He believes that the proper assessment of nurses to the patient lays at the heart of nursing care which includes the determination of the problem and the planning of the care not just more on clipboards and forms to be filled out by sick According to the author, carrying out any nursing assessment is not just a matter of asking questions and checking the boxes. Moreover, the author said that the art of nursing is caring enough and Patients that require ostomies include those with carcinomas of the bowel, female reproductive organs, and bladder.
The "daVinci Anatomy Icon" denotes a link to related gross anatomy pictures. A large percentage of the time, you will actually be able to make a diagnosis based on the history alone. The value of the history, of course, will depend on your ability to elicit relevant information.
Your sense of what constitutes important data will grow exponentially in the coming years as you gain a greater understanding of the pathophysiology of disease through increased exposure to patients and illness.
However, you are already in possession of the tools that will enable you to obtain a good history. That is, an ability to listen and ask common-sense questions that help define the nature of a particular problem. It does not take a vast, sophisticated fund of knowledge to successfully interview a patient.
In fact seasoned physicians often lose site of this important point, placing too much emphasis on the use of testing while failing to take the time to listen to their patients. Successful interviewing is for the most part dependent upon your already well developed communication skills.
What follows is a framework for approaching patient complaints in a problem oriented fashion. The patient initiates this process by describing a symptom.
It falls to you to take that information and use it as a springboard for additional questioning that will help to identify the root cause of the problem. Note that this is different from trying to identify disease states which might exist yet do not generate overt symptoms.
To uncover these issues requires an extensive "Review Of Systems" a. Generally, this consists of a list of questions grouped according to organ system and designed to identify disease within that area.
For example, a review of systems for respiratory illnesses would include: Do you have a cough? If so, is it productive of sputum? Do you feel short of breath when you walk?
In a practical sense, it is not necessary to memorize an extensive ROS question list. Rather, you will have an opportunity to learn the relevant questions that uncover organ dysfunction when you review the physical exam for each system individually.
In this way, the ROS will be given some context, increasing the likelihood that you will actually remember the relevant questions.
Always introduce yourself to the patient. Then try to make the environment as private and free of distractions as possible.
This may be difficult depending on where the interview is taking place. The emergency room or a non-private patient room are notoriously difficult spots. Do the best that you can and feel free to be creative.
If possible, sit down next to the patient while conducting the interview. Remove any physical barriers that stand between yourself and the interviewee e.
These simple maneuvers help to put you and the patient on equal footing. Furthermore, they enhance the notion that you are completely focused on them. You can either disarm or build walls through the speech, posture and body languarge that you adopt.
Recognize the power of these cues and the impact that they can have on the interview. While there is no way of creating instant intimacy and rapport, paying attention to what may seem like rather small details as well as always showing kindness and respect can go a long way towards creating an environment that will facilitate the exchange of useful information.
If the interview is being conducted in an outpatient setting, it is probably better to allow the patient to wear their own clothing while you chat with them.
At the conclusion of your discussion, provide them with a gown and leave the room while they undress in preparation for the physical exam. Ideally, you would like to hear the patient describe the problem in their own words. Open ended questions are a good way to get the ball rolling.
How can I help you? What seems to be the problem?This article outlines the process of taking a history from a patient, including preparing the environment, communication skills and the importance of order. Taking a comprehensive health history is a core competency of the advanced nursing role.
The purpose of the health history is to source important and intimate knowledge about the patient and allow. “A guide to taking a patient’s history” is an article published in Nursing Standard in the December 5, issue. Lecturers of nursing practice in the United Kingdom, Hillary Lloyd, and Stephen Craig explore the methodology of obtaining patient history/5(1).
Sep 30, · A Patient's Guide to Taking Warfarin Warfarin (brand names Coumadin and Jantoven) is a prescription medication used to prevent harmful blood clots from forming or growing larger.
Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a heart attack, stroke, deep vein thrombosis or pulmonary embolism.
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James Ryan P. Reblando MENA College of Management Dubai Academic City, United Arab Emirates [email protected] The article begins by elaborating why environmental preparation is essential.