Interview and Examination for Patients.
Please use ONLY the online lesson and ebook for citation and references.
Hello Professor and class
Lets discuss Casey's story.
What part of the interview and examination can be done prior to his mother's arrival?
Prior to his mothers arrival, can be done a brief physical examination, also past medical history. "Past health events are important because they may have residual effects on the current health state. The previous experience with illness may also give clues about how the person responds to illness and the significance of illness for him or her" (Jarvis, 2016). First i would make sure that Casey has appropriate development age, to proceed with my assessment. I will ask Casey his current pain level, if he is comfortable, what else can i do for him. As the mother arrives to the Hospital, I will verify the information, and complete my full assignment to begin treatment.
As you enter the room for the first time, what should you observe as part of the general survey?
As I enter the room, first I will introduce myself, tell him my name, date of birth, what happened to his leg, hows the pain level. These questions will help me evaluate his developmental age if its appropriate. Also how he interacts with me how is his behavior.
As you complete his history, what areas are especially important?
I will put special attention of Casey's current health status, past medical history. Also nutrition, activities, interests any drug or alcohol use. "Providing age-appropriate assessment is the foundation of creating a quality plan of care" (Chamberlain College of Nursing, 2015).
What are the important developmental considerations for Casey?
Physical, and Psychological Development. Teens are very self aware of their looks. How other perceive them. Casey may want to know how the fracture may affect his look and his social life. How it would affect his activities. "Usually you can assess mental status through the context of the health history interview". (Jarvis, 2016).
Jarvis, Carolyn. (2016) Physical Examination and Health Assessment 7th Edition. Elsevier: St Louis, Missouri.
Chamberlain College of Nursing (2015). NR351 RN Health Assessment. Week 3 lesson. Downers Grove, IL: Online Publication.
Mr. Yoder does seem to have some moderate functional decline since his hospitalization. Mr. Yoder's decline seems like a normal decline with a man his age and just being hospitalized. I think his recovery should be good as long as he receives some strengthening physical and occupational therapy at home. As long as Mr. Yoder can stay active by doing his moderate-intensity aerobic workout during the week, in 10 minute intervals for at least a 150 minutes each week he should do great. He just needs to gain back some strength he lost while in the hospital, he can start off slow and gradually work his way back to his baseline or better. The risks of Mr. Yoder living with Jon and Judy are that Jon and Judy are at risk for caregiver burnout which leads to disturbances, depression, morbidity and even increased mortality. The health and well-being of the caregiver are closely linked, that is why assessing the well-being of the caregiver is just as important as assessing the well-being of the older adult. That is why it is important for Jon and Judy to take advantage of any help they can get in the home with Red and any support groups that are available for caregivers in the community. The benefits of Red living with Jon and Judy are that Red will be home amongst his family where he feels comfortable. Jon and Judy can help him with his ADLs and get him back to where he needs to be. Red wont be so isolated alone on that farm by himself, he will be engaging with the family and friends that will help keep his spirits up and give him a better quality of life. The risks of Red living at home at discharge are that he could fall apart and really hurt himself. The isolation of living alone could make him really depressed and he will start to not care about taking care of himself which will lead to a bigger health decline. The benefits would be that he retains his independence in his own home where he feels comfortable and is familiar with the environment. If services were in place I still don't feel that it would be a safe discharge right away I feel he still needs to go home with Jon and Judy until he gets his strength back to his baseline pre hospitalization. I think the best option for Red at this time are home with his family and HHC, if he progresses to get worse I think his family should look at an ALF or a Continuing-Care retirement community. If he declines even further, then a Long Term Care Facility will have to be an option. But if Red improves back to baseline, I think he should be able to go home with hopefully continuing family and community support.
This is why a total comprehensive assessment is of utmost importance at the time of discharge so the right decision can be made for Red.
Jarvis, C. (2016). Physical examination & health assessment (7th ed). Philadelphia, PA.
Chamberlain College of Nursing. (2016) NR-305 Week 3. Introduction to Health Assessment. [Online Session] Downers Grove, IL: Devry Education Group.