NUR 2092 SECTION 03 HEALTH ASSESSMENT TEST 1
(DOWNLOAD FOR COMPLETE AND USEFUL RESOURCES)
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
, ▪ 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?
• HEALTH
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
(DOWNLOAD FOR COMPLETE AND USEFUL RESOURCES)
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
, ▪ 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?
• HEALTH
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
