Health assessments are a central part of a medical professional’s daily work, helping with the evaluation of a patient’s condition and the selection of treatments. A range of assessment tools and screening processes can be used, and the information gleaned does not just benefit the patient; it can also be collated by community medical teams and used to provide insights into the overall population.
Assessments can vary in scope, but they are carried out on individuals of all ages and genders. While some can be completed through a paper questionnaire or over the phone, an advanced healthcare assessment will require an in-person visit.
A learned set of skills
Because they are so crucial for making an accurate diagnosis and ensuring a patient recovers, nurses and physicians need to be confident and proficient when it comes to advanced assessments. Most of these professionals refine their skills after carrying out numerous assessments and gaining more experience, but as students, they are given the core proficiencies they need when starting out.
At Walsh University, the FNP program online has been designed for working nurses who want to progress in their careers. It combines expertly delivered coursework with supported clinical placements to prepare students for working independently in advanced practice.
How does an advanced health assessment begin?
A nurse is likely to start an assessment in a gentle way. Often, they will simply speak with a patient to make sure they are oriented and aware of their surroundings. A standard physical check involves listening to the heart and lungs, looking for swelling and redness in the limbs, and asking about recent changes in their symptoms. However, to guide a more accurate diagnosis, advanced exams tend to consider other aspects of a patient’s health.
What is the patient’s health status?
Doctors use a range of techniques to measure a person’s health status. They can work using various tools or reach conclusions based on their own knowledge and observations. They will often start by asking a patient about the specific symptoms they are experiencing, if any, or whether they have any minor health worries.
Next, they will move on to checking their vital signs. This will include taking the patient’s blood pressure, temperature, oxygen saturation levels and pulse. These are basic tests, but the findings can help a clinician to identify conditions that are related to increases or decreases in these measurements. They can also carry out further tests if needed to prevent the development of a more serious condition.
Investigating the patient’s health risks
In addition to reading the patient’s records, a practitioner will speak to the patient about their medical history and that of their family to form a more complete picture of their health risks.
Asking about allergies
It’s important to find out more about a patient’s allergies because doctors can use this information to make a diagnosis. For example, if a patient does have an allergy that is becoming worse, with more persistent bouts of sneezing, the formation of rashes and trouble breathing, this problem must be addressed. The next bad attack might result in the need for emergency medical help.
Therefore, the doctor will offer treatment in advance so the patient is less at risk. Furthermore, they can arrange for tests to pinpoint the exact cause of an allergy, then provide advice on avoiding the trigger or refer a patient to an allergist for specialist guidance.
Past illnesses can impact a diagnosis
Patients might consider the illnesses they have already recovered from to be irrelevant when it comes to their current problem. However, a doctor can use this information to request screening tests that can rule out a recurrence of serious diseases, such as cancer, and potentially catch problems early. Knowing about your past illnesses puts your doctor in better control of your health in the present.
Which surgeries has a patient had?
In addition to major injuries, physicians typically ask about past surgeries, from common ones such as appendix removal to more complex procedures, such as heart surgery. A patient might feel this is all in the past, but in fact, these experiences are a rich source of information. Their experience can reveal details of their healing, their pain tolerance, their post-operative issues and scarring.
There may also be details of reactions to certain medications or bleeding disorders that a patient remembers while speaking about their surgery. Finally, some people experience pain, as well as nausea and bloating, as a result of adhesions after surgery. These occur when tissue sticks to other tissue inside the body while healing is taking place.
Therefore, physicians have many things to learn from a patient’s surgical history. During an advanced assessment, they will inquire about when and why a procedure was performed, what (if any) complications occurred, and whether any follow-up care was needed.
Finding out about medications
In addition to learning more about their patient based on the medications they have already been prescribed, physicians can consider the side effects of these drugs when making a diagnosis. Every medication has potential side effects; some are very rare, but others can be quite common.
Headaches, weight gain and tiredness are often reported, but some prescription drugs can change the color of a patient’s urine and others can cause hair loss or tremors. By comparing the known side effects of a patient’s medication with their current symptoms, physicians can make more informed clinical decisions.
The patient’s lifestyle
Many factors influence a person’s health, but their lifestyle is one of the most significant. This means doctors should ask several questions about their patient’s habits and choices as part of an advanced assessment. The general direction these take will usually depend on the symptoms a patient is concerned about.
For example, if there are heart or lung problems, a physician will look for what circumstances might be contributing to this. They might ask how often the patient exercises, whether they drink, what type of diet they follow and whether they smoke. Furthermore, they will inquire about the level of stress the patient is dealing with and how they are managing this.
With this information on hand, they can consider a diagnosis, arrange tests and provide advice on adopting a healthier lifestyle. If there are elements of a patient’s lifestyle that are seriously impacting their health, a doctor can suggest self-help groups or other resources where they can seek support for quitting smoking, losing weight or drinking less.
Is there any relevant family medical history?
Patients will be asked about their children, parents, siblings, aunts, uncles, grandparents and maybe more distant relatives. This is because families share a genetic background, and close family members also live in a similar environment and may have a similar lifestyle. Using this information, physicians can consider which conditions may be hereditary and whether patterns are emerging. They can use this information, along with the concerns a patient is expressing about their health, to form an opinion about how likely their patient is to inherit a condition. Again, if the diagnosis is early enough, steps can be taken to prevent a disorder from becoming harmful.
Conducting a physical exam
Recording a patient’s vital signs is essential, but during an advanced exam, a doctor will look in more detail at the separate body systems. When the symptoms are specific, the exam could be tailored to the system it relates to, but often they will examine the body as a whole.
A patient’s pulse and blood pressure give a general indication of their heart health, but there are many more advanced tests available. Physicians may order an echocardiogram to scan the heart and check its size and overall function. Alternatively, an electrocardiogram could be carried out to monitor the heart’s electrical activity. This can offer insight into the rhythm of the heart and the speed at which it works.
The most basic lung function test is spirometry, which involves the patient filling their lungs and then exhaling forcefully. An advanced assessment could also include a lung volume test. A patient will usually exercise while breathing into a mouthpiece and having their heart monitored. The test will determine how much air the lungs can hold and how quickly oxygen is dispersed into the bloodstream. Both tests show how well the lungs are working and whether the patient is at risk of conditions that affect the airways, such as asthma.
How can advanced health assessments benefit patients?
It is often the case that patients only visit their physician when they are feeling ill. However, by this time, their symptoms have usually already had an impact on their well-being. Advanced assessments can therefore be advantageous, even when a patient is in excellent health. They can assist with the prevention of future problems and suggest lifestyle changes that keep a patient feeling good. Furthermore, physicians can use the assessment to spot any underlying issues, improve their prognosis and ensure the best outcome for their patients.