Collects holistic subjective & objective data on overall functioning
What is the Nursing Health Assessment
Listen, observe cues, and think critically to validate what you hear
What is the Working phase
Confirms that the collected data are reliable and accurate
What is Validation
Used when there are concerns about cognitive impairment in an adult
What is the Mini-Cog
Systolic 130 to 139 mmHg; diastolic 80 to 89 mmHg
What is Stage I Hypertension
Health patterns and conditions across the client’s family
What is Family History
Appearance, attitude, facial expression, demeanor
What is Nonverbal Communication
Can determine eligibility for care and payment
What is Documentation
Sudden-onset confusion sometimes associated with possible infection
What is Delirium
rate, rhythm, amplitude, contour, elasticity.
What are the Characteristics of the pulse
Very rapid, life-threatening situations. The only goal is preventing death.
What is an Emergency Assessment
Character, Onset, Location, Duration, Severity, Pattern, Associated Factors
What is COLDSPA?
Keep an open mind and Use rationale to support opinions or decisions.
What are Steps in the Critical Thinking Process
Identity versus role confusion.
What are Erikson's Stages of Psychosocial development for the adolescent
One of the methods for collecting current dietary intake information
What is 24 hr dietary recall
Nutrition, activity, relationships, culture, community
What is Lifestyle and Health Practices
Touch and feel for texture, temperature, size
What is palpation
Exposure to violence, environment, economy, social factors
What are Factors Affecting Mental Health
Temperature may range from 35.0°C to 36.4°C (95.0°F to 97.5°F).
What are the considerations for the aging adult
weight in kilograms/height in meters squared
What is BMI
Ensure comfort and privacy; build trust with verbal and nonverbal skill
What is the Introductory phase
Use a stethoscope to listen for body sounds
What is Auscultation
Assesses Eye-opening response, verbal response, and motor response
What is the Glasgow Coma Scale
Measurement of the pressure of the blood on the wall of the arteries
What is Blood Pressure
oOpen shallow wound like an abrasion or a small crater with a pink, red, or moist wound bed. Can also present as an intact or ruptured blister
What is Stage 2 Pressure Injury