7.3

• Health Assessment


  Collection of data about an individual's health
• Purpose of Health Assessment


  • To make a clinical judgment or diagnosis about the individual's health state or condition
  • To obtain baseline data about the client's functional abilities
• Health Assessment encompasses


  • Physical
  • Psychological
  • Social
  • Spiritual
• Physical Examination


  Head-to-toe review of each body system that offers objective information about the client and allows the healthcare provider to make clinical judgments
• Purpose of Physical Examination

  • For routine screening to determine the client's eligibility for health insurance
  • For acquiring a new job
  • For the client's admission to the hospital
• Modes of Examination

  • Inspection
  • Palpation
  • Percussion
  • Auscultation
• Positions in Physical Examination


  • Dorsal Recumbent
  • Dorsal/Supine
  • Sitting or Seated Position
  • Fowler's position
  • Lithotomy
  • Genupectoral/Knee-Chest Kneeling position
  • Lateral/Side-lying Position
  • Sim's Position/Semi-Prone Position
  • Prone/Face-lying position
• Assessing the General Appearance and Behavior of an Individual


  • Age, sex, race
  • Body built, height, and weight in relation to the client's age, lifestyle, and health
  • Hygiene and grooming
  • Signs of distress
  • Attitude
  • Speech
  • Posture and gait
  • Body and breath odor
  • Obvious sign
  • Affect and mood
  • Thought process
• Laboratory and Diagnosis Examinations

  Specimen used: urine, stool, blood, other body secretions
• Functional Health Framework


  Evaluates the effects of the mind, body, and environment in relation to a person's ability to perform the task of daily living
• 11 Functional Patterns


  • Health Perception and Health Management
  • Activity and Exercise
  • Nutrition and Metabolisms
  • Elimination
  • Sleep and Rest
  • Cognition and Perception
  • Self-Perception and Self-Concept
  • Roles and Relationships
  • Coping and Stress Tolerance
  • Sexuality and Reproduction
  • Values and Belief
• Head-to-Toe Framework


  • Collecting data from head and systematically to toe in a Cephalo-Caudal Manner
  • Assessing general health state: vital signs, weight, nutritional status
  • Assessing head, neck, chest, abdomen, extremities, genitals, rectum
• Body System Framework


  • May be used during the assessment, especially among acutely and critically ill clients/patients
  • Assessing respiratory, cardiovascular, musculoskeletal, gastrointestinal, integumentary, endocrine, reproductive, psychosocial, neurologic, sensory systems
• Vital Signs

  • Body temperature
  • Pulse
  • Respiration
  • Blood pressure
• Core Temperature


  Temperature of the deep tissue of the body, measured by taking an oral and rectal temperature
• Surface Temperature


  Temperature of the skin, subcutaneous tissue, and fat, measured by taking axillary temperature
• Factors Affecting the Body's Heat Production

  • Basal Metabolic Rate (BMR)
  • Muscle Activity
  • Thyroxin Output
  • Epinephrine, Norepinephrine, and Sympathetic Stimulation
  • Increase Temperature of the Body Cells
• Processes Involved in Heat Loss

  • Radiation
  • Conduction
  • Convection
  • Evaporation
• Factors Affecting Temperature

  • Alterations in Body Temperature
  • Types of Fever
  • Decline of Fever
  • Clinical Signs of Fever
  • Interventions in Clients with Fever
• Factors Affecting the Pulse Rate

  • Pulse Sites
  • Assessment of the Pulse
• Two Types of Breathing

  • Costal
  • Diaphragmatic
• Respiratory Centers


  • Medulla oblongata
  • Pons
  • Carotid and Aortic Bodies
• Assessing Respiration

  • Rate
  • Depth
  • Rhythm
  • Quality or Character
• Determinants of Blood Pressure


  • Blood Volume
  • Cardiac Output
  • Elasticity or Compliance of Blood Vessels
  • Peripheral Resistance
  • Blood Viscosity
  • Sex/Gender
  • Medications
  • Diurnal Variations
  • Diseases Process
• Core body temperature


  The temperature of the deep tissue of the body, measured by taking an oral and rectal temperature
• Surface temperature


  The temperature of the skin, subcutaneous tissue, and fat, measured by taking axillary temperature
• Body heat is primarily produced by metabolisms
• The heat-regulating center is found in the hypothalamus
• Basal Metabolic Rate (BMR)


  • The younger the person, the higher the BMR
  • The older the person, the lower the BMR
  • Therefore, older persons have lower body temperature than the young
• Muscle activity


  • Exercise and swimming increase cellular metabolic rate, therefore increasing body heat temperature
• Thyroxin output


  • Increases cellular metabolic rate (chemical thermogenesis)
  • Hyperthyroidism is characterized by an increase in body temperature
• Epinephrine, Norepinephrine, and Sympathetic Stimulation


  • Increase the cellular metabolisms, thereby increasing body temperature
• Fever


  • Increases the rate of cellular metabolisms
• Processes involved in heat loss

  1. Radiation

  2. Conduction

  3. Convection

  4. Evaporation
• Factors affecting temperature

  • Age
  • Diurnal variations
  • Exercise
  • Hormones
  • Stress
• Pyrexia


  Body temperature above the normal range
• Hyperpyrexia


  Very high fever, 41°C (105.8 F) and above
• Hypothermia


  Subnormal core body temperature, caused by excessive heat loss, inadequate heat production, or impaired hypothalamic function
• Types of fever


  • Intermittent
  • Remittent
  • Relapsing
  • Constant
• Crisis of flush or defervescence stage


  The sudden decline in fever, indicating impairment of the function of the hypothalamus