NURS 3212 FAMILY HEALTH ASSESSMENT(FHA) EXAM 1 Complete Guide, Download to get a HIGHSCORE.

PRIORITY SETTING: FIRST ADDRESS ANY LIFE-THREATENING SITUATIONS o And then other issues that need immediate attention INVOLVES USING o Knowledge o Clinical experience o Expertise o Judgement  Life threatening issues o Circulation o Airway o Breathing over elevated temperature o Human violence o Suicide Priority Levels o First Level: Life threatening (ABCs + V) o Second level: Urgently require treatment to prevent deterioration o Third Level: Important, but can wait for stabilization of first and second levels o Collaborative: Approach requires multiple disciplines of caregivers THREE TYPES OF NURSING ASSESMENTS: 1) Emergency and Urgent Assessment o Center on immediate & highest priority problem o Life threatening or unstable situation o Nurses obtain details until patient is stable o Most common Chest pain **TREATED IMMEDIATELY MYOCARDIAL INFARCTION Back pain Headache **TREATED IMMEDIAETLY – CEREBEAL HEMORRHAGE o Includes Medication Allergies Current health problems Reason for seeking care Extreme anxiety Acute distress Pallor Cyanosis Change in mental status o ABCDE A: Airway (cervical spine protection if an injury is suspected) B: Breathing (rate and depth, use of accessory muscles) C: Circulation (pulse rate and rhythm, skin color ) D: Disability (level of consciousness, pupils, movement ) E: Exposure o Critical Interventions: Provide assistance with circulation Open patient’s airway Assist the patients breathing Protect the cervical spine if the patient is injured Ensure that the disoriented or suicidal patient is safe Provide pain management and sedation 2) Comprehensive Assessment (???each unit ))) o Complete health history and Physical Assessment o Includes all body systems and areas o Includes Demographics Family history Individual health history Psychosocial areas o Reason of seeking care o Head to toe format Assessment of skin Head, neck, eyes, ears, nose, mouth, throat, thorax and lungs, neurologic systems o Ex) physical required by school, annual PE, hospital admission, Sports Part. Screening o History might be obtained by patient filling out with family history of illness, personal illness, and medical treatment or surgeries o Can obtained secondary information from family members o Includes patient perception of health, strengths to build on risk factors for illness functional abilities methods of coping support systems o Note dates of diagnoses treatments reason for medication important to reconcile the medication list 3) Focused Assessment o Involves questions that relate to the current situation o Based on patient’s health issues o Involves one or 2 body systems o Smaller in scope than the comprehensive assessment BUT more in depth on the specific issues or issues o Ex) patient with a cough Focuses on duration of the cough Associated symptoms such as wheezing or shortness of breath Factors that relieve or worsen the cough PA: evaluation of the nose and throat, auscultation of the lungs, inspection of septum 4) Follow Up Assessment: o Performed 30 to 60 days later o Determines whether patient’s medication is working o Determines if patient needs further teaching or different treatments o Ex) Diabetes ( follow up on HBP) EVIDENCE BASED PRACTICE Approach to patient care that minimizes intuition and personal experience and instead relies on research findings and high- grade scientific support Three aspects o Best evidence according to research o Best evidence according to Nurses expertise o Patient Preference Helps solve common problems through four steps o Clearly Identify the issue or difficulties based on accurate analysis of current nursing knowledge and practice o Search the literature for relevant research o Evaluate the research evidence using established criteria governing scientific merit o Choose interventions and justify the selection with the most valid evidence Some evidence is evaluated in COMMUNICATION: PATIENTS WITH LIMITED ENGLISH SKILLS: Obtain an interpreter if patient uses another primary language o Keep in mind translators are costly - Cover one concept at a time - Use simple words or phrases - Pantomime questions: such as pretending to be in pain - Resources with pictures are helpful - Principles o Limitations in language are NOT a reflection of intellectual functioning o Patients tend to think in their native language and translate= delayed response o Patients interpret the message that reflects their cultural beliefs, often changing the speaker’s intent o Written information in the native language supports verbal communication WORKING WITH AN INTERPRETER - Establish need during patients first contact - When is a trained medical interpreter needed? o Sensitive topics such as end of life care o Permission for consent to treat o Admission assessment o Complex treatments Performing clinical trails The Cochrane Database MEDLINE Relies on research finding and high grade scientific support IMPORTANT TO NOT BASE YOUR PLAN OF CARE BASED ON YOUR PERSONAL EXPERIENCE BUT INSTEAD ON MEDICAL UP TO DATE DECISIONS. o Patient education o Informed consent o Discharge planning - Interpreter may check in with patients daily o Have list of questions and areas for patient teaching