NUR 2092 SECTION 03 HEALTH ASSESSMENT TEST 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