Browse through your books and internet and answer the following questions.
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1. Define Functional Assessment
- This method of measuring improvement, an individual’s ability to perform a task, or response to
treatment has lacked the consistency needed for making comparisons and for tracking changes over time
to study their real rehabilitation outcomes
Source: https://now.aapmr.org/functional-assessment/
2. Describe the importance of a functional assessment
- Functional assessment measures an individuals level of function and ability to perform functional or
work related tasks on a safe and dependable basis over a defined period of time. Assessment should
include an examination consisting of a pertinent clinical history, behaviors that might impact physical
performance, musculoskeletal, neuromuscular, functional testing, and an assessment of effort.
Source: https://now.aapmr.org/functional-assessment/
3. Discuss the components of a functional assessment.
a. Physical assessment
- Score each task 0 or 1 except for vision and hearing (Vision - 2 points for 20/20, allow 2 errors, and 1
point for 20/60, allow 1 error; Hearing, 1 point each ear, if hears correctly). If a task cannot be complete
in less than 30 seconds, go on to the next one.
Follow-up recommendations: The complete physical exam and formal motor/mobility evaluation will
dictate interventions such as OT, PT, hearing and vision aids, etc.
b. Health history
- Height and weight and direct observation of teeth, gums, and dentures.
c. Self-care assessment
- Observation of patient transfer from waiting room to exam room, to undressing, to exam table.
d. Psychological assessment
a. cognitive functioning
- Attentional: If all correct = 4. Subtract #'s of each miss down to 4 which = 0.
Memory: 1 point for each object recalled.
Visual-Spatial: Clock face, 1 point for valid attempt, 2 if clearly recognizable.
Depression: Translate 0-10 to a 0-4 scale as follows: 9-10 = 4, 6-8 = 3, 4-5 = 2, 2-3 = 1, 0-1 = 0.
Follow-up recommendations: Formal Folstein testing and/ or use of the Geriatric Depression Scale
(G.D.S. short form). If the patient fails the attentional question, evaluate for delirium and correlate with
neurological exam, level of consciousness, etc. Memory impairment raises the question of dementia.
Impairment in spatial relations suggests possible parietal lobe dysfunction.
b. affective functioning
- Vision- Hearing - Waiting room observation of patient and care giver and ask, for example, "how did
you get here today?
c. Social assessment
- These are crucial risk factors. For post-hospital care and preventing readmission, contact Social
Work/Case Management for follow-up
Source: http://projects.galter.northwestern.edu/geriatrics/chapters/functional_status_assessment.cfm
4. Outline the elements of a comprehensive nursing assessment focused on function using Gordon’s
Functional domains.
I. The Health Insurance Portability and Accountability Act (HIPAA) has a privacy rule to set standards
for the protection of health information, info in a patient's record is confidential. Requires patients to sign
an authorization before you collect personal health data, unless in emergency.
A. Termination Phase
- Give patient a clue that the interview is coming to an end. Gives patient a chance to ask questions. When
ending the interview, summarize the important points and ask your patient if the summary is accurate.
B. Working Phase
- Gather information about patient's health status. begin by obtaining health history. First interview is
most extensive of all.
II. Teaching
- Important nursing responsibility. focus of change is intellectual growth or the acquisition of new
knowledge or psychomotor skills. as a nurse, you teach correct principles, procedures, and techniques of
health care to inform patients about their health status and to prepare them for self-care.
III. Validation
- comparison of data with another source to confirm accuracy.
IV. Wellness nursing diagnosis
- Describes human responses to levels of wellness in an individual, group, or community. supported by
defining characteristics that cluster in patterns of related cues and or inferences.
V. Use of standard formal nursing diagnoses serves several purposes:
1) Provides a precise definition that gives all members of the health care team a common language for
understanding patient needs.
2) Allows nurses to communicate what they do among themselves, with other health care professionals,
and with the public.
3) Distinguishes the nurse's role from that of physicians and other health care providers.
4) Helps nurses to focus on the scope of nursing practice.
5) Fosters the development of nursing knowledge.
VI. Taxonomy Domains (NIC)
Domain 1: Physiological: Basic. care that supports physical functioning.
Domain 2: Physiological: Complex. care that supports homeostatic regulation.
Domain 3: Behavioral. care that supports psychosocial functioning and facilitates life-style changes.
Domain 4: Safety. care that supports protection against harm.
Domain 5: Family. care that supports the family unit.
Domain 6: Health System. care that supports effective use of the health care delivery system.
Domain 7: Community. Care that supports the health of the community.
VII. Sources of data
(Primary)patient,(secondary) family and significant others, health care team, medical records, and other
records and the literature.
VIII. Six factors to consider when choosing interventions:
1. characteristics of the nursing diagnosis
2. expected outcomes and goals
3. evidence base for the intervention
4. feasibility of the intervention
5. acceptability to the patient
6. your own competency
XI. Seven guidelines when writing goals and expected outcomes:
1. Patient centered
2. Singular goal or outcome
3. Observable
4. Measurable
5. Time limited
6. Mutual factors (agreement between patient and nurse)
7. Realistic
Source: https://quizlet.com/11738761/chapter-8-flash-cards/
