Unit 3

HEALTH ASSESSMENT IN COMMUNITY AREA

1. UNIT-3 HEALTH ASSESSMENT By-Mandeep Kaur

2. Nursing assessment is a continuous, systematic, critical, orderly analysing and interpreting information about physical, psychological , social needs of a person, the nature of self care deficient, others factors influencing conditions and care. HEALTH ASSESSMENT

3. There are two main components of health assessment- 1.TAKING HISTORY 2.PHYSICAL EXAMINATION COMPONENTS OF HEALTH ASSESSMENT

4. Characteristics of a healthy person can be discussed under the following headings- 1.PHYSICAL CHARACTERISTICS 2.SOCIAL CHARACTERISTICS 3.SPIRITUAL AND CULTURAL CHARACTERISTICS 4.MENTAL CHARACTERISTICS CHARACTERISTICS OF A HEALTH PERSON

5. Physical wellbeing refers to the normal functioning of all tissues , organs, and system of the body.Some physical characteristics of a health individual are atated below- 1.GENERAL PHYSICAL EXAMINATION -Healthy appearance, appropriate weight and height, intelligent, smiling face, well dressed and good posture. 2 . MENTAL STATUS- Well oriented to person, place and time, maintain good eye contact, fully conscious. 3.SPEECH -Clear and appropriate, correct selection of words during speech, command on sentence and wordings. 1.PHYSICAL CHARACTERISTICS

6. 1.HEAD AND NECK (a)HAIR (b)FACE (C)NECK (d)EYES (e)EARS (f)NOSE HEAD TO TOE EXAMINATION

7. 2.MOUTH ( a)LIPS (b)BUCCAL MUCOSA (c)GUMS (d)TEETH (e)TASTE 3.CHEST 4.HEART 5.BREAST 6.ABDOMEN 7.UPPER AND LOWER EXTREMITIES 8.SENSORY SYSTEM

8. A health individual should have good relations, harmony with members of family, society or community , also participate in social activities and also active socially for over all well being of the society 2.SOCIAL CHARACTERISTICS

9. A healthy individual should have holistic approach.He believes in his religion but should show respect other's religions and beliefs. He should also respect thecultural values of self, society as well as should give respect to other's cultural norms and values. 3.SPIRITUAL AND CULTURAL CHARACTERISTICS

10. Mental health is related to mind and refers to normal functioning of mind and not merely the absence of mental disease and illness.Mentally health person is free from mental conflicts and tension.A mentally healthy person maintains good social relations with the people of society. 4.MENTAL CHARACTERISTICS

11. NEW BORN ASSESSMENT

12. A complete physical assessment will be done that includes every body system. Throughout the hospital stay, doctors, nurses, and other health care providers continually assess the health of the baby, observing for signs of problems or illness. Assessment may include: 1.FAMILY HISTORY 2.PAST MEDICAL HISTORY 3.PRESENT ILLNESS AND CHIEF COMPLAINT 4.ASSESSMENT OF DEVELOPMENT 5.REVIEW OF SYSTEM 6.HEAD TO TOE EXAMINATION HEALTH ASSESSMENT OF INFANT

13. 1.FAMILY HISTORY- Information about the financial, social, domestic , educational and nutritional condition of the family can be obtained from the mother or guardian. 2.PAST MEDICAL HISTORY -Health of mother during pregnancy,Birth history,History of neonatal stage, Immunization,General health of the child etc.

14. 3.Present illness and chief complaints 4.Assessment of Development- Weight , height and the circumference of head or arm, developmental milestones. 5.Review of system -Presence of Pediculosis ,Ear discharge,Excessive running of nose, allergic conditions. 6.Head to toe examination

15. Pre school going age (3-5) years is that period in a child's life when intense growth and development takes places.Following component can be included in the health assessment- 1.Past medical history of child. 2.Personal and family history of child. 3.Various health checkups related to the growth and development of child . Pre school children

16. 4.Immunization status of child 5.Nutrition level of child and his eating habits 6.Present condition of a child's health and his major problems. 7.Head to toe physical examination of a child.

17. 1.Past medical history 2.Personal and family history of children- CHN mmeting is held at the time of admission in the school. 3.Periodic checkup of children- checkup at the time of admission, Health checkups of child after 4 year, Checkup at the time of leaving the school. 3.SCHOOL GOING CHILDREN

18. 4.Nutritional assessment- assessment of food, child gets at home and the supplementary meals given in the school. 5.Daily examination -is conducted by the teachers.It is essential that the teachers can be trained in diagnosing the illness and providing routine treatment.It is necessary to keep an eye on the cold, cough, headache, skin diseases and other infections.

19. Adulthood of a person can be determined on the basis of his age at level of maturity.Adulthood can be divided into three parts- YOUNG ADULT-18-40 YEARS MIDDLE AGED ADULTS-40-60 YEARS IDERY ADULTS-ABOVE 60 YEARS OF AGE Complete physical check up and history have an important place in the health assessment of an adult person.It is essential to pay attention to the following steps of health assessment- HEALTH ASSESSMENT OF ADULT PERSON

20. 1 .Psychological development 2.Cognitive development 3.Moral and spiritual development 4.Health protection- accidents,infections, suicide, sex related problems, drug addiction, obesity,blood pressure and mental disorders are the major health hazards of adult.

21. It is necessary to pay attention to the following factors- 1.Old people may be suffering from one or more than one health problems. 2.Symptoms of disease may not be well pronounced in the old people. 3.Old people may habitate to live with disease as they believe that now there is no remedy for it. 4.Behaviour of family and society towards aged person plays an important role in their health assessment. HEALTH ASSESSMENT OF AGED PERSON

22. 1.Past medical history General health and strength Disease of youth and childhood Surgery or serious accidents Previous treatment 2.Personal and family history -In this attention is paid to place of birth, marriage, divorce, education ,position of familyetc. 3.Present Illness

23. 4.CHIEF COMPLAINTS- While assessing the health of old people, their chief complaint should be inquired so as the priorities may be decided in the implementation of care.

24. 5.REVIEW OF SYSTEM- head to toe examination is desirable for correct assessment .Result of examination help in determining many disease or health problems.

25. 6.ASSESSMENT OF DISABILITIES- They may have problem in movement , sitting, getting up, climbing the stairs and maintaining balance etc.Old persons may be suffering from physical, psychological response, social and sexual impairment or disabilities.

26. Right from the time of confirmation of pregnancy, antenatal assessment of the pregnant women begins. 1.COMPONENTS OF ANTENATAL ASSESSMENT Taking medical history Physical examination Laboratoey examination Monitoring of growth and development of embryo HEALTH ASSESSMENT OF PREGNANT WOMEN

27. 2.MEDICAL HISTORY History regarding cycle started *Age at which menstrual cycle started *Regularity of menstrual cycle, amount and interval *Obstetrical history *Previous Pregnancy *Experience at the time of delivery *Age, sex , birth and weight of the child delivered *Health condition of former child at present *Planned/unwanted

28. 3.PERSONAL AND FAMILY HISTORY *Social History *Educational/standard of women and her husband *Marital and social sexual problem *General status of health 4.PHYSICAL EXAMINATION *General examination *Measuring weight and height *Vital signs *Gynaecological examination *Examination of breasts or abdomen *Vaginal examination

29. 5.LABORATORY EXAMINATION *Testing haemoglobin *Blood group and Rh factor, WBC count *Urine Examination *Blood sugar test *Stool test

30. 6.MONITORING OF GROWTH AND DEVELOPMENT OF FETUS-P regnant women should be called to the clinic for examining the growth of the embryo in womb in the following manner- *From 30 to 36 week , every 15 days. *After that till pain starts, once in every 7 days

31. 7.DETECTING THE HIGH RISK PREGNANCY *Age of the pregnant women is either below 15 or above 30 years *Multipara pregnant women *Anaemia *Malpresentation *Pre eclampsia and eclampsia *Antepartum Haemorrhage *Longer period of gestation *Hydramnios *Medical conditions *Earler still birth, baby died in womb, instrumental delivery, c-section