İstinye University Overview

İstinye University

• Founded in 2015 by the 21st Century Anatolian Foundation, continuing the 25-year knowledge of the MLPCare Group.
• This group united three separate hospital brands: "Liv Hospital”, “Medical Park" and "VM Medical Park".
• Aims to be among the distinguished universities in Turkey and the world by contributing to the production of new information.
• Provides a learning and advancement environment encompassing technology and art
• Emphasizes a student-centered education approach applied in all processes.
• Aims to expand the boundaries of science through the research of faculty members
• Strives to implement scientific developments for the welfare of society
• Dedicated to providing quality and accessible healthcare services to the community.

General Survey Importance

• Begins during the interviewing and history-taking process.
• Healthcare professionals observe patients and develop initial impressions while collecting subjective data.
• This observation helps in formulating plans for collecting objective physical data.
• Vital signs serve as key indicators of a patient's physiological status and their response to the environment.

Acute Assessment Indicators

• Indicators include extreme anxiety, acute distress, pallor, cyanosis, and changes in mental status.
• Nurses should start interventions while continuing the assessment, obtaining vital signs, and requesting help.
• Rapid response team consideration is needed if irregularities are sensed or displayed.
• Call a rapid response team for:
  • Respirations less than 10 or greater than 32 breaths/min
  • Increased effort to breathe
  • Oxygen saturation less than 92%
  • Pulse less than 55 or greater than 120 beats/min
  • Systolic BP less than 100 or greater than 170
  • Temperature less than 35°C or greater than 39.5°C
  • New onset of chest pain
  • Agitation or restlessness

Objective Data Collection Equipment

• Scale
• Tape measure (for infants)
• Height bar
• Stethoscope
• Pulse oximeter
• Watch with second hand
• Thermometer

General Survey Components

• It is the first component of assessment
• Mental notes of overall behavior, physical appearance, and mobility are used.
• This information helps form a global impression of the person.

Physical Appearance Assessment

• Assess overall appearance, hygiene, dress, skin color, and body structure/development.
• Determine if the patient appears their stated age and if their face and body are symmetrical.
• Look for obvious deformities and assess if the patient looks well, ill, or in distress.
• Observe skin tones, symmetry and note any redness, pallor, or cyanosis.
• Observe for any lesions or variations in pigmentation while noting the amount, texture, quality, and distribution of hair.
• Check if physical and sexual development are consistent with stated age.
• Determine if the patient is obese and how tall they are while checking if body parts are symmetrical.
• Note any fingertips, and check for any joint abnormalities.

Behavior Assessment

• Assess the face for symmetry and note expressions during rest and speech.
• Check for symmetrical movements and if the patient maintains eye contact appropriate to culture?
• Check if the patient can state their name, location, date, month, season, and time.
• Can you tell if they are awake, alert, and oriented, and note any agitation, lethargy, or inattentiveness?
• Assess speech pattern:
  • How quick the speech is
  • If speech is clear
  • Appropriate words
  • Vocabulary and sentence structure to offer in depth clues for education
  • Assess for the fluency in language
  • Assess the need for an interpreter.

Mobility Assessment

• Note how the patient sits and stands.
• See if the patient is sitting upright, and when standing, is the body straight and aligned?
• Observe movements around the room for ambulatory patients looking for tremors/tics and body parts that do not move.
• Check assistive devices used?
• Steady and balanced gait includes:
  • Even heel-to-toe foot placement
  • Smooth movements
  • Smooth, purposeful, effortless, and symmetrical qualities

Anthropometric Measurements

• Height and weight
• Body mass index (BMI)

Vital Signs Overview

• Reflect: health status, cardiopulmonary function and overall body function.
• Establish a baseline and assess:
  • Patient's condition
  • Responses to treatment
  • Identification of problems
  • Monitor risks for alterations in health

Temperature Ranges

• Oral: 35.8°C to 37.3°C
• Axillary: 36.5°C or approximately 1°C lower than oral
• Tympanic: 37.5°C or approximately equal to oral
• Temporal: 37°C or approximately equal to oral
• Rectal: 37.5°C or approximately 1°C warmer than oral

Pulse Assessment

• Contraction of the heart causes blood to flow forward, creating a pressure wave known as a pulse.
• Normal heart rate for an adult is 60 to 100 beats/min (bpm).
• Apical pulse should be 60 to 100 beats/min and regular.

Respiration Assessment

• Respiration (breathing) supplies oxygen and eliminates carbon dioxide.
• Observe inspiration & expiration discretely and count for 30 seconds then multiply by two to obtain breaths per minute.
• Respiratory rates are 12 to 20 breaths/min and regular for adults.

Oxygen Saturation

• Oximetry is a noninvasive way to measure hemoglobin saturation of arterial blood.
• It does not replace arterial blood gases of abnormalities but indicates abnormal gas exchange.
• Typically, a finger is used to obtain a reading, and pulse oximetry is SpO2 of 95% to 100.

Blood Pressure

• It is the force of blood against the arterial walls, changing during contraction and relaxation of the heart.
• Systolic pressure is the maximum pressure against arterial walls when ventricles contract.
• Diastolic pressure is the lowest pressure when ventricles relax.

Pain Assessment

• It is the fifth vital sign
• Assess and note
  • Location
  • Duration
  • Severity
  • Quality
  • Alleviating/Aggravating Factors
• Use the numeric pain intensity scale with 10 numbers ranked from 0 (no pain) to 10 (worst possible pain) to indicate pain severity.
• The higher the number that patient selects, the more severe the pain.

Questions to Assess Pain Symptoms

• Location:
  • "Where is the pain?"
  • Ask the patient to point the the painful area.
  • If more than one area hurts, have the patient rate each separately and note which is most painful.
• Duration:
  • "When did you first become aware of the pain?"
  • "How long you had it?"
• Intensity:
  • "How much pain do you have on a 0 to 10 scale? (0 being none and 10 the worst you can imagine?"
  • "Is the pain worse or better at different times of the day?"
  • "Does current pain medication decrease the intensity?"
• Quality/Description
  • "What does your pain feel like? Describe it in your own words."
• Alleviating/Aggravating Factors
  • "What makes the pain better?"
  • "What makes it worse?"
  • "What have you used to manage it?"
  • "Does applying heat make pain better or worse?"
  • "Does a cold pack help?"
  • "Does activity increase the pain?"
  • "Does sitting make it better?"