Health Assessment Exam 1 Flashcards

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Questions and Answers

What are the most common non-English languages spoken at home?

Italian

French (correct)

Tagalog (correct)

Spanish (correct)

What is cultural care?

Culturally sensitive, appropriate, and competent health care.

What is heritage consistency?

The degree to which a person's lifestyle reflects his or her traditional heritage.

Culture has four characteristics: it is ___, _, _, and ___

learned, shared, adapted, dynamic Signup and view all the answers

What does ethnicity pertain to?

Membership in a social group with a common geographic origin, migratory status, religion, race, language, and shared values. Signup and view all the answers

What is religion?

Belief in a divine or superhuman power to be obeyed and worshipped. Signup and view all the answers

Define spirituality.

A personal effort to find meaning and purpose in life. Signup and view all the answers

What is socialization?

The process of being raised within a culture and acquiring its characteristics. Signup and view all the answers

Cultural conflicts between nurses and patients arise from different perceptions.

True Signup and view all the answers

In evaluating health histories, which belief system must be understood first?

The logic of traditional belief systems Signup and view all the answers

Which of the following theories has been expanded to study lifestyle reflection of traditional heritage?

Heritage consistency Signup and view all the answers

Which symptom is greatly influenced by a person's cultural heritage?

Pain Signup and view all the answers

Which of the following areas must nurses understand for cultural competence? (Select all that apply)

The heritage of the health care system Signup and view all the answers

What is empathy?

Viewing the world from another person's perspective while remaining oneself. Signup and view all the answers

What is a health interview?

A structured interaction between a nurse and a patient. Signup and view all the answers

What type of communication involves exchanging information?

Communication Signup and view all the answers

What are the three internal factors that promote good communication?

Liking others, expressing empathy, and having the ability to listen. Signup and view all the answers

The interview has three phases: introduction, _____ phase, and closing phase.

working Signup and view all the answers

What occurs during the working phase of an interview?

Gathering data through open-ended and closed questions. Signup and view all the answers

What should a nurse do during the closing phase of an interview?

Signal that the interview is ending and summarize what was learned. Signup and view all the answers

What are the different types of verbal responses used to assist the narrative in an interview?

Types of verbal responses Signup and view all the answers

What does facilitation in communication refer to?

Responses that encourage the patient to say more. Signup and view all the answers

What is the primary focus during silence in an interview?

Allowing patients time to think and organize their thoughts. Signup and view all the answers

The _____ of interviewing refers to nonproductive verbal messages.

10 traps Signup and view all the answers

Which nonverbal modes of communication are included?

Facial expressions Signup and view all the answers

What should be modified based on each patient's developmental stage?

Communication techniques Signup and view all the answers

What is important when communicating with patients who have special needs?

Using effective communication techniques tailored to their needs. Signup and view all the answers

For a patient with _____ English proficiency, use a bilingual team member.

limited Signup and view all the answers

What reaction should be modified when a patient comes from a different culture?

The communication approach. Signup and view all the answers

Which of the following statements represents an appropriate response from an interviewer?

Tell me what you mean by 'bad blood'. Signup and view all the answers

Nonverbal communication is primarily used with which group of individuals?

Infants Signup and view all the answers

What is the use of euphemisms to avoid reality known as?

Avoidance language Signup and view all the answers

The use of _____ is recommended when dealing with a patient who is culturally different.

cultural sensitivity Signup and view all the answers

When can a child begin to be interviewed directly about symptoms?

7 years Signup and view all the answers

What is an example of an open-ended question?

Tell me about your pain. Signup and view all the answers

What is assessment?

Assessment is the collection of subjective and objective data about a patient's health. Signup and view all the answers

What does subjective data consist of?

Information provided by the affected individual. Signup and view all the answers

What does objective data include?

Information obtained by the health care provider through physical assessment, the patient's record, and laboratory studies. Signup and view all the answers

What is the database in health assessment?

The totality of information available about the patient. Signup and view all the answers

What is diagnostic reasoning?

The process of analyzing health data and drawing conclusions to identify diagnoses. Signup and view all the answers

What are the four major components of diagnostic reasoning?

<ol> <li>Attending to initially available cues, 2) Formulating diagnostic hypotheses, 3) Gathering data relative to tentative hypotheses, 4) Evaluating each hypothesis with the new data collected.</li> </ol> Signup and view all the answers

What are the six phases of the nursing process?

<ol> <li>Assessment, 2) Diagnosis, 3) Outcome identification, 4) Planning, 5) Implementation, 6) Evaluation.</li> </ol> Signup and view all the answers

What characterizes the novice nurse?

The novice nurse has no experience with specific patient populations and uses rules to guide performance. Signup and view all the answers

What characterizes the experienced nurse?

The experienced nurse understands a patient situation as a whole and acts without consciously labeling it. Signup and view all the answers

What is critical thinking?

The multidimensional thinking process needed for sound diagnostic reasoning and clinical judgment. Signup and view all the answers

What are first-level priority problems?

Emergent, life-threatening, and immediate problems. Signup and view all the answers

What are second-level priority problems?

Next in urgency, requiring prompt intervention to prevent deterioration. Signup and view all the answers

What are third-level priority problems?

Important to the patient's health, but can be addressed after more urgent problems. Signup and view all the answers

What is evidence-based practice?

A systematic approach to practice that uses the best evidence, clinician's experience, and patient's preferences. Signup and view all the answers

What are the four kinds of databases necessary for examiners?

<ol> <li>Complete database, 2) Focused database, 3) Follow-up database, 4) Emergency database.</li> </ol> Signup and view all the answers

What does the biomedical model of Western medicine focus on?

Health as the absence of disease. Signup and view all the answers

What does the holistic health model assess?

The whole person, including mind, body, spirit, and environment. Signup and view all the answers

What should health assessment consider?

Developmental tasks for each age group and cultural beliefs and practices. Signup and view all the answers

According to the biomedical model, a narrow definition of health is?

The absence of disease. Signup and view all the answers

What type of database is most appropriate when a rapid collection of data is required?

Emergency Signup and view all the answers

A medical diagnosis is used to evaluate:

The cause of disease. Signup and view all the answers

An example of subjective data is:

Left knee has been swollen and hot for the past 3 days. Signup and view all the answers

What type of database is most appropriate for an individual admitted to a long-term care facility?

Complete Signup and view all the answers

Which of the following is considered an example of objective data?

Alert and oriented. Signup and view all the answers

What is an example of objective data?

Crepitation in the left knee joint. Signup and view all the answers

A nursing diagnosis is best described as:

A concise statement of actual or potential health concerns. Signup and view all the answers

What is a complete database?

Used to perform a thorough health history and physical examination. Signup and view all the answers

Which problem is a first-level priority for a patient with asthma?

Impaired gas exchange. Signup and view all the answers

In the United States, about how many people are immigrants?

One in eight people are immigrants. Signup and view all the answers

How many residents belong to a group other than single-race, non-Hispanic White?

One in every three residents. Signup and view all the answers

Of the emerging majority in the US, who is the largest population?

Hispanics. Signup and view all the answers

What is the second largest population followed by several others?

Asians, followed by Blacks, American Indians, Alaska Natives, Native Hawaiians, and other Pacific Islanders. Signup and view all the answers

What challenges do many new immigrants face regarding health care?

Little understanding of the modern health care system and limited English proficiency. Signup and view all the answers

What do the National Standards for Culturally and Linguistically Appropriate Services in Health Care state?

Health care organizations should ensure effective, understandable, and respectful care in a manner compatible with cultural health beliefs and preferred language. Signup and view all the answers

When people with limited English proficiency seek health care, services can be denied to them.

False Signup and view all the answers

Study Notes

Health Assessment Key Concepts

Assessment: Collection of both subjective and objective data regarding a patient's health status.
Subjective Data: Information shared by the individual, reflecting their personal experiences and perceptions.
Objective Data: Information gathered by healthcare providers through direct observation, physical examinations, and lab results.
Database: Comprehensive collection of all available information about a patient, essential for making informed clinical judgments and diagnoses.
Diagnostic Reasoning: Process involving the analysis of health data, leading to the identification of medical diagnoses. Key components include:
- Attending to initial cues and data
- Formulating diagnostic hypotheses
- Gathering additional data
- Evaluating hypotheses with new data for a final diagnosis
Nursing Process: Dynamic framework consisting of six phases:
- Assessment
- Diagnosis
- Outcome identification
- Planning
- Implementation
- Evaluation
Novice Nurse vs. Experienced Nurse:
- Novice nurse relies on rules and lacks specific patient experience.
- Experienced nurse comprehensively understands patient situations, noting patterns and acting intuitively.
Critical Thinking: Essential for effective diagnostic reasoning and clinical judgment, encompasses seventeen identified skills, including priority setting.

Priority Problems in Nursing

First-level Priority Problems: Emergencies requiring immediate attention (e.g., airway obstruction, breathing difficulties).
Second-level Priority Problems: Urgent issues needing prompt intervention to prevent worsening, such as mental status changes or severe pain.
Third-level Priority Problems: Non-emergent issues significant to health, can be managed after higher priority problems (e.g., knowledge deficits, family coping strategies).

Health Care Models

Biomedical Model: Views health strictly as the absence of disease, focusing on biophysical signs and the treatment of illnesses.
Holistic Health Model: Examines the whole person, emphasizing the interdependence of mind, body, spirit, and environment, recognizing their collective role in health.

Cultural Considerations in Health Assessment

Health assessments incorporate the usual developmental tasks by age group and consider cultural beliefs and practices to ensure culturally sensitive care.
Diversity in the U.S.:
- Approximately one in eight people are immigrants.
- One in three residents are part of a group other than single-race, non-Hispanic White.
- The largest demographic among minorities is Hispanic, followed by Asians, Blacks, and other groups.
Language Barriers: Many immigrants may have limited understanding of the healthcare system and little proficiency in English, necessitating tailored communication strategies.
Culturally and Linguistically Appropriate Services (CLAS): Standards promoting effective patient care that aligns with their cultural health beliefs and preferred languages.

Definitions and Characteristics

Cultural Care: Health care that is sensitive and appropriate to cultural backgrounds; involves understanding one's own heritage and that of the patient.
Heritage Consistency: Reflects how an individual’s lifestyle aligns with their traditional cultural values.
Characteristics of Culture:
- Learned: Acquired from birth through language and socialization.
- Shared: Common among group members.
- Adapted: Evolved based on environmental and technological contexts.
- Dynamic: Continually changing and evolving.
Ethnicity: Identification with a social group based on common geographic origin, language, cultural values, and traditions.
Religion: Acknowledgment of divine powers worshipped as creators or rulers of the universe.
Spirituality: Personal exploration for meaning and purpose in life influenced by individual experiences.### Spirituality and Illness
Spirituality can help individuals find meaning and purpose during illnesses.

Socialization

Defined as the process of being raised within a culture and acquiring group characteristics.
Education serves as a form of socialization.

Assessing Heritage

Assess factors related to heritage to understand cultural beliefs and practices impacting patient care.

Understanding Values

Recognize both culturally dominant values and personal values to grasp the role they play in individuals' lives.

Cultural Conflicts

Conflicts may arise due to varying perceptions of time and relationships between nurses and patients from diverse backgrounds.
Some cultures emphasize influence of the past on current health practices.

Embracing Differences

In multicultural societies, acknowledge and respect the significance of diverse cultural practices for patients.

Cultural Definitions of Health

Culture shapes the understanding of health and illness, defining perceived causes and symptoms as biomedical, naturalistic, or magicoreligious.
Patients may turn to both biomedical professionals and traditional healers.

Religion and Health Perception

Religion and spirituality provide comfort during illness and influence perceptions and practices regarding health.

Influence of Religious Beliefs

Religious beliefs can affect a person's understanding of illness causes, perceived severity, and choice of healers.

Individual Responses to Stimuli

Each person reacts differently to stimuli, despite cultural backgrounds.
Avoid stereotyping individuals and understand culture-bound syndromes.

Folk Healers

Each culture has its own healers, often speaking the native language, providing home visits, and offering affordable services.
Traditional practices led by folk healers tend to be harmless.

Hot/Cold Theory of Health

Patients subscribing to this theory believe wellness is achieved through balancing the body's humors.

Cultural Practice Evaluation

Nurses must comprehend the logic of traditional belief systems before assessing whether practices are helpful, harmful, or neutral.

Population Median Age

Non-Hispanic whites have a higher median age compared to Hispanics and minorities, who tend to be younger.

Spirituality Definition

Spirituality is a personal quest to find meaning and purpose in life.

Language Barriers and Healthcare

Laws exist ensuring access to healthcare for individuals with limited English proficiency, as mandated by the Civil Rights Act of 1964.

Yin/Yang Theory of Health

Health is identified by the balance of all aspects of a person.

Heritage Consistency Theory

This theory studies how lifestyles reflect an individual's traditional heritage.

Pain and Cultural Heritage

Pain perception is heavily influenced by cultural background, making it a subjective experience.

Cultural Competence in Nursing

Knowledge areas for cultural competence include understanding one's own heritage, patient heritage, and healthcare system heritage.

Empathy in Healthcare

Empathy involves understanding another's perspective while maintaining one's own identity.

Health Interview Structure

A health interview consists of three phases: introduction, working phase, and closing.

Interview Phases and Techniques

The introduction phase requires establishing the interview context.
The working phase focuses on data gathering through open-ended and closed questions.
The closing phase provides a chance to summarize and check for remaining patient concerns.

Nonverbal Communication

Nonverbal cues include physical appearance, posture, and gestures, which convey messages and aid in understanding.

Approaching Patients with Special Needs

Adjust communication techniques for diverse developmental stages and conditions, ensuring clarity and understanding.

Cultural Sensitivity

Adapt health communication strategies for patients from different cultural backgrounds, acknowledging cultural interpretations of behaviors.

Use of Interpreters

Employ trained medical interpreters for patients with limited English proficiency to uphold confidentiality and comprehension.

Facilitation Techniques

Facilitation encourages patients to share more about their experiences through attentive listening and supportive gestures.

Importance of Silence

Allowing moments of silence after open-ended questions gives patients space to reflect and articulate their thoughts.

Reflection and Clarification

Reflection reiterates patients’ statements for validation, while clarification seeks understanding of ambiguous information.

Confrontation in Communication

Confrontation involves expressing personal thoughts and feelings based on the patient's responses but should be used judiciously.### Communication Techniques in Patient Interaction
Confrontation focuses on observable actions, feelings, or statements, providing honest feedback to direct attention.
Interpretation links events and implies cause; it aids patients in understanding their feelings in relation to verbal messages.
Explanation serves to convey factual information and rationale, ensuring clarity in instructions or reasons for medical procedures.

Interview Setting Preparation

Optimal interview conditions include comfortable room temperature, reduced noise, and maintaining an appropriate distance of 4 to 5 feet between the interviewer and patient.
Standing next to a patient may convey haste or superiority; comfortable seating is preferred.

Engaging with Children During Interviews

Interviewers should begin asking children about symptoms around age 7, as they can contribute valuable information.
Parents or caregivers should be included but asking the child directly is essential when presenting symptoms exist.

Appropriate Communication Responses

Avoid false reassurance, unsolicited advice, and "why" questions as they hinder communication; instead, encourage further clarification.
Asking open-ended questions fosters enhanced dialogue and understanding of patient concerns.

Understanding Patient Dynamics

A nurse's interpretation of a patient's discomfort with the physician may facilitate better understanding of the patient’s feelings and concerns.
Communication barriers often arise when patients feel intimidated by authority figures in healthcare settings.

Language Use in Communication

Avoidance language refers to euphemisms that obscure reality or feelings; direct language is preferred for discussing sensitive topics.
Effective communication with toddlers involves simple, concrete sentences; older children and adults require more detailed explanations.

Nonverbal Communication and Empathy

Infants primarily rely on nonverbal communication, while older age groups may engage in more complex verbal exchanges.
Empathy entails understanding another's perspective, which is essential for building rapport and trust during patient interactions.

Questioning Techniques

Open-ended questions, such as "Tell me about your pain," encourage patients to provide comprehensive responses, enhancing information gathering.
Closed-ended questions limit responses and should be used sparingly to ensure thorough understanding of the patient's condition.

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Test your knowledge with these flashcards focused on key terms in Health Assessment. Each card includes definitions for important concepts like assessment, subjective data, and objective data essential for understanding patient health. Perfect for exam preparation and review.