NSE 13A/B Final: NSE13WinterExamReview
16 Dec 2016
School
Department
Course
Professor
NSE 13 : Health Assessment- Winter Exam Review
Week 1: Relational practice and cultural considerations
1. Describe expectations of students related to professional behaviour
● Be respectful
● Ask for help when needed, know your limitations
2. Describe the assessment phase of the nursing process and its relation to setting priorities and
diagnostic reasoning in clinical judgement and critical thinking
Assessment
● Point of entry in an ongoing process
● Assessment takes 2-3 years to develop competency
● Collect data, use evidence based assessment, document relevant data
Setting priorities
● First level
○ Emergencies, life threatening, immediate action required
● Second level
○ Prompt intervention to prevent further deterioration
● Third level
○ Important to health but can be treated after more urgent ones are assessed
Diagnostic reasoning
● Process of analyzing health data and drawing conclusions to identify a diagnosis
○ Attend to initial available cues
○ Formulating diagnostic hypotheses
○ Gathering data relative to tentative hypothesis
○ Evaluating each hypothesis to get the final diagnosis
Critical Thinking
● Dynamic process using clinical practice to make informed choices
3. Describe relational practice and how they relate to health assessment
Relational practice
● Accounts for health, illness and the meaning they hold for each person
● People’s meanings depend many factors such as on social, cultural, family, historical etc
● Nurses are to focus on what is significant to people in the context of their everyday lives and how
capacities and socienvironmental limitations shape people’s choices
● Central skills include:
○ Reflectivity: a process of continually examining how you view and respond to patients on
the basis of your own assumptions, cultural and social orientation etc
4. Describe subjective and objective data and identify the association between the two
● Subjective data:
○ What the person says about themselves
● Objective data:
○ What you observe by inspecting, percussing, palpating, and auscultating
5. Identify the association between assessment and evidence-informed practice
Evidence informed Assessment
● All patients must be treated with the most current best practice techniques
● Assessment is the collection of data about an individual
Evidence informed practice
● EIP
● Is increasingly used to include more of a view of what counts as evidence
● Is a systematic approach to practice that focuses on the use of best evidence in combination with
clinicians experience and assessment skills.
6. Describe the expanding concept of health and health promotion
Concepts of health
● Biomedical model
○ Health is the absence of disease
○ Focuses on diagnosis and treatment of those pathogens and curing the disease
● Behavioural model
○ Health care extends beyond treating diseases to include secondary and primary
preventions with emphasis on changing behaviour and lifestyle
● Socio-environmental model
○ Incorporates sociological and environmental aspects in addition to the biomedical and
behavioural ones
○ Social determinants of health
■ Social
■ Economics
■ Political conditions etc
7. Describe the four types of databases and frequency of assessment
1. Complete (total health) data base:
a. Full physical
b. Current and past health to form base line
c. Yields first diagnosis
d. Coping patterns and daily living, health goals
2. Episodic data base
a. Short term problem
b. Concerned with one main problem
c. Used in all settings
3. Follow up data base
a. Status of identified problem should be evaluated regularly in intervals
b. Used in all settings
4. Emergency data base
a. Rapid collection of data while life saving measures are occurring
Frequency of exams
● Varies on the person
● Immunizations
● Periodic health examinations
○ Designed to prevent morbidity by identifying modifiable risk factors and early signs of
treatable conditions
8. Explore values and beliefs that underpin Client Centred Care as they relate to creating an
inclusive learning environment.
Client centered care
● Clients goals coordinate care of the health care team; continuity and consistency of care and
caregiver, timeliness; responsiveness and universal access to care- RNAO quote
● Respect
● Human dignity
● Experts for own lives
9. Describe the central concepts of cultural and social considerations
● Complex dimension of people’s lives
● Values, beliefs, customs
● Need to avoid stereotypes
● Critical cultural perspective
○ Culture is a relational aspect of people’s lives
○ It shifts and changes
● Culturalism
○ Acting in a certain way due to their culture
○ We can not assume anything
10. Describe how awareness of your own culture will affect patient care
● Remain critically reflective about how you may be conveying your own culture and how it may
affect the client
● The more you know about yourself the more objective you can be and set your own biases aside
11. Discuss demographic profile of Canada and enthnocultural diversity of the Canadian
population
● 70% immigrants have a native language
● We are an aging population
● Very divers
● Some people can’t communicate in our
national languages
● Immigrants
○ Very diverse patients & qualifying for health care takes time
● Aboriginals
○ Receive little health care benefits
○ Lots of inequalities
Document Summary
Nse 13 : health assessment- winter exam review. Week 1: relational practice and cultural considerations: describe expectations of students related to professional behaviour. Ask for help when needed, know your limitations: describe the assessment phase of the nursing process and its relation to setting priorities and diagnostic reasoning in clinical judgement and critical thinking. Point of entry in an ongoing process. Assessment takes 2-3 years to develop competency. Collect data, use evidence based assessment, document relevant data. Important to health but can be treated after more urgent ones are assessed. Process of analyzing health data and drawing conclusions to identify a diagnosis. Evaluating each hypothesis to get the final diagnosis. Dynamic process using clinical practice to make informed choices: describe relational practice and how they relate to health assessment. Accounts for health, illness and the meaning they hold for each person. People"s meanings depend many factors such as on social, cultural, family, historical etc.
