Question

The nurse prepares to conduct a general survey on an adult patient. Which assessment is performed first while the nurse initiates the nurse-patient relationship? A. Appearance and behavior B. Measurement of vital signs C. Observing specific body systems D. Conducting a detailed health history

Short answer

The first assessment performed while initiating the nurse-patient relationship during a general survey is A. Appearance and behavior.

Step-by-step solution

Understand the Concept of a General Survey

A general survey is an overall review or first impression a healthcare provider has of a person's well-being. This initial assessment is crucial as it can give insight into the patient's health status and often begins with observing basic aspects of the patient's appearance and behavior.

Recognize the Order of Assessments

During the initial nurse-patient interaction, the most appropriate method of assessment is to begin with non-invasive and general observations before proceeding to more specific evaluations or measurements.

Apply the Order to the Options Given

Looking at the given choices, measuring vital signs, observing specific body systems, and conducting a detailed health history involve more specific and sometimes invasive procedures. Hence, these are typically conducted after the initial general survey.

Deducing the Correct Answer

Since the general survey should capture the first impressions of the patient's overall appearance and behavior, the correct answer is A. Appearance and behavior, which is the assessment performed first when initiating the nurse-patient relationship.

Key concepts

Nursing Assessments

Nursing assessments are the cornerstone of patient care, forming the first step in the nursing process. They involve a systematic method to collect and analyze data about the patient. This process typically begins with a general survey, where nurses create a holistic view of the patient's current condition by noting their appearance and behavior. This includes observations of skin color, hygiene, level of consciousness, and emotional state.

Nurses use this opportunity to align their senses—sight, hearing, smell, and touch—to pick up on cues that may indicate the patient's health status. This visual and interactive examination is vital as it sets the stage for further, more specific assessments. The manner in which a patient enters the room, the level of eye contact, and their speech pattern can all provide invaluable information without a single medical instrument being used.

Nurse-Patient Relationship

Building a therapeutic nurse-patient relationship is an essential part of the nursing assessment. It relies heavily on effective communication, empathy, and trust. When initiating the relationship, it is important for the nurse to establish rapport with the patient, which can significantly affect the quality of information obtained and the patient's comfort level.

Creating a non-threatening environment allows for an open exchange of information. This impacts the success of patient interviews where the nurse gathers the patient's detailed health history. Patients are more likely to share personal and sensitive information in a space where they feel their privacy and dignity are respected. In turn, this helps the nurse in making accurate diagnoses, planning, and delivering tailored care.

Patient Health Evaluation

A comprehensive patient health evaluation is a multi-layered process starting from the initial general survey and spans to specific diagnostic tests. After the preliminary observation of appearance and behavior, subsequent steps include measuring vital signs such as temperature, pulse, respiration, and blood pressure. These vital signs are critical indicators of homeostasis and could hint at underlying health problems if they are outside normal ranges.

Nurses then proceed to conduct a focused examination of specific body systems—especially those relevant to the patient's presenting problems or chronic conditions. A detailed health history is also taken, which encompasses past medical history, family history, lifestyle choices, and other factors that influence health. Together, these components of evaluation provide a full picture of the patient's well-being.