Physical Examination and Health Assessment - Canadian Edition, 3e (Nov 12, 2018)_(1771721545)_(Saunders Canada)

Get a clear, logical, and holistic approach to physical examination and health assessment across the lifespan! Using easy-to-follow language , detailed illustrations, summary checklists, and new learning resources Physical Examination and Health Assessment, 3 rd Canadian Edition is the gold-standard in physical examination textbooks. This new edition reflects the latest in what is happening in nursing today with coverage of emerging trends, examples of how to document patient assessments using the Electronic Health Record, and new evidence-informed content throughout. It's easy to see why this text is #1 with Canadian nursing students! A two-column format distinguishes normal findings from abnormal findings, and uses colour, step-by-step photos to clarify examination techniques and expected findings. Sectional colour bars segment body systems according to content (Structure and Function, Subjective Data, Objective Data, Documentation and Critical Thinking, Abnormal Findings). Summary checklists offer reviews of key examination steps. Documentation and Critical Thinking sections provide real world clinical examples of specific patients and how to document assessment findings. Abnormal findings tables help you recognize, sort, and describe abnormalities. Separate chapter on Pregnancy provides a thorough foundation for assessing the pregnant patient. Developmental Considerations sections highlight content specific to infants, children, adolescents, pregnant women, and older adults. Promoting Health boxes focus on this key aspect of Canadian health care. NEW! Content covering the Electronic Health Record, charting, and narrative recording provides examples of how to document assessment findings. UPDATED Case Studies provide you with opportunities to test and develop your analytical skills and apply what you’ve learned. NEW! Approximately 150 normal and abnormal examination photos for the nose, mouth, throat, thorax, and pediatric assessment gives you a fresh perspective on these key system examinations, with cultural diversity and developmental variations. NEW! Social determinants of health considerations cover the shifting landscape of Canada’s populations with strategies for integrating social, economic and ethnocultural diversity into your health assessments. NEW! Assessment strategies relevant to Indigenous populations, harm reduction, nutrition, and transgender persons inform practitioners on respectful, complete care. Front Cover Inside Front Cover Endpage 2 Endpage 3 Physical Examination and Health Assessment - Canadian Copyright Page Dedication About the Author About the Canadian Editors Contributors Reviewers of the Third Canadian Edition Preface Dual Focus as Text and Reference New to the Third Canadian Edition Approaches Used in This Edition Conceptual Approach Ancillaries In Conclusion Acknowledgements for the U.S. Seventh Edition Acknowledgements for the Third Canadian Edition Unit 1 Assessment of the Whole Person 1 Critical Thinking and Evidence-Informed Assessment Assessment: Point of Entry in an Ongoing Process Diagnostic Reasoning Critical Thinking and the Diagnostic Process Evidence-Informed Assessment Expanding the Concept of Health A Relational Approach to Nursing Practice Collecting Four Types of Data Complete (Total Health) Database Episodic or Problem-Centred Database Follow-Up Database Emergency Database Frequency of Assessment Assessment Throughout the Life Cycle Social Determinants of Health Considerations References 2 Health Promotion in the Context of Health Assessment Health Promotion: Development and Concepts The Population Health Promotion Model as a Guide to Nursing Assessment Specific Health Promotion Interventions Health Education and Counselling Activities in Health Promotion Immunizations Screening Screening Tools for Developmental Tasks Case Example: Incorporating Health Promotion Strategies Summary References 3 Cultural and Social Considerations in Health Assessment Cultural and Social Considerations: Central Concepts Culture, Ethnicity, and Culturalism: What Do Nurses Need to Know for Accurate Health Assessments? “Race” and Ethnicity: Why Is It Important to Distinguish Between These Terms? Cultural Sensitivity, Cultural Competence, and Cultural Safety: What Do Nurses Need to Know? Cultural Safety Demographic Profile of Canada: Trends and Their Relevance to Health Assessment Ethnocultural Diversity Within the Canadian Population Indigenous Populations in Canada Policies Affecting Indigenous Peoples in Canada Inequities in Health Status People Who Immigrate to Canada The Process of Immigration and Effects on Health Health, Social, and Gender Inequities Complementary and Alternative Health Care Practices Spirituality and Health Guidelines for Clinical Practice Assess Culturally Based Understandings and Practices Work to Build Trust Convey Respect for Differences Pay Attention to the Social and Economic Contexts of Patients’ and Families’ Lives Additional Resources References 4 The Interview The Process of Communication Sending Receiving Attending to Power Differentials Communication Skills Unconditional Positive Regard Empathy Active Listening Attending to the Physical Setting Ensuring Privacy Refusing Interruptions Physical Environment Taking Notes Electronic Clinical Documentation Interviewing in a Telehealth Environment Techniques of Communication Introducing the Interview The Working Phase Open-Ended Questions Closed or Direct Questions Responses: Assisting the Narrative Facilitation. Silence. Reflection. Empathy. Clarification. Interpretation. Explanation. Summary. Ten Traps of Interviewing 1. Providing False Assurance or Reassurance 2. Giving Unwanted Advice 3. Using Authority 4. Using Avoidance Language 5. Engaging in Distancing 6. Overusing Professional Jargon or Casual Language 7. Using Leading or Biased Questions 8. Talking Too Much 9. Interrupting 10. Using “Why” Questions Nonverbal Skills Physical Appearance Posture Gestures Facial Expression Eye Contact Voice Silence Bodily Exposure and Touch Closing the Interview Developmental Considerations Interviewing Caregivers Infants Preschoolers School-Age Children Adolescents Older Adults Interviewing in Challenging Situations Patients With Disabilities Acutely Ill Patients Patients Under the Influence of Alcohol or Drugs Personal Questions Dealing With Sexual Advances Crying Anger Threat of Violence Anxiety Social Determinants of Health Considerations Communicating Across Cultures and Social Positions Considerations Related to Gender and Sexual Orientation Overcoming Communication Barriers Interviewing a Patient With an Interpreter Working With a Trained Interpreter Additional Resources References 5 The Complete Health History Health History: Adults Biographical Data Source of History Reason for Seeking Care* Current Health or History of Current Illness Past Health History Childhood illnesses. Accidents or injuries. Serious or chronic illnesses. Hospitalizations. Operations. Obstetrical history. Immunizations. Most recent examination date. Allergies. Current medications. Family Health History Social Determinants of Health Considerations Review of Systems General overall health state. Skin, hair, and nails. Health promotion. Head. Health promotion. Eyes. Health promotion. Ears. Health promotion. Nose and sinuses. Mouth and throat. Health promotion. Neck. Breast. Health promotion. Axilla. Respiratory system. Health promotion. Cardiovascular system. Health promotion. Peripheral vascular system. Health promotion. Gastro-intestinal system. Health promotion. Urinary system. Health promotion. Male genital system. Health promotion. Female genital system. Health promotion. Sexual health. Musculo-skeletal system. Health promotion. Neurological system. Health promotion. Hematological system. Endocrine system. Health promotion. Functional Assessment (Including Activities of Daily Living) Self-concept, self-esteem. Activity and mobility. Sleep and rest. Nutrition and elimination. Interpersonal relationships and resources. Spiritual resources. Coping and stress management. Tobacco use history. Alcohol. Substance use. Environmental hazards. Intimate partner violence. Occupational health. Perception of Health Developmental Considerations Health History: Children Biographical Data Source of History Reason for Seeking Care Current Health or History of Current Illness Past Health History Prenatal status. Labour and delivery. Postnatal status. Childhood illnesses. Serious accidents or injuries. Serious or chronic illnesses. Operations or hospitalizations. Immunizations. Allergies. Medications. Developmental History Growth. Milestones. Current development. Children aged 1 month through preschool age. School-age children. Nutritional History Family Health History Review of Systems General. Skin. Head. Eyes. Health promotion. Ears. Health promotion. Nose and sinuses. Mouth and throat. Health promotion. Neck. Breast. Respiratory system. Cardiovascular system. Gastro-intestinal system. Urinary system. Male genital system. Female genital system. Intersex genital system. Sexual health. Musculo-skeletal system. Neurological system. Hematological systems. Endocrine system. Functional Assessment (Including Activities of Daily Living) Interpersonal relationships. Activity and rest. Economic status. Home environment. Environmental hazards. Coping and stress management. Alcohol and substance use. Health promotion. Health History: Adolescents Health History: Older Adults Reason for Seeking Care Past Health History General health. Accidents or injuries, serious or chronic illnesses, hospitalizations, operations. Most recent examination. Obstetrical status. Current Medications Family Health History Review of Systems General. Skin. Eyes. Ears. Mouth. Respiratory system. Cardiovascular system. Peripheral vascular system. Urinary system. Sexual health. Musculo-skeletal system. Neurological system. Functional Assessment (Including Activities of Daily Living) Self-concept, self-esteem. Occupation. Activity and mobility. Sleep and rest. Nutrition and elimination. Interpersonal relationships and resources. Coping and stress management. Environmental hazards. References 6 Mental Health Assessment Significance of Mental Health Assessment for Canadians Defining Mental Health and Mental Illness Mental Illness and Comorbid Conditions Concurrent Disorders: Mental Health Disorders and Problematic Substance Use Mental Health, Mental Illness, and Stigma Mental Health, Mental Illness, Housing, and Homelessness Mental Health Nursing Assessment Methods and Components Sources of Information Indication for Comprehensive Mental Health Nursing Assessment Developmental Considerations Children and Adolescents Young Adults Middle-Aged Adults Older Adults Screening Mental Health Assessment: Adults Identification/Biographical Information Reason for Seeking Care Past Health Past Illness, Injury, Hospitalization Chronic Illnesses Family Health History Current Health Detailed Mental Status Examination Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Supplemental Mental Status Examination Functional Assessment (Including Activities of Daily Living) Nutritional patterns. Sleep/rest changes. Activity/mobility. Elimination. Interpersonal relationships and resources. Self-esteem/self-concept. Spirituality. Coping and stress management. Smoking, substance use, and problem gambling. Home and environmental hazards. Risk Assessment Screen for Suicidal Thoughts Screen for Assaultive or Homicidal Ideation Screen for Elopement Risk Global Assessment of Functioning Assessing Patient Attitude Toward the Examiner/Assessment Developmental Considerations Older Adult Mental Health Assessment Documentation and Critical Thinking Sample Charting Focused Assessment: Clinical Case Study Subjective Objective Assessment Examples of Nursing Assessment Statements That May Be Relevant to E.A. Overall Goals Sample Interventions Evaluation and Reassessment Abnormal Findings Special Considerations for Advanced Practice Summary Checklist: Mental Health Assessment Additional Resources References 7 Substance Use and Health Assessment Shifting Substance Use Language The Canadian Context of Substance Use Substance Use in Canada Factors Influencing Substance Use Violence, Trauma, Mental Health, and Substance Use Substance Use and Social Inequities The Effects of Substance Use Vary by Gender, Class, Age, and Sexuality Understanding Substance Use in the Context of Health Care Incorporating Knowledge of Substance Use in Health Assessment Challenging the Idea of “Choice” Putting Harm-Reduction Principles Into Action Assessing for Withdrawal Special Case: Substance Use Assessment in Pregnancy Documentation Additional Resources References 8 Interpersonal Violence Assessment A Social Determinants of Health Perspective Intimate Partner Violence Defined Sexual Assault Defined Child Maltreatment Defined Elder Abuse Defined The Prevalence of Interpersonal Violence Health Effects of Violence Health Effects of Intimate Partner Violence Health Effects of Elder Abuse Health Effects of Child Maltreatment Responding to Interpersonal Violence: Begin With Trauma- and Violence-Informed Care Responding Safely to Intimate Partner Violence Assessing for Intimate Partner Violence Listen Listening (and Observing) for “Red Flags.” Inquire Validate Enhance Safety Assessing for Danger. Support Responding to Elder and Vulnerable Person Abuse Mandatory Reporting of Abuse of Older Adults or Vulnerable Persons Responding to Child Maltreatment Assessing for Child Maltreatment Mandatory Reporting of Child Maltreatment Documenting a History of Interpersonal Violence Physical Examination Physical Examination of Children Documentation Additional Resources References Unit 2 Approach to the Clinical Setting 9 Assessment Techniques and the Clinical Setting Cultivating Your Senses Inspection Palpation Percussion Production of Sound Auscultation Setting: Context of Care Equipment A Clean Field A Safer Environment The Clinical Setting General Approach Hands On Developmental Considerations Infants Position Preparation Sequence Toddlers Position Preparation Sequence Preschool-Age Children Position Preparation Sequence School-Age Children Position Preparation Sequence Adolescents Position Preparation Sequence Older Adults Position Preparation Sequence Individuals With Acute Health Challenges References 10 General Survey, Measurement, and Vital Signs Objective Data Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings References 11 Pain Assessment Structure and Function Neuroanatomical Pathway Nociception Sources of Pain Types of Pain (by Duration) Developmental Considerations Infants and Young Children Older Adults Gender Differences Social Determinants of Health Considerations Timing of the Pain Assessment Subjective Data Examiner Asks/ Rationale Pain Assessment Tools Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Nonverbal/Behavioural Pain Assessment Acute Pain Behaviours Persistent (Chronic) Pain Behaviours The Unconscious Individual Developmental Considerations Neonates Intellectual/Cognitive Disability Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study 1 Subjective Objective Assessment Focused Assessment: Clinical Case Study 2 Subjective Objective Assessment Special Considerations for Advanced Practice Somatoform Disorders Sickle Cell Crisis Additional Resources References 12 Nutritional Assessment and Nursing Practice Structure and Function Defining Nutritional Status Developmental Considerations Infants and Children Adolescence Pregnancy and Lactation Adulthood Older Adults Social Determinants of Health Considerations Food Security Dietary Practices and Cultural Diversity Purposes and Components of Nutritional Assessment Assessing Nutritional Intake The 24-Hour Recall The Food Frequency Questionnaire The Food Diary Direct Observation Canada’s Food Guide and the Dietary Reference Intakes Nutrition Labelling in Canada Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective: General Assessment Objective Focused Assessment: Clinical Case Study Subjective Objective Assessment Recommendations Abnormal Findings Management of Chronic Disease Obesity Central Obesity Diabetes Screening for Type 2 Diabetes Classification of Diabetes Metabolic Syndrome Celiac Disease Links to Nutrition Information Summary Checklist: Nutritional Assessment References Unit 3 Physical Examination 13 Skin, Hair, and Nails Structure and Function Skin Epidermis Dermis Subcutaneous Layer Hair Sebaceous Glands Sweat Glands Nails Function of the Skin Developmental Considerations Infants and Children Pregnant Women Older Adults Social Determinants of Health Considerations Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Skin, Hair, and Nails Examination References 14 Head, Face, and Neck, Including Regional Lymphatic System Structure and Function The Head The Neck Lymphatic System Developmental Considerations Infants and Children Pregnant Women Older Adults Subjective Data Health History Questions Objective Data Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice Normal Range of Findings/ Abnormal Findings Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Head, Face, and Neck, Including Examination of Regional Lymphatic System 15 Eyes Structure and Function External Anatomy Extraocular Muscles Internal Anatomy The Outer Layer The Middle Layer The Inner Layer Visual Pathways and Visual Fields Visual Reflexes Pupillary Light Reflex Fixation Accommodation Developmental Considerations Infants and Children Older Adults Social Determinants of Health Considerations Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study 1 Subjective Objective Assessment Focused Assessment: Clinical Case Study 2 Subjective Objective Assessment Focused Assessment: Clinical Case Study 3 Subjective Objective Assessment Focused Assessment: Clinical Case Study 4 Subjective Objective Assessment Abnormal Findings Summary Checklist: Eye Examination Additional Resources References 16 Ears Structure and Function External Ear Middle Ear Inner Ear Hearing Pathways of Hearing Hearing Loss Equilibrium Developmental Considerations Infants and Children Adults Older Adults Social Determinants of Health Considerations Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study 1 Subjective Objective Assessment Focused Assessment: Clinical Case Study 2 Subjective Objective Assessment Focused Assessment: Clinical Case Study 3 Subjective Objective Assessment Abnormal Findings Summary Checklist: Ear Examination Additional Resources References 17 Nose, Mouth, and Throat Structure and Function Nose Mouth Throat Developmental Considerations Infants and Children Pregnant Women Older Adults Social Determinants of Health Considerations Subjective Data Nose Mouth and Throat Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study 1 Subjective Objective Diagnostic Tests Assessment Focused Assessment: Clinical Case Study 2 Subjective Objective Assessment Focused Assessment: Clinical Case Study 3 Subjective Objective Assessment Abnormal Findings Summary Checklist: Nose, Mouth, and Throat Examination Nose Mouth and Throat References 18 Breasts and Regional Lymphatic System Structure and Function Surface Anatomy Internal Anatomy Lymphatic System Developmental Considerations Adolescents Pregnant Women Older Women The Male Breast Social Determinants of Health Considerations Subjective Data Breast Axilla Health History Questions Special Considerations for Advanced Practice Breast Cancer Screening Tools Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting: Female Subjective Objective Assessment Sample Charting: Male Subjective Objective Focused Assessment: Clinical Case Study 1 Subjective Objective Assessment Focused Assessment: Clinical Case Study 2 Subjective Objective Assessment Abnormal Findings Summary Checklist: Breasts and Regional Lymphatic Examination Additional Resources References 19 Thorax and Lungs Structure and Function Position and Surface Landmarks Anterior Thoracic Landmarks Suprasternal Notch. Sternum. Sternal Angle. Costal Angle. Posterior Thoracic Landmarks Vertebra Prominens. Spinous Processes. Inferior Border of the Scapula. Twelfth Rib. Reference Lines The Thoracic Cavity Lung Borders. Lobes of the Lungs Anterior. Posterior. Lateral. Pleurae Trachea and Bronchial Tree Mechanics of Respiration Control of Respirations Changing Chest Size Developmental Considerations Infants and Children Pregnant Women Older Adults Social Determinants of Health Considerations Women and Chronic Obstructive Pulmonary Disease Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Thorax and Lung Examination References 20 Heart and Neck Vessels Structure and Function Position and Surface Landmarks Heart Wall, Chambers, and Valves Direction of Blood Flow Cardiac Cycle Diastole Systole Diastole Again Events in the Right and Left Chambers Heart Sounds Normal Heart Sounds Effect of Respiration Extra Heart Sounds Third Heart Sound (S3) Fourth Heart Sound (S4) Murmurs Characteristics of Sound Conduction Pumping Ability The Neck Vessels Carotid Artery Pulse Jugular Venous Pulse and Pressure Developmental Considerations Infants and Children Pregnant Women Older Adults Hemodynamic Changes With Aging Dysrhythmias. Electrocardiograph. Social Determinant of Health Considerations High blood pressure. Smoking. Serum cholesterol. Obesity. Diabetes. Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Heart and Neck Vessels Examination Neck Precordium References 21 Peripheral Vascular System and Lymphatic System Structure and Function Arteries Temporal Artery Carotid Artery Arteries in the Arm Arteries in the Leg Veins Jugular Veins Veins in the Arm Veins in the Leg Venous Flow Lymphatics Related Organs Developmental Considerations Infants and Children Pregnant Women Older Adults Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Special Considerations For Advanced Practice Normal Range of Findings/ Abnormal Findings Documentation And Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Peripheral Vascular Examination References 22 The Abdomen Structure and Function Surface Landmarks Internal Anatomy Developmental Considerations Infants and Children Pregnant Women Older Adults Social Determinants of Health Considerations Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study 1 Subjective Objective Assessment Focused Assessment: Clinical Case Study 2 Subjective Objective Assessment Focused Assessment: Clinical Case Study 3 Subjective Objective Assessment Abnormal Findings Summary Checklist: Abdomen Examination References 23 Anus, Rectum, and Prostate Structure and Function Anus and Rectum Peritoneal Reflection. Prostate Regional Structures Developmental Considerations Social Determinants of Health Considerations Cancer Risk and Indigenous Communities Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Anus, Rectum, and Prostate Examination References 24 Musculo-Skeletal System Structure and Function Components of the Musculo-Skeletal System Nonsynovial or Synovial Joints Muscles Temporomandibular Joint Spine Shoulder Elbow Wrist and Carpal Joints Hip Knee Ankle and Foot Developmental Considerations Infants and Children Pregnant Women Older Adults Social Determinants of Health Considerations Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice: Wrist and Hand Normal Range of Findings/ Abnormal Findings Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice: Knee Normal Range of Findings/ Abnormal Findings Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice: Spine Normal Range of Findings/ Abnormal Findings Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Musculo skeletal Examination References 25 Neurological System Structure and Function The Central Nervous System Cerebral Cortex Basal Ganglia Thalamus Hypothalamus Cerebellum Brain Stem Spinal Cord Pathways of the Central Nervous System Sensory Pathways Spinothalamic Tract. Posterior (Dorsal) Columns. Motor Pathways Corticospinal or Pyramidal Tract. Extrapyramidal Tracts. Cerebellar System. Upper and Lower Motor Neurons The Peripheral Nervous System Reflex Arc Cranial Nerves Spinal Nerves Somatic and Autonomic Nerve Fibres Developmental Considerations Infants Older Adults Social Determinants of Health Considerations Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Neurological Examination Screening Neurological Examination Complete Neurological Examination References 26 Male Genitourinary System Structure and Function The Male Genitalia Penis Scrotum Inguinal Area Developmental Considerations Infants Adolescents Adults and Older Adults Sexual Expression in Later Life Social Determinants of Health Considerations Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study Subjective Objective Assessment Abnormal Findings Summary Checklist: Male Genitalia Examination Reference 27 Female Genitourinary System Structure and Function External Genitalia Internal Genitalia Developmental Considerations Infants and Adolescents Pregnant Women Older Women Social Determinants of Health Considerations Subjective Data Health History Questions Objective Data Preparation Equipment Needed Position Normal Range of Findings/ Abnormal Findings Special Considerations for Advanced Practice: External and Internal Genitalia Normal Range of Findings/ Abnormal Findings Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Sample Charting Subjective Objective Assessment Focused Assessment: Clinical Case Study 1 Subjective Objective Assessment Focused Assessment: Clinical Case Study 2 Subjective Objective Assessment Abnormal Findings Summary Checklist: Female Genitalia Examination References Unit 4 Integration of the Health Assessment 28 The Complete Health Assessment Equipment List Subjective Data Sequence/ Selected Photos Objective Data Sequence/ Selected Photos Documentation and Critical Thinking Recording the Data Focused Assessment: Clinical Case Study Health History Biographical Data Past Health Family History Review of Systems Functional Assessment Perception of Health Physical Examination Measurement Head-to-Toe Examination Assessment References 29 Bedside Assessment and Electronic Health Recording Subjective and Objective Data Sequence/ Selected Photos Documentation and Critical Thinking Electronic Health Recording Patient Safety Using the SBAR Technique for Staff Communication Situation 1 Situation 2 References 30 Pregnancy Structure and Function Pregnancy and the Endocrine Placenta Changes During Normal Pregnancy First Trimester Second Trimester Third Trimester Determining Gestational Age Weight Gain During Pregnancy Developmental Considerations Social Determinants of Health Considerations Safe Motherhood: Global Pregnancy Outcomes Subjective Data Health History Questions Objective Data Preparation Equipment Needed Normal Range of Findings/ Abnormal Findings Documentation and Critical Thinking Focused Assessment: Clinical Case Study 1 Subjective Objective Assessment Plan Focused Assessment: Clinical Case Study 2 Subjective Objective Assessment Plan Abnormal Findings Summary Checklist: Pregnancy Examination References 31 Functional Assessment of the Older Adult Functional Ability Activities of Daily Living The Katz Index of ADL Additional Activity of Daily Living Instruments Instrumental Activities of Daily Living Lawton Instrumental Activities of Daily Living Additional IADL Instruments Advanced Activities of Daily Living Measuring Physical Performance Assessment of Cognition Social Domain Maintaining Independence Environmental Assessment Falls Spiritual Assessment Assessment at the End of Life Medical Assistance in Dying Health Promotion Exercise Sexual Health Polypharmacy Immunizations and Vaccinations Social Determinants of Health Considerations Special Considerations Assessing Older Adults With Pain Assessing Older Adults With Altered Cognition Caregiver Assessment Assessment of Caregiver Burden Elder Abuse Assessing for Elder Abuse Documentation Conclusion References Illustration Credits Inside Back Cover Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Chapter 14 Chapter 15 Chapter 16 Chapter 17 Chapter 18 Chapter 19 Chapter 20 Chapter 21 Chapter 22 Chapter 23 With an easy-to-read approach and unmatched learning resources, Physical Examination & Health Assessment, 7th Edition offers a clear, logical, and holistic approach to physical exams across the lifespan. A total of 1,200 illustrations, checklists of key exam steps, and practical insights ensure that you learn all the physical exam skills you need to know. Written by Carolyn Jarvis, an experienced educator and clinician, this gold standard in physical examination reflects what is going on in nursing today with coverage of emerging trends and the latest on evidence-based practice. It's easy to see why this text is, far and away, #1 in this field! "With an easy-to-read approach and unmatched learning resources, this text offers a clear, logical, and holistic approach to physical exams across the lifespan. A total of 1,200 illustrations, checklists of key exam steps, and practical insights ensure that you learn all the physical exam skills you need to know. Written by Carolyn Jarvis, an experienced educator and clinician, this gold standard in physical examination reflects what is going on in nursing today with coverage of emerging trends and the latest on evidence-based practice"--Publisher's website