NR 304 FINAL WORKSHEET / NR304 FINAL WORKSHEET: LATEST,CHAMBERLAIN COLLEGE OF NURSING
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Course
NR 304 (NR304)
Institution
CHAMBERLAIN COLLEGE OF NURSING
NR 304 FINAL WORKSHEET / NR304 FINAL WORKSHEET: LATEST,CHAMBERLAIN COLLEGE OF NURSINGNR 304 FINAL WORKSHEET / NR304 FINAL WORKSHEET: LATEST,CHAMBERLAIN COLLEGE OF NURSINGNR 304 FINAL WORKSHEET / NR304 FINAL WORKSHEET: LATEST,CHAMBERLAIN COLLEGE OF NURSING
This activity provides each student with the opportunity to review some of the main concepts
that have been covered in Health Assessment I and II. This worksheet can help students better
understand the concepts, learn strategies for mastering this content from other students, and more
accurately apply the concepts to future patient care situations.
Due Date: Submit the completed worksheet to the Canvas Module on or before the due date of
Dec 10, 2017 at 1159 pm for up to 50 points.
Points Possible: 50 points
Requirements:
1. You may work alone or with a partner for this assignment.
2. Please answer these questions. If working on a computer, please use a color font other
than black.
3. You may use any notes that you have taken in this class session.
4. You may use the textbook, any other book or other resource to answer the questions.
Questions:
1. Define subjective and objective data. Give three examples of each and state if the
findings are documented in the history or physical examination findings.
a. Subjective data: information given to you by the pt.
i. pain, cramping, decreased sensation
b. Objective: information that is gathered by examination and assessment
i. Pallor, skin texture, capillary refill
2. List five actions a nurse should take when assessing a patient with a potentially
critical hemodynamic state. Put your actions in priority order of 1-5.
- Unstable
- (1) Oxygen, (2) Circulatory,(3) Vitals, (4)
, 3. What does the priority setting ABC mean? How does the nurse use this mnemonic
in patient assessment? If a patient has a slow or rapid respiratory rate, is airway the
primary concern?
a. Airway, breathing, circulation
b. the nurse will assess by priority if the patient has any obstruction or abnormality
with their airway, they will then assess if they can breathe or not, lastly assess if
anything is wrong with their cardiovascular circulation.
c. If the patient is having trouble breathing but is still breathing that may show
something lodged in the airway. If nothing is seen then circulation could be the
underlying problem.
4. What is HIPAA? Describe one situation when the nurse must adhere to HIPAA.
a. Health Insurance Portability & Accountability Act
i. Helps protect client’s medical records
b. When over hearing a coworker talk about their pt. to another coworker
5. Describe the process of taking a pulse. What is a normal pulse? What are qualities
of a normal pulse? What is the first action a nurse should take when the pulse is not
as expected?
a. Assess by palpating the surface using gentle pressure over the artery location
chosen
i. Normal qualities: 2+, equal in rhythm, rate, and strength, no signs of bruit
or thrill
b. The nurse should normally take a pulse for 30sec. and x2, if irregular or
abnormal, retake the pulse for a full 1min/60sec., if irregular still take apical pulse
for 1min/60sec. If pulse cannot be felt at first, Doppler may need to be used
6. What is dehydration? List three subjective and three objective findings of
dehydration. List the expected vital signs of a patient who is dehydrated.
a. Lack of fluid volume in your blood
b. Sub: drowsiness, lightheadedness, increase thirst
c. Obj: dry tongue/mucosa, sunken eyes, decreased skin turgor
d. Decreased BP, increased RR/temp/HR (will be weak and thread)
7. How is fluid volume deficit related to dehydration? How would concentrations of
some solutes (solids) change with dehydration? Why?
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