Assessment Basics
This is where everything in nursing care begins.
What is assessment?
This should be done before touching a patient.
What is explain the assessment and ask permission?
"I feel dizzy when I stand up."
What is subjective data?
Use this ABC framework to identify immediate priorities.
What are airway, breathing, and circulation?
This technique means looking, listening, and smelling.
What is inspection?
Assessment helps establish this so future changes can be noticed.
What is baseline data?
Closing the curtain and draping the patient protects this.
What is privacy/dignity?
Oxygen saturation of 88%
Chest pain and shortness of breath are examples of this type of subjective data.
What is priority subjective data?
This assessment technique uses touch.
What is palpation?
Assessment is described as dynamic and this.
What is continuous?
The nurse should use this type of interpreter when there is a language barrier.
What is a professional interpreter?
"Patient remained in bed and declined ambulation three times."
What is objective data?
Vital signs outside expected limits are this type of priority data.
What is priority objective data?
The abdomen has this special assessment order.
What is inspect, auscultate, palpate?
Assessment influences clinical decision making by helping nurses recognize these.
What are cues/abnormal findings?
Asking, "Can you tell me more about what brought you in today?" is this type of question.
What is an open-ended question?
Family says, "She hasn't eaten since yesterday."
What is supplemental/history information from another source?
A sudden change from baseline should make the nurse do this.
What is assess further/reassess?
When assessing lungs, the nurse should compare this way.
What is side-to-side/symmetry?
Experienced nurses move beyond only completing this and begin seeing the whole patient.
What is a checklist?
Cultural awareness means the nurse should ask instead of doing this.
What is assume?
Pain rated 8/10 while the patient is quietly watching TV.
What is objective data?
When subjective and objective data do not match, the nurse should do this.
What is gather more data or further assess?
Painful assessments should usually be performed when?
What is at the end?