FOCUS OF HEALTH ASSESSMENT IN NURSING

Virtually every health care professional performs assessments to make

professional judgments related to clients. A comprehensive health assessment
consists of both a health history and physical examination. However, the
purpose of a nursing health history and physical examination differs
significantly from medical or other types of health care examination.

TYPES OF HEALTH ASSESSMENT

The four basic types of assessment are:

• Initial comprehensive assessment

• Ongoing or partial assessment

• Focused or problem-oriented assessment

 • Emergency assessment

Initial Comprehensive Assessment

An initial comprehensive assessment involves the collection of

subjective data about the client’s perception of their health of all body parts or
systems, past health history, family history, and lifestyle and health practices
(which include information related to the client’s overall function) as well as
objective data gathered during a step-by-step physical examination.

Ongoing or Partial Assessment

An ongoing or partial assessment of the client consists of data collection

after the comprehensive database is established. This consists of a mini-
overview of the client’s body systems and holistic health patterns as a follow-up
on health status. Any problems initially detected in the client’s body system or
holistic health patterns are reassessed to determine any changes (deterioration
or improvement) from the baseline data.

Focused or Problem-Oriented Assessment

A focused or problem-oriented assessment does not replace a

comprehensive health assessment. Instead, it is performed when a
comprehensive database exists for a client who comes to the health care agency
with a specific health concern.

Emergency Assessment

An emergency assessment is a very rapid assessment performed in life-

threatening situations. An immediate assessment is needed to prompt
treatment in such cases (choking, cardiac arrest, drowning).

TYPES OF ASSSESSMENT

TYPES TIME PURPOSED EXAMPLE

PERFORMED

Initial Performed within To establish a Nursing admission

assessment a specified time complete database assessment.
after admission to
a healthcare for problem
agency. identification,
reference,

and future
comparison.
Problem- Ongoing process Specific problem Hourly assessment of
focused integrated with identified in an client’s fluid intake and
assessment nursing care. urinary output in an
earlier
assessment. ICU.

Assessment of client’s
ability to perform self-
care while assisting a

client to bathe.

Emergency During any To identify life- Rapid assessment of an

assessment physiological or threatening individual’s

psychological crisis Problems. airway, breathing status,

of the client. and circulation during a
To recognize new cardiac arrest.
or overlooked
Assessment of suicidal
Problems. tendencies or potential
for violence.

Time-lapsed Several months To compare the Reassessment of a client’s

reassessment after initial client’s current functional health patterns
in a home care or
Assessment. status to baseline outpatient setting or, in a
data previously hospital, at shift change.
obtained.

The Nurse’s Role in Health Assessment

The nurse’s role in health assessment has changed significantly over the year.
In the 21st century, the nurse’s role in assessment continues to expand, becoming
more crucial than ever. The nurse's role in assessment and diagnosis is more prevalent
today than ever before in the history of nursing. The rapidly evolving roles of nursing
(e.g., forensic nursing) require extensive focused assessments and the development of
related nursing diagnoses. In addition, the current focus on managed care and internal
case management has dramatically impacted the nurse's assessment role.

The acute care nurse performs a focused assessment and then incorporates
assessment findings with a multidisciplinary team to develop a comprehensive care
plan.
 Critical care outreach nurses need enhanced assessment skills to safely
assess critically ill clients outside the structured intensive care environment (Coombs
& Moorse, 2002).

Ambulatory care nurses assess and screen clients to determine the need
for physician referrals.

Home health nurses make independent nursing diagnoses and referrals for
collaborative problems.

Public health nurses assess the needs of communities.

School nurses monitor the growth and health of children.

Hospice nurses assess the needs of terminally ill clients and their families in
all settings.

Nurse increasingly documents and retrieves assessment data through

sophisticated computerized information systems (Lee, Delaney, & Moorhead, 2007).
As a result, nursing health assessment courses with informatics content are
becoming the norm in baccalaureate programs.
 ACTIVITY 2

Instructions: Identify and provide each example of each type of

Health Assessment given below. You may answer in a separate
sheet/s.

No. Types of Health Assessment Examples

1.

2.

3.

4
 ACTIVITY 3

Instructions: Describe five to ten (5-10) Nurse's Role in Health

Assessment in a Hospital Setting. You may answer in a separate sheet/s.