Question

Practice Focused Assessment Scenarios: can you describe each type of focused assessment for me please. thanks

1). 87yoF with new altered mental status. She has a history of HTN, HLD and DMII.

2.) 67yoM who fell down a flight of stairs and has a laceration on the posterior side of head. The laceration has stopped bleeding but did require four sutures.

3.) 56yoM with new onset 10/10 CP and LUE throbbing pain. He has a history of HTN, OSA, HLD, CVA four years ago

4.) 68yoF with Hemoptysis, cough, SOB and Dyspnea. She has no PMH. Her cough started two days ago however over the last few hours her sputum has changed from yellow and thick to pink-tinged.

5.) 35yo F with N/V and persistent LUQ abd pain. She has history of hypothyroidism, and lupus. She last had emesis two hours ago and it had a coffee ground consistency.

6.) 21yoM who fell off of a chairlift while skiing. He struck his RLE on rock and has a compound fx. It was immobilized in the field. He has no PMH and did not sustain a head strike during is fall.

Answer 1

Focused assessment means specific assessment focusing on the system or systems involved in the patient's problem.It helps to identify actual or potential patient problems and evaluating the effectiveness of treatments, medications, and nursing or medical interventions.

1)87yoF with new altered mental status. She has a history of HTN, HLD and DMII.

A focused neurological assessment is needed. It includes the assessment of motor and sensory function tests, as well as cranial nerve testing. Then,

• Mental status.
• Motor function and balance.
• Sensory assessment
• Reflexes
• Evaluation of the nerves of the brain.
• Coordination assessment

2.) 67yoM who fell down a flight of stairs and has a laceration on the posterior side of head. The laceration has stopped bleeding but did require four sutures.

• Health history. Keep the patient's clinical status in mind when performing a wound assessment.
• Location and type of laceration.
• Dimensions.
• Tissue type.
• Drainage and its odour
• Periwound skin.

3.) 56yoM with new onset 10/10 CP and LUE throbbing pain. He has a history of HTN, OSA, HLD, CVA four years ago

Assessment of pain includes the assessment of onset, duration and frequency of pain. Then assessment of neurological system including cranial nerves.

Then assess the cardiovascular and renal function.

4.) 68yoF with Hemoptysis, cough, SOB and Dyspnea. She has no PMH. Her cough started two days ago however over the last few hours her sputum has changed from yellow and thick to pink-tinged.

Detailed history-taking and careful physical assessments are necessary to identify the exact cause.

Assess the respiratory sytem. Observe respiratory effort, use of accessory muscles, mental status, and ability to speak. Pulsus paradoxus may exist in COPD, asthma, or cardiac tamponade. Stridor is indicative of an upper airway obstruction.

5.) 35yo F with N/V and persistent LUQ abd pain. She has history of hypothyroidism, and lupus. She last had emesis two hours ago and it had a coffee ground consistency.

This type of vomiting is due to the presence of coagulated blood in the vomit.

Inspect emesis for colour, consistency, quantity, odour. Blood (bright red or black) in emesis, coffee ground emesis. The color of the vomited blood varies depending on how long the blood was in your gastrointestinal (GI) system

Assess the gastrointestinal system.

6.) 21yoM who fell off of a chairlift while skiing. He struck his RLE on rock and has a compound fx. It was immobilized in the field. He has no PMH and did not sustain a head strike during is fall.

• Assessment of pain which includes duration, onset and intensity.
• Observe for compartment syndrome .
• Monitor for fat embolism , especially if this is a long bone fracture: Assess mental status and respiratory system: confusion, restless, increased respiration, difficulty breathing
• Assess neurovascular status. Assess the function of the nerves and blood flow for possible compartment syndrome