▪ YOU CANNOT DISCREDIT THEIR RELIGION OR THE IMPORTANCE OF THEIR

SPIRITUALITY

• SOCIALIZATION

O PROCESS OF BEING RAISED WITHIN A CULTURE AND ACQUIRING CHARACTERISTICS

OF THAT GROUP

• ACCULTURATION

O PROCESS OF ADAPTING TO AND ACQUIRING ANOTHER CULTURE

• ASSIMILATION

O PROCESS OF DEVELOPING A NEW CULTURAL IDENTITY AND BECOMING LIKE

MEMBERS OF DOMINANT CULTURE

• BICULTURALISM

O DUAL PATTERN OF IDENTIFICATION AND OFTEN OF DIVIDED LOYALTY

• HEALTH-RELATED BELIEFS AND PRACTICES

O BALANCE AND BELIEFS ABOUT CAUSES OF ILLNESS

O BIOMEDICAL OR SCIENTIFIC THEORY

▪ BIOMEDICAL

• ASSUMES CAUSE AND EFFECT

• VIEWS THE BODY AS A MACHINE

• LIFE CAN BE DIVIDED INTO PARTS

• ENDORSES GERM THEORY

O NATURAL OR HOLISTIC THEORY

▪ NATURALISTIC

• FORCES OF NATURE MUST BE KEPT IN BALANCE

• EMBRACES IDEAS OF OPPOSING CATEGORIES OR FORCES

O YIN AND YANG

O HOT AND COLD

O MAGICORELIGIOUS PERSPECTIVE

▪ SUPERNATURAL POWERS PREDOMINATE IN AREA OF HEALTH AND ILLNESS

• VOODOO ETC

O TRADITIONAL BELIEFS AND HEALTH HEALERS

▪ SOME CULTURES JUST GO TO THEIR LOCAL “DESIGNATED NOT OFFICIAL”

HEALTH CARE PROVIDER

▪ SOME ETHNIC GROUPS BELIEVE THAT CURE IN INCOMPLETE UNLESS

HEALING IS CARRIED OUT FOR THE BODY, MIND, AND SPIRIT

• HEALTH-RELATED BEHAVIORS AFFECTED BY RELIGION

O MEDITATING

O EXERCISE

O SLEEP

O VACCINATIONS

O STRESS

O GENETIC SCREENING

O CARE FOR CHILDREN

• FOLK HEALERS

O HISPANIC

▪ HERBALISTS