HAP 239 Study Guide: COMPREHENSIVE WEEK 1,2,3,4,5 & 6 GUIDE FOR EXAM 1-2021

HAP 239 Study Guide: COMPREHENSIVE WEEK 1,2,3,4,5 & 6 GUIDE 2 main components of health assessment: 1. Health history – subjective 2. Physical exam – objective Subjective data can be PRIMARY (from pt) or SECONDARY (from caregivers, family, med charts)  ID areas of concern to be addressed via physical exam, topics for teaching/health promotion (i.e. if they tell you they smoke) Goals: do a complete health hx, make database that can be used for plan, prevent disease, resolve problems, minimize limitations, build trust & rapport (contract btwn nurse is a LEGAL CONTRACT) Non-verbal behaviors form nurse:  Appearance, posture, eye contact, gesture, facial expressions o May be culture specific (American culture uses most eye contact) o May be gender specific (Muslim female and male nurse)  Touch – can comfort elderly with dementia, also culturally specific, more rapport  more touch The interview  Phases o Preinteraction – after you’ve gotten shift report you go into room w/ set of info you’ve been giving o Beginning – introduce self with first and last name  Use statements and less questions because you don’t want to ask permission when you need to get answers o Working – biggest part, health hx and review of systems o Closing – thank for time, summarize info, discuss next time  Therapeutic communication – single most important factor for successful interviewing, communication skill of nurse gains pt trust  Factors effecting interview: setting, nurse behaviors, types of Q you have to ask, how you ask Q, personality and behavior of patient, how pt feels at that specific time, nature of info being discussed o Physical setting should be private, quiet, comfy, w/o distractions (TV off)