Summarize the following text to main points and sub-points and make detailed explain for them:

Introduction to Nursing Health Assessment
Mastoura MohammedBSN-RN- MSC in CHN  PhD CHN SIU
Course Objectives: 
 
  Demonstrates a comprehensive physical assessment
applies critical thinking skills necessary to provide quality patient care 
 Differentiates between normal or abnormal physical assessment findings. Define assessment
Discuss the role of assessment as part of the nursing process
Identify skills needed for assessment
Differentiate subjective and objective data


Course Objectives:

Differentiate primary and secondary data sources
 Describe factors that affect communication
Demonstrate communication techniques
Identify phases of the interview
Describe data collection methods
Demonstrate the four techniques of physical assessment
Discuss methods used to validate assessment data
Describe various documentation methods for charting assessment data
Purpose of Assessment
The purpose of assessment is to collect data relevant to the patient’s health status, to identify deviations from normal, to discover the patient’s strengths and coping to determine actual problems, and to spot factors that place the patient at risk for health problems. 
To identify health-promoting behaviors 

Assessment requires skills. 
The Nursing Process
Nursing is the diagnosis and treatment of human responses to actual or potential health problems.
Diagnosis and treatment are achieved through a nursing process, that guides nursing practice.
The nursing process is a systematic problem-solving method that has five steps.
Definition of (NANAD)
The North American Nursing Diagnosis Association (NANAD 1994) defines a nursing diagnosis as “A clinical judgments about individual, family or community response to actual and potential health problems and life responses” 
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Skills of Assessment
Assessment requires cognitive, problem-solving, psychomotor, affective/interpersonal, and ethical skills.
Assessment is a “thinking” process. 
Cognitive/Reasoning skills are needed for critical thinking, and clinical decision making to enables you to assess your patient holistically.
 The knowledge base includes not only biophysical knowledge but also developmental, cultural, psychosocial, and spiritual knowledge. 
This knowledge base enables you to differentiate normal from abnormal findings and to identify and prioritize actual and potential problems.
Critical Thinking
Critical thinking is a complex thinking process that has been defined as reflective, reasonable thinking (Ennis, 1985). about thinking that enables you to think better (Paul,1990). Paul (1990) It is not just doing, it is asking “why?” Critical thinking involves interpretation, analysis It is the art of thinking needed for critical thinking. 
Psychomotor Skills
Psychomotor skills are needed to perform the four techniques of physical assessment: inspection, palpation, percussion, and auscultation. 
As a beginning practitioner, you may feel unsure of your technique ,but practice will enhance your skills Through experience you will become competent at performing the physical assessment and confident in interpreting your findings.
Problem-Solving Skills
Various problem-solving methods can be used for nursing process.
With experience, you will develop your problem-solving skills. 
Select the method that best suits your patient’s needs. 
prove helpful at times because it allows you to "think outside of the box.” to formulate new ideas
Affective skills 
a “feeling” process. Affective skills are needed to practice the “art”of nursing
 Interpersonal skills include both verbal and nonverbal communication skills.
 The quality of your assessment depends on your communication skills and relationship develop with your patient.
Establishing trust is essential before begin the assessment. 
conveys a message of caring and promotes human dignity
the power of a caring relationship can impact patient’s sense of worth and well-being. 
interpersonal skills are also needed to communicate with family members and members of the healthcare team.
 Communicating with healthcare team is essential for  successfully meet patient’s goals.
Clinical Decision Making
Assessment also requires clinical decision making.
 As you collect data, you will make clinical decisions  to relevance finding 
By experience, you will be able to identify what differs from the norm and use the data to make decisions that will best meet your patient’s need.
Step 1:Assessment 
is the first step in nursing process.is the process of collecting, confirming data 
. Assessment identifies patient’s strengths and limitations and performed continuously throughout the nursing process.
 After performing initial assessment, establish baseline, identify nursing diagnoses, and develop a plan. 
Then, as you implement your plan, you also assess your patient’s response. Finally, you assess the
effectiveness of your plan of care to patient.
Step 2: Nursing Diagnoses
Formulating a nursing diagnosis involves identifying and prioritizing health problems 
collect your data, you need to analyze them and  identify actual and potential health problems state them as nursing diagnoses.
. An actual nursing diagnosis identifies an occurring health problem for your patient.
 A potential nursing diagnosis identifies a high-risk health problem that most likely will occur unless preventive measures are taken. 
Once you have identified the diagnoses , you need to prioritize them in order to develop a plan of care. 
Step 3: Planning
The planning phase involves setting goals and prioritized  diagnoses
identify nursing interventions needed to meet the goals 
Communicate your plan to both the patient and all members involved
in the plan of care to maintain continuity of care to ensure success.
Step 4: Implementation
Implementation (also called intervention) involves.
carrying out your plan to achieve goals of the nursing process, which implemented  continue to assess patient’s responses and modify the plan as needed.
Be sure to document your care.

This is the “doing”phase of the nursing process, in which
you actually implement the nursing interventions in the
plan. As you implement your plan, you continue to assess
your patient’s responses and modify the plan as needed.
Be sure to document your care
step 5: Evaluation
Evaluation involves determining the effectiveness of
your plan. Did you meet your goals and outcomes? Once
again, assess your patient’s response based on the criteria you set for the outcome. If the goals and outcomes have not been met, you’ll need to rethink the plan and work through the process again to develop a more effective plan of care for your patient
Sample Nursing Diagnoses
A postoperative cholecystectomy patient might have the following nursing diagnoses:
■ Actual nursing diagnosis: Ineffective breathing pattern r/t pain as evidenced by shallow respirations, tachypnea, and lack of cough.
■ Risk nursing diagnosis: Risk for infection  r/t postoperative incision .
■.
TYPES OF HEALTH ASSESSMENT
• Initial comprehensive assessment
• Ongoing assessment
• Focused /problem-oriented assessment
• Emergency assessment


1-Initial Comprehensive Assessment
Comprehensive Assessment (head to toe) 
An initial comprehensive assessment involves
1-subjective data-
 about the client’s awareness of healthy systems,
 past health history
family history
lifestyle and health practices
2-objective data
gathered during a step-by-step  physical examination.
The nurse  collects subjective data and objective data in many settings (hospital, community, clinic, or home). 
 In a community clinic the   nurse is usually responsible for performing most of the  physical examination
assessments depends on  - 
the client’s age 
risk factors
health status
health promotion practices 
lifestyle
2- Ongoing Assessment
.An ongoing or partial assessment of the client consists of-
data collection that occurs after the comprehensive database is established. 
This consists of the client’s body systems  as a follow-up on health status.  

3-Focused or Problem-Oriented Assessment
.  It is performed when a client  comes to the health care agency with a specific health concern 
. A focused assessment consists of assessment of a particular  client problem and does not cover areas not related to the problem. 
 
4-Emergency Assessment
. An emergency assessment is a very rapid assessment performed  in life-threatening situations  
such situations is needed to provide quick treatment.  





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