Question d,
Physical Examination rationale for methodology
BP Blood pressure reflects the pressure that is exerted on the walls of the arteries. Varying with cardiac cycle, high with systole and low with diastole. A measurement of the pressure of the blood in the arteries. As ventricles contract you have systolic blood pressure and when the ventricles relax you have diastolic blood pressure. Expressed as a ratio of the systolic over diastolic pressure external influences like caffeine, nicotine, exercise, emotions, pain and temperature affect blood pressure as it reflects the stroke volume of the volume of blood ejected with each heartbeat. Blood pressure can vary depending on the position of the body and of the arm. (Preassessment Overview, 2003)
HR When the heart contracts a shockwave is produced pumps blood forcefully out of the ventricles into the aorta the shock wave travels along the fibres of the arteries and is commonly called the arterial or peripheral pulse. The pulse weather regular, irregular, thready or strong, gives a good overall picture of the clients health status. Several characteristics should be assessed when measuring the radial pulse rate, rhythm, amplitude, contour and elasticity of the various characteristics. amplitude can be quantified as follows 1 thready or weak 2 normal 3bounding If abnormalities are noted during assessment of the radial pulse further assessment should be performed for more information on assessing pulses and abnormal pulse findings
(Preassessment Overview, 2003)
Rr The respiratory rate is an additional clue to the clients overall health status. Respirations can be easily observed without alerting the client by watching chest movement before you have removing the s...
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(2003). Preassessment Overview. In J. Weber, & J. Kelley, Health Assessment in Nursing Second Edition (p. 85). Philadelphia: Lippincott Williams & Wilkins.
(2003). Take Vital Signs. In J. Weber, & J. Kelly, Health Assessment in Nursing Second Edition (p. 99). Philadelphia: Lippincott Williams & Wilkins.
(2003). The Client in Context Chapter Three. In J. Weber, & J. Kelley, Health Assessment in Nursing (p. 19 to 26). Philadelphia: Lippincott Williams & Wilkins.
(2008). Unit 2 Approach to the Clinical setting. In C. Jarvis, Jarvis Physical Examination & Health Assessment (p. 169). Missouri: Saunders Elsevier.
(2008). Unit 3. In C. Jarvis, Jarvis Physical Examination & Health Assessment fifth edition (p. 542 Chapter 20 Unit 3 Peripheral Vascular System and Lymphatic System). St Louis: Saunders Elsevier.
Ascertaining the adequacy of gaseous exchange is the major purpose of the respiratory assessment. The components of respiratory assessment comprises of rate, rhythm, quality of breathing, degree of effort, cough, skin colour, deformities and mental status (Moore, 2007). RR is a primary indicator among other components that assists health professionals to record the baseline findings of current ventilatory functions and to identify physiological respiratory deterioration. For instance, increased RR (tachypnoea) and tidal volume indicate the body’s attempt to correct hypoxaemia and hypercapnia (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). The inclusive use of a respiratory assessment on a patient could lead to numerous potential benefits. Firstly, initial findings of respiratory assessment reveals baseline data of patient’s respiratory functions. Secondly, if the patient is on respiratory medication such as salbutamol and ipratropium bromide, the respiratory assessment enables nurses to measure the effectiveness of medications and patient’s compliance towards those medications (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). Thirdly, it facilitates early identification of respiratory complications and it has the potential to reduce the risk of significant clinical
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... theory. The enablers, communication and assessment, have been used to reflect on the care of an individual patient. I have learnt that communication is important, both verbal and non-verbal, while nursing patients as you use appropriate languages for their understanding as well as recognising and understanding body language. Also, assessment is the first phase in providing nursing care to a patient. Failure to correctly identify a patient’s previous behavioural patterns, in order to compare them to current ones, can cause a patient’s needs not to be met or unnecessary care being provided. This assignment has discussed how communication is linked with assessment, through handovers by any healthcare professions, assessing a patient’s needs while talking to them, communication to their families and always make patients feel included by encouraging their independence.
Spark Ralph, S. & Taylor, C. M. (2011). Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
LoBiondo-Wood, G., & Haber, J. (2010). Nursing research. (7 ed.). St. Louis, MO: Mosby Inc.
1) Crisp, J. & Taylor, C. (2005). Potter and Perry’s Fundamentals of nursing (2nd ed). Australia: Elsevier.
This course has broaden my knowledge and clinical skills through comprehensive assessment across all ages, races and gender. The nursing foundation, theory and physical assessment courses has all come together to play a vital role on APN. In this past eight weeks, I have learned that not everything is cut and dry when it comes to patient’s complaints and symptoms as to what we may actually think at the initial assessment. I love the fact that we learn how to take the patient’s complaint, assessments, disease process, labs and etc… and put it all together piece by piece in reaching a definite diagnosis. This class has prepared me for the role of APN to meet each individual goal and health outcome regardless of gender, race and disease process.
Ralph, S. S., & Taylor, C. M. (2014). Nursing Diagnosis Pocket Guide (13th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkinson.
Kozier, B., Erb, G., Berman, A., Snyder, S., Bouchal, D., Hirst, S., Yiu, L., Stamler, L., Buck, M., et al. (2010). Fundamental of Canadian Nursing 2nd Edition, Toronto: Pearson Canada Inc
There are 2 types of breathing, costal and diaphragmatic breathing (Berman, 2015). Costal refers to the intercostal and accessory muscles while diaphragmatic refers to breathing using your diaphragm (Berman, 2015).It is important to understand the two different types of breathing because it is vital in the assessment of the patient. For example, if a patient is suing their accessory muscles to aid in breathing then we can safely assume that they are having breathing problems and use a focused assessment of their respiration. Assessing respiration is fairly straightforward. The patient’s respiration rate can be affected by anxiety so a useful to avoid this is to check pulse first and after you have finished that, while still holding their pulse point, check their respiration rate. Inconspicuous assessment avoids the patient changing their breathing because they know they are being assessed which patients can sometimes do subconsciously. Through textbooks and practical classes I have learned what to be aware of while assessing a patient’s respiratory rate. For example; their normal breathing pattern, if and how their health problems are affecting their breathing, any medications that could affect their respiratory rate and also the rate, depth, rhythm and quality of their breathing (Berman, 2015). The only problem I found while assessing respiration rate was I thought it seemed a bit invasive looking at the
Dillon, P. M. (2007). Nursing health assessment: Clinical pocket guide (2nd ed.). Philadelphia: F.A. Davis Co.