While conducting a physical assessment for a client with asthma, ...

[tnt_battle]

While conducting a physical assessment for a client with asthma, the nurse notes that the client is wheezing and documents this finding in the medical record.
 
  Which phase of critical thinking is represented by this nurse's actions?
  1. Collection of information.
  2. Evaluation.
  3. Generation of alternatives.
  4. Analysis of the situation.

Question 2

The nurse is completing an admission assessment. The assessment form allows for the separation of subjective and objective data. Which data is considered subjective?
 
  Select all that apply.
  1. The client's mother informs the nurse that her daughter has not been sleeping due to pain.
  2. The client states, I have pain in my belly that is 7 out of 10.
  3. Abdominal assessment reveals a firm, hard abdomen.
  4. The client is weak and looks very pale.
  5. The client appears nervous during the data collection period.

[dominiqueenicolee]

Answer to Question 1

Correct Answer: 1

Collection of information is the initial step in the process. During this phase the nurse will assess available information. Evaluation is the final step in the process. During evaluation the nurse will determine the effectiveness of actions taken. When generating alternatives for action the nurse will use critical thinking skills to determine available options for action. Analysis of the situation occurs when the nurse employs assessment skills to review and analyze the situation. The analysis will provide the nurse with the understanding of what the best plan of action will be.

Answer to Question 2

Correct Answer: 1, 2

Subjective data is information the client experiences and communicates to the nurse. This information can be provided by either the client or other individuals. Primary subjective data is information the client experiences and communicates to the nurse. Information provided by family is also considered subjective but is termed secondary. Assessment data that are observed by the examiner are termed objective data. Reports by the client's mother are considered secondary subjective information. The statements made by the client are referred to as primary subjective data. The characteristics of the abdomen, the client's strength level, color, and psychosocial assessment are termed objective data.

[tnt_battle]

TYSM

[ghepp]

Gracias!