Nutrition Assessment
This is used to determine correct medication dosages and assess nutritional and fluid volume status.
What is body weight?
This is the first step in a comprehensive patient assessment, providing foundational information for the nurse’s evaluation.
What is reviewing the patient's medical diagnosis and current health problems from medical record or with the patient/ family
Changes in this area of the skin may reflect poor nutrition or behavioral issues.
What is hair distribution?
This is the correct action if a pediatric patient exhibits injuries or behaviors that suggest abuse.
What is notifying child protective services?
True or False: Asking the patient for their weight is a reliable method of weight measurement.
What is False
This aspect of the general assessment includes factors such as hygiene, skin condition, body image, and mental health.
What is assessing the patient’s general behavior and appearance?
This skin condition may result from pressure against the tissues and mucosa, such as from a nasogastric tube.
What is excoriation or inflammation?
These types of injuries are highly suspicious of physical abuse or nonaccidental trauma.
What are injuries to the torso, eyes, or neck in a patient younger than 4 years?
What is included in a patient history?
This part of the assessment includes both psychological and social factors.
Medical errors may occur when confusing these two units of weight.
What are pounds and kilograms?
The assessment should take into account this aspect of the patient, which can influence communication and the approach to assessment (think age of the patient).
What is the patient’s developmental stage?
This term describes the skin’s ability to return to its original position after being pinched, and is a sign of hydration.
What is skin turgor?
This observation technique helps identify neglect or abuse when examining a patient.
What is observing for signs of fear, a flat affect, or inappropriate interaction with family?
What are anthropometric measurements?
The term used to describe the measurement of the size and proportions of the human body.
A weight in pounds is more than ______ the same number in kilograms.
What is double?
A slumped, erect, or bent posture may indicate this type of problem.
What is a musculoskeletal problem, mood, or pain?
If a lesion on the skin has exudate, it is important to assess this characteristic to document its nature.
What is the color, odor, volume, and consistency of the exudate?
When documenting suspected abuse, it’s essential to include these two key pieces of information from the patient and family.
What are the patient’s exact words and the family’s account of the injury?
These four components make up a holistic nutritional assessment.
What are patient history, dietary history, physical examination & anthropometric measurements, and biochemical indices?
According to policy, this unit is typically used for medication calculations based on weight.
What are kilograms?
This skin change could indicate iron deficiency anemia.
What are concave nails (koilonychia)? Or pallor
The color of these areas, including the face, conjunctivae, and nail beds, should be carefully assessed during a skin inspection.
What is pallor or cyanosis?
This pattern of injuries, such as bruises in specific shapes, could be an indication of physical abuse.
What are contusions, burns, or abrasions with a patterned or shaped appearance?