M. B. COLLEGE OF PARAMEDICAL AND NURSING EDUCATION, KOTA B. Sc. Nsg. III Year (2011-2012) CLASS PRESENTATION ON HEALTH ASSESSMENT SUBJECT; NURSING FOUNDATION SUBMITTED TO: SUBMITTED BY: RESP. UMESH SIR MISS ABHILASHA VERMA B. Sc. NSG. PART-III (2011-2012)
1. SUBMITTED TO: SUBMITTED BY: RESP. UMESH SIR MISS ABHILASHA
VERMA B. Sc. NSG. PART-III (2011-2012)
2. 1. INTRODUCTION: A health assessment is type of survey that
ask question about your health & life style. It is a risk
appraisal that focus on your health with an emphasis on education
& behavior changes. Health assessment is very important in any
health care setting.
3. HEALTH ASSESSMENT IN ARMY
4. 2. TYPES; COMPREHENSIVE HEALTH ASSESSMENT ; It includes
health history & complete physical examination, & is
usually done when a client enters a health care setting. ONGOING
PARTIAL ASSESSMENT ; Is one that conducted at regular intervals
during care of client. A FOCUSED HEALTH ASSESSMENT ; Is conducted
to assess a specific health problem. AN EMERGENCY ASSESSMENT ; Is
type of rapid focused assessment conducted to determined
potentially fatal situations.
5. 3. PURPOSE; 1) To get a clear picture of clients health
status & health related problems. 2) To get a holistic view of
client. 3) To establish a database of clients normal abilities,
risk factors, that can contribute to dysfunction. 4) To alleviate
or manage existing health problem. 5) To encourage continuation of
healthy pattern. 6) To help to formulate a conclusion or problem
statement. 7) To making accurate treatment decision.
6. 4) TERMINOLOGY: 1)DIAGNOSIS; It is determination of nature
& extent of a disease. 2)PROGNOSIS; It is forecast of course
& duration of a disease. 3)AETIOLOGY; It is science of cause of
disease. 4)PATHOLOGY; The branch of medicine treating a disease. It
also indicates the changes that can take place in the structure
& function of body during course of disease.(any deviation from
normal). 5)SIGNS ; The presense of disease that can be seen or
elicited , e.g.,fever.
7. 6)SYMPTOMS; Any evidence as to the nature or location of a
disease as noted by patient. when symptoms noted by patient alone,
it is called subjective symptoms, e. g. pain. When symptoms noted
by observer it is called objective symptoms . e.g. jaundice.
7)SYMPTOMATOLOGY; study of sign & symptoms of disease.
8)COMPLICATION; Another disease process arising during a course of
disease.
8. 5.FRAMEWORK ; The three major frame works are; 1)Functional
health frame work. 2)Head to toe framework. 3)Body system
framework.
9. 6.COMPONENT: There are two components: < Health history .
< Physical examination.
12. 3)HISTORY OF PRESENT ILLNESS: On set ,sign and symptoms,
duration,treatment taken if any,for the same.other complaints such
as loss of appetite, insomnia,disorder of stomach.find out client
health habits eating, sleeping etc. 4) PAST MEDICAL HISTORY:
Childhood illness- mumps, measles and so on. Allergies,mental
disease, accidents, injuries, surgeries,blood transfusions.
13. 5)FAMILY HISTORY: Informations about all family members
(father ,mother,grandparents,brothers and sisters) living or dead,
causes of death( if dead) condition of there health (if living),
family history of any illness, e.g diabetes mellitus,cancer, heart
disease etc. 6) LIFE STYLE: Smoking alcoholism,substance abuse.
Food habits, likes and dislike,pattern of sleep and exercise.
14. 8.DEFINITION : It is thorough inspection or detailed study
of entire body or some part of body to determine the
general,physical,mental condition of body.
15. 9.PURPOSE : 1)To understand the physical and mental well
being of patient. 2) To detect the disease in its early stage. 3)To
determine cause and extent of disease. 4)To understand any changes
in the condition of disease any improvement and regression.
16. 5) To determine the nature of treatment or nursing care
needed for patient. 6)To safeguard the patient and its family by
noting the early signs specially in case of communicable disease.
7) To contribute to the medical research. 8) To find out whether
the person is medically fit or not fit for perticular task.
17. 10.METHODS OF EXAMINATION: 1) INSPECTION 2) PALPATION 3)
PERCUSSION 4) AUSCULTATION 5) MANIPULATION 6) TESTING OF
REFLEXS
18. A).INSPECTION: *Visual examination of body is called
inspection. *It is the observation with naked eyes to determine the
structure and function of body.
19. B.)PALPATION: 1)It is the feeling of body or a part with
the hands to note the size and position of the organs. 2In
palpation the finger pads are used not the finger tips.
20. C.)PERCUSSION: 1) It is the examination by tapping with the
finger on the body to determine the condition of the internal
organs by the sounds that are produced. 2) It is done by placing a
finger of the left hand firmly against a part to be examined[chest
or abdomen] and tapping with the finger tips of right hand.
21. PERCUSSION HAMMER
22. USE OF PERCUSSION HAMMER
23. D.)AUSCULTATION: It is the listening to sounds with in the
body with the aid of a stethoscope,foetoscope or directly with the
ear placed on the body.
24. E.)MANIPULATION : It is the moving of a part of the body to
note its flexibility. Limitation of movements is discoverded by
this method.
25. F.).TESTING OF REFLEXES: The response of tissues to
external stimuli is tested by means of percussion hammer,safety
pin,wisp of cotton,hot and cold water etc.
26. 11.)HEAD TO FOOT EXAMINATION : The observation of the
patient starts as the patient walks into the examination room.
27. **General appearence : NOURISHMENT :Well nourished or mal
nourished or under nourished. BODY BUILD :Thin or obese.
HEALTH:Healthy or unhealthy. ACTIVITY:Active or dull(tired).
28. Well nourished baby :
29. Abnormalities in nutrition : Under nourished Baby :
Malnourished Baby :
30. **Thin , Normal & obesity :
31. **Mental status examination : CONSCIOUSNESS: Conscious,
unconscious,delirious,talking incoherently. LOOK: Anxious or
worried,depressed,etc.
32. **Delirious : **Anxity :
33. **Posture: BODY CURVES: Lordosis , kyphosis &
scoliosis. MOVEMENT : Any limp.
34. *Before : *After : Scoliosis .
35. **Height & weight : Height measured in
inches(in),feet(ft),centimeter(cm),& meter(m). A scale for
measurement attached to standing weight scale. Weight measured in
ounce(oz),pound(lb),gram(gm),kilogram(kg).
40. **Head & face: Shape of skull & fontanels(noted in
newborn). Skull circumference: -Scalp; Cleanliness,condition of
hair,dandruff,pediculi,infection like ring worm. -Face;
Pale,flushed,puffiness,fatigue,pain,fear,anxity,enla rgement of
parotid gland.
41. **enlargement of parotid gland:
42. **ring worm infection :
43. **Eyes : Eye brows: Normal or absent. Eyelashes: Infection
& sty. Eye lids: Oedema, lesion, ectropion(eversion),
entropion(inversion). Eye balls: sunken or protuded. Conjuctiva:
Pale,red,purulent. Sclera: Jaundiced.
65. **Abdomen: Observation : skin rashes, scar , hernia ,
ascites , distension , & pregnancy. Auscultation : Bowel sounds
& foetal heart sound. Palpation : liver margins , palpable
spleen, tenderness at area of appendix ,inguinal hernias.
Percussion : presence of gas,fluids or masses.
66. **Extremities : Movement of joints. Tremors. Ankle oedema .
Varicose vein . Reflexes.
67. ** Back : Spina bifida. Body curves.
68. **Body Curves :
69. **Spina Bifida :
70. **Genital & Rectum : Inguinal lymphnodes enlarged &
palpable. Patency of urinary meatus & rectum. Descents of
testes in infant. Vaginal discharges.
71. Presence of sexually transmitted disease(STD).
Haemorroides. Pelvic masses. Enlargement of prostate gland.
72. **Neurological Tests: Co-odination test. Reflexes.
Equilibrium tests. Test for sensation.
73. 12.ROLE OF NURSE : PREPRATION OF ENVIORNMENT : 1.)
Maintenance of privacy : *Prevent unnecessory exposure. *Ensure
privacy. *Quite & ventilated room. *Special need for client.
*Surface for placement of equipment. *Draping should be done.
*Separate examination room should be needed ,keep the door
closed.
74. 2.)Lighting : *As for as possible natural light should be
available.Because if patient is jaundiced.it may not be detected in
the artificial light. *There should be adequate lighting.
75. 3. Comfortable bed or examination table: *Patient should be
placed comfortable through out the examination ensure possibility
to body part being assessed. *There should be provision for
maintenance of suitable position.
76. PREPARATION OF EQUIPMENT: *All articles needed for physical
examination are kept ready for the examination at hand. *Maintain
good body mechanics.
77. PREPARATION OF PATIENT: 1)Physical preparation:- *Keep the
patient clean,shave the part if necessary. *Keep patient in a
comfortable position. *Empty the bladder prior to examination.
*Empty the bowel by giving enema. *Drape the patient,prevent
unnecessary exposure.
78. **Draping :
79. 2)Mental preparation: *Patient may be quite new to hospital
situation and anxious about his illness. *Explain the procedure
*Remove false belief.