NSG 500 Health Assessment MIDTERM
Exam 2024/2025 Fall-Spring Wilkes University
Assessment
Assessment is the collection of subjective and objective data about a patient's health.
Subjective data
Subjective data consist of information provided by the affected individual.
Objective data
Objective data include information obtained by the health care provider through physical
assessment, the patient's record, and laboratory studies.
The database
The database is the totality of information available about the patient. The purpose of assessment
is to make a judgment or diagnosis.
Diagnostic reasoning
Diagnostic reasoning is the process of analyzing health data and drawing conclusions to identify
diagnoses.
,NSG 500 Health Assessment
Diagnostic reasoning has which four major components?
(1) Attending to initially available cues, which are pieces of information, signs, symptoms, or
laboratory data;
(2) Formulating diagnostic hypotheses, which are tentative explanations for a cue or a set of cues
and can serve as a basis for further investigation;
(3) Gathering data relative to the tentative hypotheses;
(4) evaluating each hypothesis with the new data collected, which leads to a final diagnosis.
The nursing process includes which six phases?
(1) assessment,
(2) diagnosis,
(3) outcome identification,
(4) planning,
(5) implementation, and
(6) evaluation.
It is a dynamic, interactive process in which practitioners move back and forth within the steps.
The novice nurse
The novice nurse has no experience with specific patient populations and uses rules to guide
performance.
The experienced nurse
,NSG 500 Health Assessment
The experienced nurse understands a patient situation as a whole rather than as a list of tasks,
attends to an assessment data pattern, and acts without consciously labeling it.
Critical thinking
Critical thinking is the multidimensional thinking process needed for sound diagnostic reasoning
and clinical judgment. Seventeen critical thinking skills have been identified, including setting
priorities.
First-level priority problems
First-level priority problems are emergent, life-threatening, and immediate, such as establishing
an airway or supporting breathing.
Second-level priority problems
Second-level priority problems are next in urgency. They require prompt intervention to prevent
deterioration, and may include a mental status change or acute pain.
Third-level priority problems
Third-level priority problems are important to the patient's health, but can be addressed after
more urgent problems. Examples include lack of knowledge or family coping.
Evidence-based practice
, NSG 500 Health Assessment
Evidence-based practice is a systematic approach to practice that uses the best evidence, the
clinician's experience, and the patient's preferences and values to make decisions about care and
treatment.
Every examiner needs to collect four kinds of databases based on the situation. What are the four
kinds of databases?
(1) A complete (or total health) database includes a complete health history and a full physical
examination.
(2) A focused (or problem-centered) database is used for a limited or short-term problem. It is
smaller in scope and more targeted than the complete database.
(3) A follow-up database evaluates the status of any identified problem at regular intervals to
follow up on short-term or chronic health problems.
(4) An emergency database calls for rapid collection of data, which commonly occurs while
performing lifesaving measures.
The biomedical model
The biomedical model of Western medicine views health as the absence of disease. It focuses on
collecting data on biophysical signs and symptoms and on curing disease.
The holistic health model
The holistic health model assesses the whole person because it views the mind, body, and spirit
as interdependent and functioning as a whole within the environment. Health depends on all
these factors working together.
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