NUR322

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NUR322

• Welcome to Holistic
• Health assessment for Registered Nurses
• Carole J. Howe, RN, PhD

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• The greatest disease in the West today is not
  TB or leprosy it is being unwanted, unloved, and
  uncared for. We can cure physical diseases with
  medicine, but the only cure for loneliness,
  despair, and hopelessness is love.
• Mother Teresa (1995). The Simple Path

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Objectives

• Health Assessment
• Holism
• Nursing Process
• Health Promotion
• Functional Health Patterns

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Health Assessment

• Process of systematically collecting and
  analyzing data to make judgments about health and
  life processes of individuals, families, and
  communities.
• Fuller Schaller-Ayers (2000)

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Health Assessment

• A systematic, dynamic process by which the
  nurse, through interaction with the client,
  significant others, and health care providers,
  collects and analyzes data about the client.

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Health Assessment cont.

• To determine
• Care treatment needs
• Overall health status
• Health promoting factors
• Health risk factors

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Data include

• Physical
• Social
• Cultural
• Environmental
• Emotional factors that impact the overall
  wellbeing of the client

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Health Status

• Wellness behavior
• Illness signs symptoms
• Client strengths weaknesses
• Risk factors

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• Wellness behavior
• Illness signs symptoms
• Client strengths weaknesses
• Risk factors

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Holistic

• More than the physical status of the person
• All factors that impact persons physical
  emotional well-being
• Understanding of life as a unified, continuous
  interrelated event as the context of human
  health
• Holistic nurse is an instrument of healing and a
  facilitator in the healing process who integrates
  self-care, self-responsibility, spirituality and
  reflection in his or her own life (Bright, 2002)

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Functional Health Patterns

• Framework for
• Data collection (assessment)
• Data base organization
• Gordon (1987)

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Purpose of FHP

• Allow for an approach to data collection and
  analysis that is
• Systematic
• Standardized

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Nursing Process(Scientific Approach)

• Assessment
• Nursing Diagnosis
• Planning
• Implementation
• Evaluation

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Assessment

• Data collection
• Documentation
• Diagnostic Reasoning

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The nurse makes

• Observations
• Inferences
• Judgments
• Diagnostic or clinical reasoning

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Data Collection

• Interview
• Physical Examination
• Review of Records

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Data

• Subjective
• eg., I have a headache every day.
• Objective
• eg.,Total Cholesterol 190 mg/dl

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• Objective Data

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Scope of Assessment

• Comprehensive
• Focused
• Follow-up
• Emergency
• Episodic

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Comprehensive or Focused

• How do I decide which type of data collection to
  do?

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Answer

• Determined by the individuals immediate
  condition

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Nursing Diagnosis

• The human responses to actual or potential health
  problems that nurses are qualified to manage
  (NANDA).

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Documentation

• Avoid inferences/judgments/objectives
• Record findings/comprehensive
• Record individuals perceptions
• Concise/efficient/accurate
• Record relevant details/relevant negatives
• Describe normal findings
• Organize in a logical fashion
• Use correct grammar

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Health Promotion

• Those actions used to increase health or
  well-being and the improvement of the health of
  individuals, families and communities.
• Prevention of Disease
• Primary Prevention

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Health Promotion

• Those actions used to increase health or
  well-being and the improvement of the health of
  individuals, families and communities.
• Prevention of Disease
• Primary Prevention

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Perspectives

• Determined by
• risk factors
• physical fitness
• nutrition
• health behaviors
• life style

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Explaining Health Behavior

• My mother had breast cancer, so I always do BSE
• I could die from cancer
• If I brush my teeth I wont get cavities
• No way am I going to have a colonoscopy!
  Rosenstock (1974)

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cont.

• If I go to a stress management group, I might do
  better on my exams
• I just dont have time to attend a stress
  reduction group
• Sure I can manage an hour a day for exercise.
• I feel so much better after I work out.
• I have some friends who go to the gym with me

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cont.

• I always wear gloves when I examine the mouth.
• I have already called the counseling center to
  talk about a stress reduction group.
• I know I have to study for the exam, but I will
  work out first so I can think better.
• Pender (2002)

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Healthy People 2010Leading Health Indicators

• Physical activity
• Substance abuse
• Responsible sexual behavior
• Mental health
• Injury and violence
• Environmental quality
• Immunization
• Access to health care

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Tobacco Use
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Obesity