4. use ongoing assessment to revise diagnoses, outcomes, plan
5. distribute results to patient and family
evidence-based practice - Answer-_____________________ is a systematic approach to practice that
emphasizes the use of best evidence in combination with the clinician's experience, as well as the
patient preferences and values, to make decisions about care and treatment.
Evidence based clinical decision making - Answer-Four factors: the best evidence from a critical review
of research literature; the patient's own preferences; the clinician's own experience and expertise; and
finally physical examination and assessment.
Complete (Total Health) Database - Answer-_______________ Includes complete health history and full
physical examination. It describes current and past health state and forms a baseline to measure all
future changes. Yields first diagnoses
Focused or Problem-Centered Database - Answer-For limited or short term problem. Collect "mini"
database, smaller in scope, concerns mainly one problem, one cue complex, or one body system
Follow-Up Database - Answer-The status of any identified problems should be evaluated at regular and
appropriate intervals. What change has occurred? Is the problem getting better or worse? Which coping
, strategies are used? This type of database is used in all settings to follow up both short-term and chronic
health problems.
Emergency Database - Answer-Rapid collection of the database, often compiled concurrently with
lifesaving measures Diagnosis must be swift and sure.
Open-ended questions - Answer-what kind of questions elicit a response that is more than one word?
ex: what brings you in today? Tell me all about your headaches?
Close-ended questions - Answer-_________________ questions require one or two word answers
ex: what is your age? Are your headaches on one side or both?
Used for specific information
Elicits cold facts
Limits rapport and leaves interaction neutral.
Follow these guidelines for open and closed/direct questions: - Answer-1. Ask only one direct question
at a time. Avoid bombarding the person with long lists: "Have you ever had pain, double vision,
watering, or redness in the eyes?" Avoid double-barreled questions such as, "Do you exercise and follow
a diet for your weight?" The person will not know which question to answer. And if the person answers
"yes," you will not know which question the person has answered.
2. Choose language the person understands. You may need to use regional phrases or colloquial
expressions. For example, "running off" means running away in standard English, but it means diarrhea
to Appalachian mountain people.
Therapeutic communication techniques - Answer-What communication techniques include:-
CLARIFICATION (rephrase).
FACILITATION (nodding, Hmm,hmm).
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