Health and Physical Assessment In Nursing 3rd Edition DAmico Solutions Manual

Health and Physical Assessment In Nursing 3rd

Edition DAmico Solutions Manual

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CHAPTER 8
THE HEALTH HISTORY

Learning Outcomes

1. Discuss the purpose of the nursing health history.

• Suggested Classroom Activity: Ask students to contrast and compare the medical
and nursing health histories and discuss the significance of each to patient care.

• Suggested Clinical Activity: Assign students to patients. Instruct students to review

the nursing and medical histories of their patient and document the differences
observed between the two.

2. Summarize components of the nursing health history for patients across the life
span.
• Suggested Classroom Activity: Ask students to identify each component of the
nursing health history.

• Suggested Clinical Activity: Assign students to patients and instruct students to

review their assigned patients’ nursing health history noting if the history is complete
and, if not, what components are missing. Instruct students to discuss the importance
of the missing components to the patients’ health history.

3. Explain the importance of combining each component of the nursing health history
to provide holistic patient care.
• Suggested Classroom Activity: Ask students to explain the meaning of holistic
patient care.

• Suggested Clinical Activity: Assign students to patients. Instruct students to review

patients’ charts with attention to nursing notes and nursing diagnoses. Ask students to
analyze nursing diagnoses and determine if the nursing diagnoses illustrate holistic
patient care. In cases where the nursing diagnoses do not indicate holistic care,
instruct the student develop at least one diagnosis that addresses a psychosocial
problem related to each patient’s health.

4. Collect a nursing health history that incorporates patient-specific findings related to

health, illness, and wellness.
• Suggested Classroom Activity: Instruct students to work in pairs and perform a
complete health history on each other. From the history, ask each student to develop
three diagnoses that reflect health, illness (this may be fabricated), and wellness of the

©2016 by Pearson Education, Inc.

D’Amico/Barbarito, Instructor’s Resource Manual for Health & Physical Assessment In Nursing,
3rd Edition
 other student.

• Suggested Clinical Activity: Assign students to patients. Instruct students to collect a

nursing health history on their assigned patient. From the patient’s history, develop
three nursing diagnoses related to health, illness, and wellness.

5. Develop a pedigree.
• Suggested Classroom Activity: Ask students to discuss the importance of genetics
and familial health to a patient’s health status. Also, ask students to develop their own
pedigree.

• Suggested Clinical Activity: Assign students to patients. Instruct students to develop

a pedigree for their assigned patient that depicts both medical history, and if
applicable, genetic relationships in the patient’s family.

©2016 by Pearson Education, Inc.

D’Amico/Barbarito, Instructor’s Resource Manual for Health & Physical Assessment In Nursing,
3rd Edition
Key Concepts

1. The health history is a comprehensive record of the patient’s past and current
health that is initiated on the first visit and updated with each subsequent visit.
2. The purpose of the health history is to document the responses of the patient to
actual and potential health concerns.
3. The nursing health history differs from the medical history in that the medical
history focuses on disease, whereas the health history obtained by the nurse
determines the extent to which the patient will need support and teaching.
4. The focus of the nursing health history is on patient-centered care or on the
patient’s response to the health concerns as a whole person not just on the
involved body system.
5. The health history is comprehensive and contains the following components:
biographical data; present health or illness; past medical history including
surgical history, hospitalizations, childhood illnesses, allergies and
immunizations; family history; psychosocial history; and review of body systems.
6. Biographical data includes the patient’s insurance status as an indicator of
access to health care.
7. Biographical data also includes the patient’s occupation as an assessment for
work-related injuries or illnesses.
8. The nurse seeks to gather data on the patient’s present health, illness, or
complaint (i.e., reason for seeking care). The nurse develops a list of statements
that reflect the patient’s major reason for seeking care.

9. The nurse collects information regarding the patient’s health beliefs and practices
including health patterns—habits or acts—that affect the patient’s health.
10. The nurse obtains the patient’s family history to determine if genetic or familial
patterns of health or illness are contributing factors to the patient’s current health
status.
11. The nurse encourages the patient to recall as many generations as possible in
order to develop a complete family history.
12. A well-documented family history enables providers to establish a basis to predict
the risk or susceptibility for common diseases such as diabetes, cancer, and
heart disease, as well as inherited diseases.

©2016 by Pearson Education, Inc.

D’Amico/Barbarito, Instructor’s Resource Manual for Health & Physical Assessment In Nursing,
3rd Edition
13. Evidence-based recommendations that stem from family history are rapidly being
implemented. Family history is now considered a critical tool for improving public
health.
14. Healthy People 2020 objectives include using genomic tools, including family
history, to improve health and prevent illnesses.
15. All healthcare professionals are encouraged to achieve competency in collecting
family history information and identifying patients who benefit from genetic
services.
16. All healthcare providers should be knowledgeable in developing a pedigree—a
graphic representation or diagram that depicts both medical history and genetic
relationships in a family.
17. The nurse obtains the patient’s psychosocial history including information
regarding his or her financial situation with regard to the ability to obtain health
insurance or pay for healthcare services.
18. Low income is associated with lowered health status and predisposition to
illness.
19. The psychosocial history includes information regarding the patient’s support
systems including family members, friends, neighbors, church membership, and
members of the healthcare team.
20. The goal of the interview process is to obtain a health history containing
information about the patient’s present health complaint or illness, but also his or
her overall health history, and to assess the patient holistically.
21. The nursing health history focuses on the patient’s physical status, patterns of
daily living, wellness practices, and self-care activities as well as psychosocial,
cultural, environmental, and other factors that influence the patient’s health
status.
22. A comprehensive health history allows the nurse to develop appropriate nursing
diagnoses that reflect the patient’s health concerns for the present illness as well
as potential health problems and wellness.
23. The information in the health history directs collaborative medical and nursing
treatment plans that complement each other.
24. The health history fosters effective communication, teamwork, and collaboration
between and among nurses, physicians, and other healthcare providers.
25. The nurse utilizes the patient’s health history to create a comprehensive account
of the patient’s past and present health.
26. The completed health history is a compilation of all the patient data collected by
the nurse combined with information obtained during the nursing physical
assessment to form a complete health database for the patient.

©2016 by Pearson Education, Inc.

D’Amico/Barbarito, Instructor’s Resource Manual for Health & Physical Assessment In Nursing,
3rd Edition
Health and Physical Assessment In Nursing 3rd Edition DAmico Solutions Manual

27. The patient’s database provides a holistic view of past and present physical,
psychological, social, cultural, and spiritual health. It is used to formulate nursing
diagnoses and plan the patient’s care.
28. Effective nurse–patient communication is necessary to obtain complete
information for the patient’s database.
29. The nurse employs effective communication techniques during the health history
interview process.

©2016 by Pearson Education, Inc.

D’Amico/Barbarito, Instructor’s Resource Manual for Health & Physical Assessment In Nursing,
3rd Edition

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