Health Assessment

Preface xi

Acknowledgements xii

Dedication xiv

List of contributors xv

1 The human body (C. Meurier) 1

Section 1: Introduction 1

Anatomical terms 2

Levels of organisation of the body 4

Hierarchy of functions 5

The basic structure of cells 5

Homeostasis 8

Organ systems 11

Section 2: The integumentary system 11

Structure of the skin 12

Thermoregulation and the skin 14

Section 3: The musculoskeletal system 14

The human skeleton 14

Bone 14

Joints 15

Muscular tissue 16

Section 4: The nervous system 17

Structure and function of the nervous system 17

The central nervous system 19

The autonomic nervous system 22

Sensations 23

Somatic senses 23

Pain 23

Section 5: The special senses 24

The eye 24

The ear 26

Section 6: The endocrine system 28

Hormones 28

Negative and positive feedback mechanisms 28

Section 7: The respiratory system 28

The mechanism of breathing 31

The transport of oxygen 32

The transport of carbon dioxide 33

Section 8: The cardiovascular system 33

The blood 33

The heart 34

Blood vessels: arteries, capillaries and veins 37

Section 9: The lymphatic and immune system 38

Components 38

Functions 38

Section 10: The digestive system 40

Functions 40

Organs of the digestive system and their location 40

Section 11: The urinary system 43

The kidney and its functions 44

Section 12: The reproductive system 46

Female reproductive system 47

The male reproductive organs 49

2 Nursing assessment and care planning (J. Aldridge, A. Eshun and C. Meurier) 52

Introduction 52

Nursing assessment and the nursing process 53

Advantages of using a conceptual model in assessment 71

Key issues and developments 72

3 Concepts of health, illness and holism (C. Meurier) 76

Introduction 76

Being ‘healthy’ 77

Health beliefs and health behaviour 80

Illness, sickness and disease 82

Seeing the person as a whole 84

Assessment 87

4 Factors to consider when assessing patients (A. Crouch, G. Rumbold, M. Thompson and W. Turner) 95

Section 1: Introduction 95

Ethical aspects of assessment 95

Respect for persons – definition 96

Privacy 98

Confidentiality 99

Respect for dignity 101

Truthfulness 102

Section 2: The environment, health status, age and cognitive ability of the patient, learning disability and health assessment 103

Environment 104

Health status of the patient 105

The patient’s age 106

Cognitive development and ability 108

The assessment of children 112

Section 3: Gender and health assessment 114

Trends and patterns of health and disease among men and women 115

Health issues and dilemmas for men and women 116

A health assessment approach: some practical aspects to consider 118

5 Communication skills for holistic health assessment (A. Crouch) 128

Introduction 128

Definition and classification 129

Factors that facilitate effective communication 131

Skills needed during holistic health assessment 132

Barriers to communication during holistic assessment 138

Record keeping 144

6 Physical assessment (C. Meurier, J. Brown and A. Crouch) 148

Section 1: Introduction 148

The purpose of physical assessment 150

Approach to physical assessment 150

Preparation for physical assessment 150

Techniques of physical assessment 151

The general survey and vital signs 154

Section 2: Physical assessment of the integumentary system 163

The skin 164

Assessment of nails 166

Assessment of hair 167

Section 3: Physical assessment of the respiratory system 168

Taking a health history 168

Physical examination 169

Section 4: Physical assessment of the cardiovascular system 171

Relevant health history 172

Risk factors for coronary heart disease 175

Physical examination 175

Section 5: Physical assessment of the nervous system 178

Relevant health history 178

Examination 178

Section 6: Physical assessment of the eyes, ears, nose and throat 187

The eyes 187

The ears 191

The mouth, nose, sinuses and throat 192

Section 7: Physical assessment of the digestive system 195

Relevant health history 196

Risk factors 196

Physical assessment 197

Section 8: Physical assessment of the urinary tract system 200

Assessment of the urinary system 201

Assessment of the prostate gland 204

Section 9: Physical assessment of the musculoskeletal system 205

The musculoskeletal system 205

Assessment 206

Section 10: Physical assessment of the female and male reproductive systems 210

Examination of the breast 210

Examination of the female genitalia 214

Assessment of the male reproductive system 224

Record keeping 228

7 Assessment of nutritional status (M. Ingham and J. O’Reilly) 234

Introduction 234

Purpose of nutritional assessment 235

Components of food 235

Nutritional requirements 245

Dietary guidelines 246

Assessing nutritional status 246

Dietary assessment 257

Nutritional interventions 259

8 Social assessment in healthcare (S. O’Brien) 264

Introduction 264

The purpose of social assessment 265

Health policy: assessing social needs 266

Nursing models, social influences and assessment 267

Nursing and interprofessional approaches to social assessment 268

The social assessment/analysis framework 271

The levels of social assessment 284

9 Psychological assessment (J. H. Parkes) 288

Introduction 288

What is psychological health? 289

Why conduct a psychological assessment? 290

What to assess 291

How to conduct the psychological assessment 299

Nurses’ role in assessment 299

The assessment process 300

Accurate reporting and documentation 307

10 Cultural and spiritual health assessment (S. Allen and A. Crouch) 311

Cultural health assessment 311

Spirituality and spiritual needs 318

Glossary 331

Index 339