1. Introduction Physical Examination Health Assessment

2. Why do I need to know Physical Assessment?

4. “What is your reason for coming here today?”

5. Assessment Collection of data about an individual’s health state. Collection of data about an individual’s health state.

6. Subjective Data Subjective Data Client history Client history Objective Data Objective Data Inspection Inspection Percussion Percussion Palpation Palpation Auscultation Auscultation

7. Data Base All the information; obj., subjective, client’s record, lab, and test results All the information; obj., subjective, client’s record, lab, and test results Study and cluster data Study and cluster data Diagnosis Diagnosis Purpose of assessment is to make a diagnosis or judgement Purpose of assessment is to make a diagnosis or judgement

8. Nursing Process ADPIE ADPIE Assessment Assessment Diagnosis Diagnosis (outcome identification) (outcome identification) Planning Planning Implementation Implementation Evaluation Evaluation

9. Critical Thinking Problem solving – the puzzle – the big picture Problem solving – the puzzle – the big picture Processing information – use theory learned, experience, intuition, intellectual and manual skills Processing information – use theory learned, experience, intuition, intellectual and manual skills

10. Priority Setting First level problems First level problems ABC’s ABC’s Vital Signs Vital Signs Second Level Second Level Mental Status changes (LOC) Mental Status changes (LOC) Acute pain Acute pain Acute urinary elimination Acute urinary elimination Untreated medical problems Untreated medical problems Abn. Bld. Values Abn. Bld. Values Risks of infection, safety, security Risks of infection, safety, security

11. Third Level Priority Third Level Priority Knowledge deficit Knowledge deficit Activity, rest Activity, rest Coping Coping

12. 4 Types of Data Base 1. Complete ( Total ) 2. Episodic or Problem Centered 3. Follow – up 4. Emergency

13. Consideration of: Developmental States Developmental States Cultural Assessment Cultural Assessment Beliefs, values, practices Beliefs, values, practices

14. The Interview “Spend more time listening” “Spend more time listening” Open /Closed ended questions Open /Closed ended questions Interpreter Interpreter Family/ professional Family/ professional

15. Communication Skills Collecting information with understanding Collecting information with understanding Verbal/Nonverbal Verbal/Nonverbal

16. Factors that impact on Communication Internal Internal Personal attributes – acceptance of client (Nonjudgemental) Personal attributes – acceptance of client (Nonjudgemental) Respect Respect Empathy Empathy Listening Listening

17. Factors that impact on Communication External Factors External Factors Privacy Privacy Interruptions Interruptions Comfortable environment – temp., noise, lunch, bloody mess Comfortable environment – temp., noise, lunch, bloody mess

18. 10 Traps of Inteviewing pg 57 1. False Assurance 2. Unwanted Advice 3. Using Authority 4. Avoidance language – dead is dead 5. Engaging in distance “the Friend” 6. Professional jargon 7. Leading or biased questions; “you don’t…?”

19. 8. Too much talking 9. Interrupting 10. Why?

20. Threat of Violence!!!! CPI training CPI training