Advanced Health Assessment for Nurse Educators

May use as references

Bates’ Guide to Physical Examination and History Taking

Bickley, L. (2017). Bates’ guide to physical examination and history-taking (12th ed.). Philadelphia, PA: Wolters Kluwer. ISBN-13: 9781469893419

1.Discuss how a nurse approaches a focused assessment versus a complete assessment. Are there differences regarding charting? Defend your rationale with references (APA format)Advanced Health Assessment for Nurse Educators.

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Include 2 references

What are the differences in the assessment portion of a focused versus a complete assessment? Defend your rationale with references (APA format).
Include 2 references

You are obtaining a health assessment on a patient and you ask them about their spiritual needs. The patient states that he does not want to answer any questions like that because they are private. How would you respond? Defend your rationale with references (APA format).
Include 2 references

You are teaching a course on health assessment and one of the nursing students states, after you mention performing a spiritual assessment, that he or she does not believe in God and will not ask anyone about “any of that stuff.” How do you respond? Defend your rationale with references (APA format).
Include 2 references

One of your coworkers does not understand what the interdisciplinary team means. How do you explain it to him or her? Defend your rationale with references (APA format).
Include 2 references

6.You are the educator on a medical/surgical unit and you notice that one of the patients would benefit from a consult by an occupational physical therapist. The provider doesn’t think she needs anything like that. He states that she can get everything she needs from his office. What do you say? Defend your answer with references (APA format).

Include 2 references

Your neighbor has taken an online health risk assessment tool for breast cancer and tells you that the results show she is at risk for breast cancer. She knows you are a nurse and wants a referral for a mastectomy. What do you say to her? Defend your rationale with references (APA format).
Include 2 references

Your brother-in-law was told by his provider that he is at risk for cardiovascular disease. He does not believe it. He said the doctor was a fool and will not change any of his eating or exercising habits. What would you say to him? Defend your rationale with references (APA format).
Include 2 references

Discuss how a nurse approaches a focused assessment versus a complete assessment. Are there differences regarding charting?
Assessment is a nursing practice component that facilitates care planning and provision. In this case, a focused assessment entails the nursing personnel conducting a detailed examination of the body system with a view to evaluating the patient’s current health concerns or the presenting problem to imply that it would only check one or a few related body systems. This implies that charting for focused assessment would only include information on the specific systems that were assessed. On the other hand, a complete assessment is a comprehensive examination that evaluates all aspects of the patient’s health to include vital signs, physical examination, general appearance, and medical history. This implies that it includes all body systems so that the charting would be complete for all the patient’s current medical state along with the presentation of all the body systems (Thomas, 2017)Advanced Health Assessment for Nurse Educators .

What are the differences in the assessment portion of a focused versus a complete assessment?
The complete assessment begins with the nurse taking down the patient’s history to include history of the current health problem, relevant history, reactions and allergies, medication, vaccination status, implants, and family history. This is followed by the general exam that checks the behavioral, emotional and physical status that includes movement, posture, calmness, agitation, lethargy, and paleness. Next is the vital signs check to reviews pain measures, oxygen saturation, blood pressure, heart rate, respiratory rate, and temperature. Finally is the physical exam that uses auscultation, percussion, palpitation, and observation to collect clinical information on disability, circulation, breathing, and airway. In contrast, focused assessment only conducts examination on selected body systems that include ear, nose and throat system, eye system, head and neck system, skin system, musculoskeletal system, renal systems, abdomen and gastrointestinal system, cardiovascular system, respiratory system, and neurological system (Thomas, 2017).

You are obtaining a health assessment on a patient and you ask them about their spiritual needs. The patient states that he does not want to answer any questions like that because they are private. How would you respond?
The first step is to assure the patient that whatever information is provided during the assessment will be kept confidential and only used for treatment planning purposes. The assurance should include an acknowledgement that nurses are ethical bound to keep patient information confidential. Additionally, it would be prudent to mention that HIPAA legislation demands that medical personal should provide data privacy and security to safeguard the information. The security step is to explain to the patient why the information on spiritual needs is necessary even it might appear not to have a bearing on health. In this case, the patient would be informed that the information on spiritual needs facilitates health planning. For that matter, it would allow for the treatment plan to be in compliance with the patient’s spiritual beliefs (Jarvis, 2015). For instance, the Catholic faith advocates against permanent sterilization so that vasectomy or tubal ligation would not be selected as a treatment option for a Catholic patient.

You are teaching a course on health assessment and one of the nursing student’s states, after you mention performing a spiritual assessment, that he or she does not believe in God and will not ask anyone about “any of that stuff.” How do you respond?
An appropriate response is that when conducting a nursing assessment and offering medical care, the focus should be on the patient and not the nurse. This means that it should the patient’s needs. Although the nurse does not believe in God that does not imply that the patient does not similarly believe in God. Given that the nurse has the mandate of offering the patient the best possible care, then it stands to reason that the nurse would objectively evaluate all the patient’s needs that would impact care (Jarvis, 2015). For instance, if the nurse is contemplating subjecting the patient to an abortion as a treatment option but the patient’s faith does not allow for abortions, then the spiritual assessment would identify the treatment-spirituality conflict so that other acceptable treatment options are considered.

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One of your coworkers does not understand what the interdisciplinary team means. How do you explain it to him or her?
An interdisciplinary team refers to a group of medical personnel with different professional backgrounds who coordinate health care delivery efforts to achieve a common objective. In this case, they share their complementary skills, knowledge and expertise to determine the most efficient and effective way to meet the patients’ care needs (Nancarrow et al., 2013). A well constituted interdisciplinary team is characterized by an effective working ability that imbues them with the capacity to increase productivity and reduce costs. In fact, any successful interdisciplinary team will be comprised of health professional who understand their roles and those of their companions within the team. In this respect, a collaborative working environment presented by an interdisciplinary team allows for the effective development of new concepts and ideas, equitable division of work responsibilities, and concurrence on the strategic plans to be implemented (Palaveev, 2012).

To create a successful interdisciplinary team, there are conditions that must be met. Firstly, forming the right team comprised of different individuals with divergent professions. Having a good team will require an individual who can work well with others, understand the need for compromise, and are flexible in their work strategies. Secondly, the team must be provided with appropriate direction that trickles from the top management to the lower management levels. This requires the designation of a team manager who presents the other team members with comprehensive instructions concerning the care goals that are to be met in a specified timeline, and how they will be measured for completion (Palaveev, 2012). Thirdly, the team must have an accountability system that holds each team member individually responsible for the group’s results to include internal checks and balances system to ensure that each member of the team performs optimally, pulling their weight to contribute equitably to the workload. Finally, the team should support its members. Just as the members of each team should be accountable to each other for outcomes in performance, the team should support each member to improve productivity. This would allow each team member to be assigned tasks that they are best suited for, thereby leading to a team dynamic that search each member using his or her talents and strengths to better the team productivity and reduce costs (Palaveev, 2012) Advanced Health Assessment for Nurse Educators.

You are the educator on a medical/surgical unit and you notice that one of the patients would benefit from a consult by an occupational physical therapist. The provider doesn’t think she needs anything like that. He states that she can get everything she needs from his office. What do you say?
As an educator, I am professionally bound to offer my honest opinion to the patient. Still, it is important that any information provided to the patient is justified and does not conflict with opinion offered by the rest of the care team. In the present case, it would be prudent to convince the provider that the patient requires a consultation with an occupational physical therapist to improve care outcomes. For that matter, I would collect tangible evidence to support this opinion and present that evidence to the provider. Once I have convinced the provider, then the next step is to inform the patient about the need for the consult (Lundy & Janes, 2016). Should the provider not be convinced an educator is necessary, then I would note the objection but still go ahead to inform the patient about the benefits from having a consult. In essence, irrespective of the situation, an educator is expected to adopt a proactive role in patient education by leveraging the extensive contact to improve outcomes thereby implying that the patient would be informed of the consult benefits regardless of provider objections. It is important to note that although it would be imprudent to duplicate duties (by informing the patient about the benefits of the consult when the provider would be providing the same information), the educator has the primary responsibility of providing this information and should do so without regard that the provider would provide the same information (Joel, 2013). In this respect, the situation requires that the educator proceed with his/her professional responsibilities of informing the patient of the benefits of the consult.

Your neighbor has taken an online health risk assessment tool for breast cancer and tells you that the results show she is at risk for breast cancer. She knows you are a nurse and wants a referral for a mastectomy. What do you say to her?
I would inform the neighbor that although the online test diagnosed her with breast cancer, additional information is necessary that would entail her visiting a medical facility that offers cancer care services. The visit to a care facility would service four principle functions. Firstly, it would confirm the diagnosis through a range of highly sensitive tests that include a physical and serology examinations, as well as imaging that were not conducted by the online test. These sensitive tests present a more accurate diagnosis while eliminating other comparative conditions that would present similar signs and symptoms. Secondly, visiting a care facility would psychologically prepare the patient for the diagnosis. This includes counselling on how to proceed in case of a negative or positive diagnosis. In addition, the psychological preparation offers the patient information on the available resources and how to access them. These resources include support systems, financial series, and emergency contacts (Benotti, 2014). Besides that, the counselling offers the patient hope that the cancer can be managed. In addition, it would inform the patient about the disease pathophysiological process, clinical manifestation, and complications. In the case of a negative diagnosis, the counseling session would inform the patient about the disease etiology and risk factors to facilitate prevention efforts. Thirdly, visiting the facility presents a prognosis that stages the cancer and its progression so that the patient knows whether it is at the early or late stages. Finally, visiting the facility allows the patient to be involved in the development of a treatment plan that discusses options as well as implications. This means that it allows the patient to be involved in decision making to consider value and economic implications, such as choosing between mastectomy and chemotherapy as the treatment (Nestel & Bearman, 2014). In this respect, the patient should visit a care facility to confirm the diagnosis and get more information before making a decision on how to proceed with care.

Your brother-in-law was told by his provider that he is at risk for cardiovascular disease. He does not believe it. He said the doctor was a fool and will not change any of his eating or exercising habits. What would you say to him?
For a patient who receives medical advice, but feels that the advice is irrelevant, the first step should be to confirm the advice. This would entail other doctors who would provide their own prognosis to include a review of his physical condition and diets. Next, he should access literature on cardiovascular diseases, particular those talking about causes and prevention. This two steps would constitute the professional medical knowledge (Weber & Kelley, 2013). The final step would entail joining support groups where persons with cardiovascular diseases congregate to discuss their condition and experiences. This step would constitute the non-professional knowledge. If none of the three steps change the patient’s opinion, then he would be advised to seek psychological help to change his opinion about medical advice. That is because if clear evidence from difference sources that present the same information fail to convince him, then it would be clear that he has a psychological problem that prevents him from accepting medical advice (Estes, 2013). As a result, the patient would be directed to confirm the doctor’s advice through other sources (other doctors, literature, and persons with cardiovascular diseases, or receive psychological care to make him more receptive of doctors’ advice Advanced Health Assessment for Nurse Educators .

References

Benotti, P. (2014). Patient preparation for bariatric surgery. New York, NY: Springer.

Estes, M. E. (2013). Health assessment and physical examination. Boston, MA: Cengage Learning.

Jarvis, C. (2015). Physical examination and health assessment. New York, NY: Elsevier.

Joel, L. A. (2013). Advanced practice nursing: essentials of role development (3rd ed.). Philadelphia, PA: F. A. Davis Company.

Lundy, K. S. & Janes, S. (eds) (2016). Community health nursing: caring for the public’s health (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Nancarrow, S., Booth, A., Arris, S., Smith, T., Enderby, P. & Roots, A. (2013). Ten principles of good interdisciplinary team work. Human Resources for Health, 11, 19. doi: 10.1186/1478-4491-11-19

Nestel, D. & Bearman, M. (2014). Simulated Patient Methodology: Theory, evidence and practice. Chichester, West Sussex: John Wiley & Sons Ltd.

Palaveev, P. (2012). The ensemble practice: a team-based approach to building a superior wealth management firm. Hoboken, NJ: John Wiley & Sons.

Thomas, M. (2017). Clinical guidelines: nursing assessment. Retrieved from https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Nursing_assessment/

Weber, J. R. & Kelley, J. H. (2013). Health assessment in nursing. Philadelphia, PA: Lippincott Williams & Wilkins Advanced Health Assessment for Nurse Educators.

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