1. Biomedical "Medical" Model
    (concept of health)
    • -Used by Dr's physicians
    • -Focus is on dx & treatment of disease
    • -Assessment factors (S&S of disease)
  2. Holistic Model
    (concept of health)
    • -Used by nurses (not just S&S)
    • -Expanded focus: views the body, mind, & spirit as interdependent & functioning as a whole w/in the enviro.
    • -Individuals are considered active participants in their health care (must believe in treatment in order for it to work)
    • -Assessment factors (not just S&S--include culture&values, family&social roles, self-care behaviors, enviro stress, developmental tasks)
  3. Health Promotion/Disease Prevention
    • *Forms core of nursing practice
    • -1° Prevention: promote optimum health prior to the onset of problems; vaccines, wash hands, exercise, diet)
    • -2° Prevention: early ID and treatment of existing health problems; pap smear, mammogram, TB test; (it identifies but doesn't prevent)
    • -3° Prevention: rehabilitation & restoration of health
  4. Assessment
    • *collection of subjective and objective data
    • -starts w/ first pt contact
    • -forms the data base
  5. Subjective/Objective
    • S: statments, sypmtoms
    • O: observations, signs
    • ex: inspection; palpation: touch skin for warmth; percussion: tap chest for sounds; auscultation: stethoscope to listen to lungs or heart; Lab values/diagnostic test results; pt records: readable, can include subjective data
  6. Diagnosis
    • -Judgement regarding an individual's state of health
    • -Derived from the subjective and objective data base
  7. Medical Diagnosis
    • -Assessment data (used to diagnose disease)
    • -Can't be made by nurses but nurse practitioner's can
  8. Nursing Diagnosis
    • -Assessment data (used to dx pt's response to actual or potential health problems)-pain, altered skin integrity, ineffective coping, etc.
    • -Pts response to illness or disease
  9. Types of Data
    • -COMPLETE: health history & physical exam. Ex: 1st appt in primary care, hospital admission
    • -EPISODIC: mini data base concerning one problem. Ex: acute illness (common cold)
    • -FOLLOW-UP: to assess progress
    • -EMERGENCY: rapid & focused data collection. Ex: chest pain (h/o of heart trouble, MI, PUD, hiatal hernia?); The type of data may quickly inc/dec level of suspicion for a certain type of problem
  10. Social Distance
    • -4-12 ft
    • -Interview range
  11. Personal Distance
    • -1.5-4 ft
    • -Distance for most physical assessment
  12. Intimate Zone
    • -0-1.5 ft
    • -Some physical assessment
  13. Interview
    • -To collect subjective data (health history, symptoms)
    • -Assist pt to ID areas of concern & perceptions of health status
    • -ID person's problems & strengths
    • -Establish trust for ongoing working relationship
    • -Provide comfortable bridge to physical exam
    • -Provide opportunity for education
  14. Terms of Interview
    • -Purpose
    • -Time (set time limits in beginning)
    • -Presence of others: (may be unable to speak freely, may help w/ info acquisition, interpreter violates confidentiality, risk of misinterpretation)
    • -Confidentiality: (or limits of; avoid convo in public places, don't discuss w/ friends/family, don't refer to pt by name, builds pt trust/dec litigation
  15. Verbal & Nonverbal Comm.
    • V: tone, words, speed, vocalizations, what you don't say
    • NV: posture, gestures, facial expression, eye contact, body position, location in room
  16. Communication
    • -Is 2 way (sending and receiving messages)
    • -Emotional impact of illness can affect interpretation of msgs. Ex: may not be able to process info, pt teaching may have minimal impact in hospital setting
Card Set
202:Intro and Interviewing