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NR 305 Week 2 Discussion; Reflection on the Nurse s Role in Health Assessment..

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Contributor
Sherwin Williams
Category
Nursing
Course
NR 305 Health Assessment
Institute
Chamberlain
Pages
49

 This is a graded discussion: 50 points possible due Jan 17 Week 2 Discussion: Reflection on the Nurse’s Role in Health Assessment (Graded) 70 84 Purpose The purpose of this reflection is for learners to reflect on the nurse's role in health assessment in various care settings. Course Outcomes This reflection enables the student to meet the following course outcomes: CO 1: Demonstrate a head to toe physical assessment. (PO 1) CO 3: Describe physical, psychosocial, cultural, and spiritual influences on an individual's health status. (PO 1) Due Date During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week): Posts in the discussion at least two times, and Posts in the discussion on two different days Points Possible 50 points Directions Reflection is an activity that involves your deep thought into your own experiences related to the concepts of the week. Answers should be detailed. In reflections students: Demonstrate understanding of concepts for the week Engage in meaningful dialogue with classmates and/or instructor Express opinions clearly and logically, in a professional manner Use the rubric on this page as you compose your answers. Scholarly sources are NOT required for this reflection Best Practices include: Participation early in the week is encouraged to stimulate meaningful discussion among classmates and Top instructor. Enter the reflection often during the week to read and learn from posts. Select different classmates for your reply each week. Reflection Questions Reflect on your current or prior practice setting. Paragraph One: Briefly describe the type(s) of nursing health assessments you commonly perform. Explain how your nursing health assessments are focused or comprehensive. Provide examples of key subjective and objective data collected by nurses in this setting. Paragraph Two: Describe the typical patient population in your practice setting. What are some special considerations that you have used for obtaining an accurate health history and physical assessment in this patient population? Examples may include age, lifestyle, financial status, health status, culture, religion, or spiritual practices. Grading To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. See Syllabus for Grading Rubric Definitions. This topic is closed for comments. Search entries or author Unread   Subscribed 788623185679 (https:/  Stacy Owens(https://chamberlain.instructure.com/courses/74479/users/1431)Jan 7, 2021  Hi Class, This week's reflection will allow us to explore similarities and differences in nursing assessments in various practice settings. Please feel free to share examples from your own practice, as this is a great way for us to learn from each other. Contact me anytime if you have any questions related to the posting requirements or any other course concerns. Here's to a great week! Stacy Top 7886239486083 ***You may begin posting in this discussion on Sunday, January 10th, 2021 for credit.*** (httpAlisha Kriech(https://chamberlain.instructure.com/courses/74479/users/188424)Jan 11, 2021  Week 2 Discussion: Reflection on the Nurse's Role in Health Assessment Health assessment in nursing is the evaluation of a patient’s health status by performing a physical exam after taking a health history. Understanding the different types of health assessments is the key to identifying the specific needs for your patient. I have worked in the emergency department for the last four years and I have used a variety of health assessments such as comprehensive and focused assessments. These assessments are based on the triage level of the patients. In the emergency room we use four levels of acuity including non-urgent, less-urgent, urgent, emergent or resuscitation. As we are triaging a patient, we are able to obtain subjective and objective data. When the patient arrives, we ask about biographical data, personal/ family health history and reasons for seeking healthcare. While obtaining the symptoms that the patient is experiencing, we are able to observe the patient’s physical appearance. This will help appropriately decide what triage level the patient will be. An example of an emergent patient would be when an elderly patient comes in for severe chest pain with a history of cardiac stents and myocardial infarction. This patient could be experiencing symptoms such as difficulty breathing, diaphoresis, clammy skin and guarding their chest which are all objective data. Subjective data that the patient could be experiencing includes chest pain, dizziness, fatigue, indigestion or nausea. This patient will receive more of a comprehensive assessment than someone who comes in because they fell and hurt their right arm. Someone with an arm injury would be considered a less-urgent patient and would have a focused assessment performed. Subjective data of this patient includes 10/10 pain with an achy, throbbing feeling to the arm. Objective data may include deformity to the arm, abrasions, swelling, redness, bruising, capillary refill and a palpable radial pulse. In the emergency department, there is no typical patient population. We care for a variety of patients. To name a few, we care for pediatrics up to geriatrics. We also care for patients who are homeless, who have psych disorders and even religious preferences. There are special considerations in each population. For pediatric patients, we rely on the parents for their child’s health history and reasons for seeking healthcare. For geriatrics, patients may have an altered mental status. In this case, calling a family member and asking the patients neurological baseline might be appropriate in order to fully understand the patients’ health concern. Patients who are homeless are most often able to verbalize their concerns, however helping them with a prescription they may need might be necessary. If a psychiatric patient is unable to verbalize the medications they usually take for their mental health, calling their pharmacy might help to facilitate getting them back on their medications. In any healthcare setting, a nurse must be un-biased about patients’ religious preferences. If a patient’s blood count is low and they are in need for a blood transfusion, a nurse may offer verbal benefits of the transfusion. However, if the patient declines, this is their preference. All in all, I feel that the emergencyTdoeppartment allows nurses to see a global view of patients and I believe this has improved my assessment skills tremendously. (http Taylor Richardson(https://chamberlain.instructure.com/courses/74479/users/125853)Jan 17, 2021  Alisha, Thank you for sharing your experience in the ER, i have always enjoyed the ER from my rotations in nursing school to getting pulled there from my unit. I love the fast-paced setting and i feel it has help me build my skills at more focused assessments as i feel that is the most important thing with the large number of patients coming through the ER on any given day. I also agree with a lot of the points you made in your second paragraph about the difficulites associated with the different patient populations. We see a lot of homeless people with mental illness at the hospital i work at because we are in an urban area close to downtown, where there is a large homeless population. It can be very hard and trying on nurses knowing that these patients dont have the resources or even the mental capacity to take care of themselves and their medications once they leave the hospital which often leads to readmission. In these cases we work closley with the social workers to try to find placement for this population but it seems in the city i live in there just isnt enough resources out there. Also one of the hardest populations we deal with is when elderly patients come in without family who are alert and oriented to self, which makes it very hard to get a full and accurate comprehensive health assessment. We as nurses have to work even harder to make sure we dont miss anything which im sure you are familiar with working in the ER. Thanks again for sharing! 788623185680 (https:/  Breanna Guenther(https://chamberlain.instructure.com/courses/74479/users/182600)Jan 10, 2021  “As practicing nurses, it's easy to fall into the routine of diligently filling out the required intake or admission forms for a patient, without stopping to really think about the reason we are asking our patients for such detailed (and sometimes quite personal) information.” (Lesson 1). We need to remember this is a new patient and we need to look at them with a fresh set of eyes. A typical assessment I complete is on newborn infants. The first initial assessment, I complete a head to toe on infant. We tend to look of course for different things with infant such as reflex's, birthmarks, port wine stains, suture lines, muscle tone, skin tags, pinpoint marks on the ears and sacral dimples. This would be some examples our objective data. Subjective data we look for can be infant bonding with parents, Care givers response to infant, reported family history of genetic disorders, home environment, siblings and parent's work schedule. “The transition to parenthood is rife with unfamiliar challenges, as parents cope with sleep deprivation, redefine their social lives, and learn to meet their infants' needs.” (Borelli, Nelson-Coffey and River, 2019). Basically, there iTsoaplot going on and we need to give the parents some grace. The two types of populations I typically care for are pregnant women and infants when I work labor and delivery. Most of our information becomes intertwined. We have the mother and the infant post-delivery. We receive most of our subjective data from the mother and the infant will mostly go home with the mother. My job is very  personal, we need to have good repour with are patients to get them through the challenges of labor. We are assessing you while getting to know you in a sense. We look for bonding struggles with infant and mom? Does mom have depression or history of postpartum depression? Is the mom testing positive for drugs? Does the family have a car seat for infant, do they need any assistance with baby supplies? Does the infant have special needs? We also have to look for concerns if these women are in safe relationships. Some women are in abusive relationships, women come in who are pregnant and assaulted by significate other. We are taught to look for things out of the ordinary, not to get someone in trouble but to help! We want to set our patient up with the best opportunities for success. Overall, these are the worst-case scenario and I feel like I care for wonderful mothers and fathers. Borelli, J., Nelson-Coffey, S. and River, L. (2019). Tolerance of infant Distress Among working Parents: Examining the Roles of Attachment Anxiety and Work-family Conflict. Parenting: Science & Practice, 19 (1/2): 137-159. (23p.) NR305-10260. (2021). Week 1: Obtaining a Health History. Chamberlain University. (httpStacy Owens(https://chamberlain.instructure.com/courses/74479/users/1431)Jan 11, 2021  Hello Breanna! Thank you for starting off our first discussion! I enjoyed learning about your current practice setting. Well done addressing the types of assessments you perform. I would like to focus on infant assessment directly after birth. Class, can anyone describe Apgar scoring and what it entails? How is the test performed and what are the components of this test? Class, any ideas? Good job! Stacy (httpKaren Andrews(https://chamberlain.instructure.com/courses/74479/users/170065)Jan 11, 2021  Apgar scoring is a simTopple numerical assessment performed by a healthcare provider that rates how a baby is doing at birth. The baby is assessed at one minute and five minutes after birth. The one minute test reflects how well the baby handled the delivery and the five minute test indicates how well the baby is doing on its own. The provider will assign a number from 0-2 to describe the 5 Apgar signs Activity, 78862311200277886233213560 Pulse, Grimace, Appearance, Respiration and will then add the numbers together. Normally, numbers 7- 10 are an indication your baby is doing well. (httpStacy Owens(https://chamberlain.instructure.com/courses/74479/users/1431)Jan 12, 2021  Great Karen! Thank you for answering my question. You are correct! Stacy (httpCrystal Wakker(https://chamberlain.instructure.com/courses/74479/users/180500)Jan 13, 2021  Hi Breanna, I really enjoyed your post not only from a nursing standpoint but also as a mom. I can remember being in the hospital with my first child. It was not an easy pregnancy nor any easy labor. I was scared and I was in a lot of pain. Long story short, it was thought that my son was about 6 weeks earlier than he truly was, so they were trying to prolong labor through bed rest and then meds, meanwhile my baby was not having it. Miscommunication between staff resulted in me getting an additional administration of medication to delay labor that I never should have gotten and therefore I was having issues delivering. My baby was becoming stressed and finally came out blue, not breathing and I was freaking out and in full panic mode. You are spot on that in your field you are nursing not only mom, but you also must consider the baby and the whole new family. With the new practice of getting mom and baby out of the hospital asap, observing objective and subjective data is critical and being sensitive to cues given out could be the difference between life and death in the coming weeks of baby’s life. I can only imagine that postpartum depression is awful, but I am so glad that it and other mental health issues are becoming a less taboo subject and health professionals are recognizing this and responding. Drugs, abuse, special needs, and finances are all additional burdens and stressors to consider and thank you for recognizing them. When I had my Labor and Delivery clinical, I think that the biggest life lessons I brought with me were that even a mom who has children may still be unsure, scared, and have questions since no birth or baby is the same as another and we as health care professionals can and will make or break an experience. You mention treating patients with grace and respect and that warms my heart. In the nursing school that I attended, there was a huge poster that said, “they may not remember your name or your face, but they will always remember the way you treated them” and that is so powerful and true. Thank you for a great post and keep up the great work. Top Crystal 78862339652917886237416793 (httpPaige Wilson(https://chamberlain.instructure.com/courses/74479/users/120323)Jan 15, 2021  Hello Breanna, I enjoy reading about your line of work. It is vastly different than mine! There seems to be quite a bit you need to assess quickly and thoroughly. You essentially have multiple patients to assess as well. Is there a team you work with or a system that makes assessments more efficient? Do you feel it is easy to overlook or misinterpret any findings because of your unique patient population? I can only imagine the rewarding experiences in which you have taken part. I haven’t thought about the assessment of an infant since nursing school! I am slightly terrified just thinking about it! I am very grateful for nurses like you that have that special skill! Paige (httpTaylor Richardson(https://chamberlain.instructure.com/courses/74479/users/125853)Jan 17, 2021  Breanna, Thank you for sharing your experience and what a cool field of nursing to work in. I recently had a baby last year and had a bad experience with my nurse and being a nurse myself it was very difficult. After going through that experience and being in such a vulnerable place it reiterated the fact that nurses need to be on our game, knowledgeable and kind at all times because sometimes that's all the patient needs. Being a labor and delivery nurse and working postpartum i could definitely see where you would have to be very in tune to reading and assessing situations for what they are as infants cannot tell us what may be going on and i can see where this field of nursing could be challenging but also very rewarding! Thanks again for sharing! (httpDanyka Garza(https://chamberlain.instructure.com/courses/74479/users/193573)Jan 17, 2021  I really enjoyed reading yTooupr post, I had a bad experience with my first pregnancy as well. I was not a nurse at the time and did not know that had my nurses taken time to listen to me, It may not have gone so bad. I went through 10 hours of labor and had gotten the epidural at about 8 hours. When I was 9 cm dilated they lost the babys heart beat and I had to go through an emergency c-section. I had several nurses and doctors in my room trying to figure out what was wrong. I do not remember much except that I started to feel pain again and I told the nurse that I was in pain and I remember her telling me that there was no way I was feeling anything because I had the epidural. Long story short they took me to the OR and I felt them cutting me open. I remember screaming and then passing out. I do not remember anything else about my daughters birth. I really enjoyed reading about how well you care for your patients no matter what their circumstance is. I did do clinicals in labor and delivery and know that it is a lot of work caring for mothers and the newborns, as well as making sure you are sending them both home to a safe environment. (https:/Stacy Owens(https://chamberlain.instructure.com/courses/74479/users/1431)Jan 11, 2021  Welcome to the first discussion of the class! Hello to all of you! You all will notice throughout the course that I typically ask quite a few questions. These questions are always addressed to the class as a whole and anyone can respond if desired. I do not respond to everyone's posts each week in order for me to avoid overwhelming the threads and to allow for more discussion among the class. I absolutely read all posts, so do not think that if I did not respond to yours that it was overlooked. I hope everyone has a great day! Stacy 788623298493 (https:/ Cynthia Augustin(https://chamberlain.instructure.com/courses/74479/users/172035)Jan 11, 2021  Professor and Class, Recently working the Emergency Department has shifted my focus to perform health assessments that are focused care. This approach provides a systematic approach to identify patient objective and subjective findings to help create a diagnosis and plan of care. The initial nursing assessment, the first step in the five steps of the Top nursing process, involves the systematic and continuous collection of data; sorting, analyzing, and organizing that data; and the documentation and communication of the data collected (Toney-Butler & Unison-Pace, 2020). For example, a patient who presents to the department of abdomen pain will direct your questions towards the GI system.  Objective findings examples: Abdominal appearance Bowel sounds auscultated Palpation of the abdomen with findings of firmness, masses and pain If possible, stool appearance Subjective findings examples: Reported bowel movements Symptoms of nausea Nutritional assessment Appetite Dysphagia Ask about last bowel movements and normal bowel patterns. Changes to bowel patterns may indicate a larger GI issue. Normal bowel patterns vary across individuals. Knowing what is normal will help the nurse differentiate if there is a new or emergent concern requiring attention. The typical patient in an emergency department ranges from life to death. Since COVID our pediatric population has decreased with an increase in middle aged and elderly patients. For exampl

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