Health Assessment I |Review with Questions and Verified
Answers| 100% Correct| A Grade -Chamberlain
All assessments involve collecting two kinds of data:
Objective and Subjective
The health history gathers which type of data about the
patient?
Subjective data
Objective data (signs)
Are observed during physical examination.
Are verifiable.
Include findings such as a red, swollen arm in a patient.
Subjective data (symptoms)
Provided by the patient.
Verified only by the patient.
Include statements such as "My head hurts" or "I have
trouble sleeping"
Review of systems (ROS)
Ask about each system from head to toe.
Ask if anything bothers them.
Drives physical assessment.
General survey
,Form your initial impression of the patient
Ex). Signs of acute distress, Pt. appears stated age,
Behavior, Visible devices, Level of consciousness.
Physical Assessment Techniques
Inspection
Palpation
Percussion
Auscultation
Inspection
Inspect each body system and observe for color, size,
location, movement, texture, symmetry, odors, and sounds
Nursing Process
Assessment
Diagnosis
Planning
Implementation
Evaluation
SBAR communication
, Situation
Background
Assessment
Recommendation
Levels of Prioritization
· 1st- (ABC); Airway, Breathing, Circulation
· 2nd- Pain, Abnormal lab diagnostics, Safety
· 3rd- Knowledge, Psychosocial, Education
Atelectasis
collapsed lung; incomplete expansion of alveoli
Visual acuity test
standard eye examination to determine the smallest letters
a person can read on a Snellen chart, or E chart, at a
distance of 20 feet
aa
Palpation
Light palpation- Assess for texture, temperature, moisture,
elasticity, pulsations, superficial organs, masses, and
surface abnormalities. Depress skin 1.5cm - 2cm with finger
pads lightly
Deep palpation- Assess internal organs and masses for size,
shape, tenderness, symmetry, and mobility. Depress skin
4cm - 5cm with firm pressure