HEALTH ASSESSMENT HESI V.2

HEALTH ASSESSMENT HESI V.2 1. Low BMI • Body mass index (BMI) is a practical marker of optimal healthy weight for height and an indicator of obesity or malnutrition. Evidence supports the use of BMI in obesity risk assessment because it provides a more accurate measure of total body fat compared with the measure of body weight alone. • A healthy BMI is a level of 19 or greater to less than 25. • 18.5 Underweight • 18.5 – 24.9 Normal weight • 25 – 29.9 Overweight • 30 – 39.9 Obesity • 40 Extreme Obesity 2. History taking document 3. History taking geriatrics • Allow for more time 4. Ataxia Asses • Ataxia—Uncoordinated or unsteady gait • A positive Romberg sign occurs with cerebellar ataxia (multiple sclerosis, alcohol intoxication), loss of proprioception, and loss of vestibular function. • Cerebellar Ataxia: Staggering, wide-based gait; difficulty with turns; uncoordinated movement with positive Romberg sign. Alcohol or barbiturate effect on cerebellum; cerebellar tumor; multiple sclerosis 5. Melena • Black stools may be tarry due to occult blood (melena) from GI bleeding or non-tarry from iron medications. • Black tarry stool with distinct malodor indicates upper GI bleeding with blood partially digested. (Must lose more than 50 mL from upper GI tract to be considered melena.) 6. Rectal Findings • The rectal temperature measures 0.4° to 0.5° C (0.7° to 1° F) higher. • Rectal temperatures are the most accurate route, and the result is as close to core temperature as possible without using more invasive measures reserved for the operating room and critical care environments. • Although the rectal temperature provides the closest approximation to core temperature, it is more invasive than other measures; therefore you must weigh the risks and benefits. • In children the temporal artery route misses fever in as many as 30% of children 6 to 36 months old; therefore it may be advantageous to use rectal temperature in children with a suspected fever or infection. • The rectal temperature is the preferred route when the other routes are not practical (e.g., for the comatose or confused person; people in shock; or those who cannot close the mouth because of breathing or oxygen tubes, wired mandible, or other facial dysfunction).