N495 -Health Assessment Exercise Essay

N495 -Health Assessment Exercise Essay

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Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.N495 -Health Assessment Exercise Essay

2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.

3. Consider the course discussions so far and any insights gained from it.

4. Create your Assignment submission and be sure to cite your sources if needed, use APA style as required, and check your spelling.N495 -Health Assessment Exercise Essay

Assignment Description

Physical Activity Resource Guide

After having read the websites cited in the introduction and read your peers posts develop an out of the box physical activity resource guide (brochure). Imagine that your peers all live in the same general locale. Research fun and unusual but accessible activities that will meet the physical activity goals of you and your peers. Your resource guide should have a minimum of 6 different activities. Each entry should contain a description of the activity, costs, when and where, contact person, website or copy of the listing location. Feel free to include photos or graphics. You may submit your resource guide in PowerPoint, pdf, Word or Microsoft publisher format.N495 -Health Assessment Exercise Essay

Remember to think out of the box-search for activities on Living Social, Groupon, Department of Recreation and Parks brochures, club and meetings sections of the newspaper, bulletin boards in your favorite neighborhood coffee shop or grocery store, etc.

Assignment Expectations:

Length: Minimum of 6 brochure pages (each activity should be given a page/slide), not including title page/slide and reference page/slide.

Structure: 6 brochure pages or slides; Include a title page/slide and reference page/slide in APA format.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

Format: Save your assignment as a Microsoft Word or PPT document (.doc or .docx or .pptx) or a PDF document (.pdf)N495 -Health Assessment Exercise Essay

File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment

Specific health assessment refers to an assessment of a specific problem and it may be the initial assessment or an ongoing assessment (Bayoumi., 2009). A risk assessment is a type of assessment that uses an individual ‘s personal data, genetic and environmental information to determine the risk of developing a specific disease such as cervical cancer, breast cancer, pancreatic cancer etc. (Duke, 2010). The objective of this essay is to discuss about a type of specific assessment which is pain assessment. In order to answer this question, first of all, the essay will touch on the differences between comprehensive health assessment and specific assessment. Later, the essay will discuss on the purpose and intent of pain assessment, how this pain assessment contributes to a person’s comprehensive health assessment and three abnormal findings when performing the pain assessment. Lastly, it will discuss the actions that I can take for each of the three abnormal findings.N495 -Health Assessment Exercise Essay

Body
A comprehensive health assessment is a thorough head-to-toe physical examination which includes a review of the medical history , a complete physical examination , a complete laboratory tests, body fat assessment, exercise tolerance test, nutrition assessment, fitness assessment and stress management. (Glymph, 2010). It is usually the initial assessment. On the other hand, a specific assessment is problem oriented . It focuses on a specific problem and not a general health (Bayoumi., 2009). If a patient’s condition does not permit a comprehensive health assessment, a specific assessment of the patient’s current health problem is done. It is done frequently to monitor and evaluate the patient’s progress (Bayoumi., 2009). A specific assessment is a part of a comprehensive health assessment. When the patient’s condition is favorable again, a comprehensive health assessment is carried out. For example, one day, a 65-year-old man came to the emergency department with acute chest pain. Instead of performing a comprehensive health assessment, I have to perform a specific pain assessment for this patient since his condition is not favorable. I should focus on chest pain assessment, perform an electrocardiography test and laboratory tests like complete blood count, biochemistry test, creatinine kinase test and test for troponin (Fogoros, 2009). Comprehensive health assessment is not suitable in this situation as it will provide less accurate information. It should be done when the patient’s condition has gotten better . Among the tests for a comprehensive health assessment are urine analysis, chest x-ray, abdominal ultrasound, fitness test, ankle brachial index, visual acuity test etc (Billinkoff, 2012).N495 -Health Assessment Exercise Essay

According to the Australian and New Zealand College of Anaesthetists, pain assessment has been identified as the 5th vital signs when assessing a patient (Wood, 2008). Pain assessment is important in providing an effective management. Pain assessment involves factors that may influence patient’s experience and expression of pain, the process of describing pain, and factors that may affect nurses in pain assessment such as inadequate knowledge or skills about pain, patient’s poor attitude, patient’s age, type and stage of disease and misconceptions about pain like the fear that patients will be addicted to pain medication (Wood, 2008). Pain assessment can be carried out using an assessment tool that identifies the quantity and quality of the patient’s experience of pain (Wood, 2008). A pain scale from 0-10 where 10 represents worst possible pain can be used.N495 -Health Assessment Exercise Essay

The first abnormal finding when I perform a pain assessment in a 55-year-old man is an acute chest pain. Generally, acute chest pain is an emergency situation as it can be life-threatening. Acute chest pain is a warning symptom for heart attack, angina pectoris, aortic dissection, pulmonary embolism, spontaneous pneumothorax , perforated viscus, pericarditis, pneumonia and other esophagus related causes (Cunha & Stoppler, 2012). As a professional nurse, first of all, I should assess the patient’s airway, breathing and circulation (Lynda, 2009). This is the primary assessment. Secondary assessment includes location of pain, the nature of pain, characteristics of pain, chronology of pain, the situation at the time of pain, provoking and relieving factors and other symptoms in association with chest pain (Lynda, 2009). In this patient, his airway and circulation are clear but he has shortness of breath. The pain started substernally after exercising and radiates to the jaw, left arm , back and neck. The pain is dull in character. The pain is continuous and constant. It lasts for more than 30 minutes and is not relieved by rest. According to the patient, he rates the pain as 8/10 according to the pain scale. For interventions, I should have the patient rests on the bed in Fowler or Semi-Fowler position (Nanda, 2009). Later, I will perform 12 leads electrocardiography to rule out the causes of the patient’s chest pain (Nanda, 2009). Also, I will observe his 5 vital signs such as body temperature, blood pressure, pulse, respiratory rate and pain (Nanda, 2009). If necessary, I will give patient oxygen or pain killer to relieve pain. At the same time, I will observe the side effects of the medications. Besides, I will set up an intravenous drip to rehydrate patient and take blood samples for further laboratory investigations. It is necessary for me to try and reduce environmental stimuli such as noises and be calm when dealing with this patient. I should continuously monitor the patient’s vital signs and look out for any complication if there is any (Nanda, 2009).N495 -Health Assessment Exercise Essay

Secondly, the patient has headache. As a professional nurse, I should start my assessment from collecting subjective data from the patient. Subjective data that I should collect are like trying to understand the causes of the headache, aware of trigger factors, measures to reduce headache, location, frequency and pattern of pain, beginning of the attack, accompanying symptoms and family history (Nanda, Nursing Assessment and Nursing Diagnosis of Headaches , 2012). The objective data include the patient’s behavior like anxious, changes in ability to perform daily activities and body temperature (Nanda, Nursing Assessment and Nursing Diagnosis of Headaches , 2012) . It is found that the patient is constantly stressed out. He always takes one or two tablets of paracetamol when he has a headache. Often, the headache is located frontally but sometimes it involves the whole head. The pain is throbbing, moderate intensity, lasts about 4 hours each time and has 2-4 attacks each month. He had the first attack 10 years ago. Migraine headache runs in his family. Objective examination shows that the patient is anxious and is not able to perform his daily activities when he has an attack. The patient also experiences fatigue and has loss of appetite too in association with migraine headache.N495 -Health Assessment Exercise Essay  The interventions that can be taken for this patient include ensure that the patient takes medication when he has migraine attack, advise the patient to make a record of the attack, discuss the physiological dynamics of stress and anxiety with the patient, instruct the patient to acknowledge me when the pain is severe, place patient in a dark and quiet room, put a cold compress on his head, massage his head if necessary, employ techniques of therapeutic touch and stress reduction, observe for any complications and give icy drinks containing carbonate to the patient (Nanda, Headache Nursing Care Plan Interventions, 2012).N495 -Health Assessment Exercise Essay

Also, during the pain assessment, it is found that the patient experiences pain during urination. To assess the patient, subjective data that need to be collected are asking the patient whether he experiences pain during urination, frequency of urination, color of urine, the amount of urine each time, the presence or absence of odor, presence or absence of pain in the abdomen and other associated symptoms (Johny, 2011). Objective data include the vital signs of the patient such as the temperature, pulse, respiratory rate, blood pressure and urine output and presence or absence of abdominal muscle guarding (Johny, 2011). A urine analysis should be carried out. If necessary, an abdominal x-ray should be scheduled. It is found that the patient has moderate pain during urination, urinate 3 times per hour, yellow colour urine, small amount of urine each time, presence of foul smell and pain is felt at the back. Patient experiences fever and malaise as well. His vital signs are normal and there is no abdominal muscle guarding. Urine analysis shows that the patient has pyelonephritis. As a professional nurse, I should constantly monitor his urine output, monitor the results of repeated urine analysis, record the location,duration and intensity of pain, provide comfort measures such as massage, encourage the used of focused relaxation breathing, provide perianal care as well as give antibiotics and analgesics according to the doctor’s order (Wiwik, 2009).N495 -Health Assessment Exercise Essay

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Conclusion
In conclusion, a comprehensive health assessment involves an assessment from head-to-toe while a specific assessment is problem oriented. The specific assessment is carried out when the patient’s condition is not favourable for a comprehensive health assessment. During the pain assessment in a 55-year-old patient, I found that he has an acute chest pain, migraine headache and pain during urination. As a professional nurse, I should carry out subjective assessment, objective assessment and laboratory tests for each abnormal findings. There is a specific care plan for each abnormal finding with the main objective which is to provide comfort to the patient and to reduce the pain.N495 -Health Assessment Exercise Essay

Despite the importance of an individual’s perspective of their health and wellbeing, individuals are extremely influenced by the extent to which their treatment outcomes meet their expectations (O’hagan et al., 2014). This is why it is important for nurses to incorporate the individual’s perspective into the interventions; to accomplish this nurses need to use effective communication, such as verbal and non-verbal techniques, to receive the appropriate subjective health information (O’hagan et al., 2014). Nurses further must implement the individual’s perspective into the development of nursing interventions; this will help influence a positive recovery (O’hagan et al., 2014). This essay will define communication in the context of nursing; it will discuss the process followed regarding the selection of an individual and the arrangements made, also which interview techniques were utilised. The essay will further discuss the health strengths of an individual, as well as any health concerns which may benefit from health promotional education. Lastly, there will be a summary about what I learnt from this assignment.N495 -Health Assessment Exercise Essay

It is crucial to understand the importance of communication in the context of nursing, in order to implement it in a nurse-client relationship. Communication is central to human interaction, as it allows individuals to establish, maintain and improve contact with each other (Juvé-Udina et al., 2014). The word communication originates centuries ago from the Greek word “communis” meaning to make common (O’hagan et al., 2014). Tay, Hegney and Ang (2011) define communication as ‘a two-way process –sending the right message that is also being correctly received and understood by the other person’. Communication in the context of nursing is where the nurse and patient perceive the other in the situation and, through communication of verbal and non-verbal messages, sets goals, and agrees on interventions to help achieve these goals (Tay et al., 2011).N495 -Health Assessment Exercise Essay

The initial goal for this assignment is to find a healthy individual between the ages of thirty and sixty five who is not a friend, family member or anyone I knew well. This was achieved by ringing my aunty and asking if she knew anyone in the area that would be happy to help with my assignment. My aunty gave me the phone number and the email of a colleague; from here I sent an email explaining the “subjective health assessment” project to her. Jenny (pseudonym) promptly replied saying she would be happy to assist, when she agreed I emailed her a consent form. I also ensured her that to be in accordance with The Nursing Council Code of Conduct (2012) as a student nurse I must respect her rights to confidentiality and therefore any personal or identifiable information will be altered to protect her privacy and dignity. From here we arranged to have the interview take place at her house as it would not only be private but it would help ensure that she feels comfortable, we worked out a time that suited us both and decided at 10am on Wednesday 30th of July.N495 -Health Assessment Exercise Essay

The quality and reliability of information is influenced by the way in which information is collected, which is related to the use of nonverbal and verbal communication (Jarvis, 2012). Nonverbal communication of appearance, demeanour, facial expression, silence, and listening are highly influential. I incorporated all these aspects into my interview. Firstly I wore my nursing uniform which made my appearance look professional, and kept a neutral friendly expression throughout the interview. I also made sure my attitude was non-judgemental and that we were seated at eye level; this helped to maintain eye contact which showed that I was alert and listening to her. Sitting at eye level also helped make us both feel equal as no one had an authoritative role over the other. However, verbal communication is just as important as nonverbal communication. I ensured that all the questions I asked were open ended this allowed Jenny to expand in areas which provided me with relevant and detailed information. Also, by using the communication technique refection I was able to respond in a way that allowed Jenny to realise that I was listening and understanding what she was communicating.N495 -Health Assessment Exercise Essay

June has the belief that, for her age she is healthy and she is content with her current level of health. She lives a healthy lifestyle and has few health issues. Junes health and wellbeing is supported by having had completed all of the immunisation programs recommended for her through her childhood. These immunisations are very important during an individual’s childhood as it protects children from negative impacts of illness (Grant, Luxford, & Darbyshire, 2005). However, even though June completed these immunisation programs she still contracted chicken pox at seven years of age. This is an extremely contagious disease which is spread by the same methods as the common cold such as coughing, sneezing and skin to skin contact (Grant, Luxford, & Darbyshire, 2005).N495 -Health Assessment Exercise Essay

There are many things that influence an individual’s overall health, and the likelihood of developing diseases (Jarvis, 2012). Diseases can occur due to a combination of genetic, lifestyle and environmental factors (Jarvis, 2012). In the context of Jennys health she is unaware of any hereditary diseases in her family history. This is a great strength to have as Jenny does not have any increased risks of getting genetic disorders or passing them onto her children. Another strength Jenny has is that she works on a farm; this means she is often outdoors in the natural environment. Tardona, Bozeman and Pierson (2014) research indicates that exposure and experiences in natural environment can improve wellbeing by increasing self-esteem, spiritual well-being, cognitive functions and relieving stress. This shows that Jenny is free of health illnesses and her job contributes to her overall wellbeing Peterson (2000) discusses how this is a proven benefit not only to the individual but the family as well.N495 -Health Assessment Exercise Essay

Regular exercise and sleep patterns are more beneficial strengths displayed by Jenny which contributes positively to her overall wellbeing. Ekblom-Bak, Ekblom, Vikström, De Faire, and Hellénius (2014) discusses how at least 150 minutes per week of moderate to vigorous exercise is important for maintaining a healthy lifestyle. Jenny well and truly does more than 150 minutes per week as she motivates herself to go for a power walk every day for around an hour. Kemmler and Von Stengel (2013) research shows that there is a lower chance of experiencing heart disease, some cancers, stroke and type two diabetes when regular exercise is implemented into everyday life. Exercise further helps to improve sleeping patterns. As Jenny is a farmer she has to wake up at 5am most mornings, this results in Jenny having to manage her time well to make sure she gets enough sleep. Jenny goes to sleep around 9.30 at night usually without waking throughout the night and does not nap throughout the day this shows Jenny has healthy sleep patterns. According to Gruber (2013) healthy sleep patterns are shown to have a positive impact on an individual’s body as it enables the individual to cope with everyday living tasks.N495 -Health Assessment Exercise Essay

Musculoskeletal disorders are the main representation for absence at work worldwide, Jenny experiences back pain which is increased by stress (Lövgren, Gustavsson, Melin, & Rudman, 2014). Lundberg and Melin (2002), look at how the conditions at work, such as time pressure and heavy lifting, can contribute to elevated stress levels and muscular tension. They further explore how the elevated levels of stress can reduce the time for rest and recuperations (Lundberg & Melin, 2002). Therefore it is important for Jenny to implement interventions that help improve her back pain, when Jenny is at work she could limit the amount of heavy lifting she does and also be educated on the correct lifting technique to avoid further injuries or strains to her back. Jenny can further implement the use of over the counter medication such as deep heat to help relieve the pain and tension in her muscles.N495 -Health Assessment Exercise Essay

The increasing instability in the economic sector and the increase in unemployment rates are likely to trigger financial worries, which can contribute to fatigue levels (Stewart, Abbey, Meana & Boydell, 1998). This is because financial worries present themselves as a psychological threat which is prolonged and chronic in nature. This causes an increase in fatigue levels as our bodies are not designed to cope with prolonged periods of increased stress hormone (cortisol) levels (Stewart et al., 1998). In Jennys context she has a job however she still feels financially unstable which could be related to her increased levels of fatigue. Therefore Jenny needs to implement interventions such as seeing a financial consultant to help her understand her future options and avoid finical crisis.N495 -Health Assessment Exercise Essay

Through completing this assignment I feel I now have a greater understanding of the importance of communication in a nurse-client relationship. I learnt that without using proper communication skills you will be unable to understand the individual’s perspective of their health and what they want in life. What I found is that by being non-judgemental and honest throughout the interview developed the nurse-client relationship more, which is extremely important with the client as they are the primary source of information. I believe this was shown when Jenny felt respected as she opened up more by telling me more about her life instead of answering briefly. I further understand the importance of asking open ended questions and using non-verbal communication skills as if I had not the information I received would have been different. I also learnt the importance of taking your time and just listening to the client, especially in Jennys case as she got very excited talking about her children and upset when I approached the subject of finical stability. So from this I understood that her major worries and weakness in her life is to do with finical pressure and that her children provide her with a source of happiness.N495 -Health Assessment Exercise Essay

In conclusion, effective communication provides nurses with a way to gather information from a client successfully. This essay looked at how I went about selecting an individual and the arrangements made. While also disusing how non-verbal techniques of eye contact and appearance helped make Jenny feel comfortable and verbal techniques of open ended questions to receive more relevant detailed information. This essay further suggested that Jenny’s strengths included having a healthy childhood, no hereditary diseases in the family history, working on a farm and having regular exercise and sleep patterns. However Jenny’s weakness of back pain and feeling financial unstable can lead to health issues which is why interventions of education of proper lifting techniques, using deep heat and seeing a financial advisor can help Jenny’s overall health. This essay also looked at what I learnt from completing this assignment which was that communication skills majorly affect the quality of the information gathered and the trust between a nurse and a client. N495 -Health Assessment Exercise Essay

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