{"id":678,"date":"2019-05-22T20:53:40","date_gmt":"2019-05-23T00:53:40","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/main-health-needs-reasons-for-seeking-care\/"},"modified":"2024-07-01T16:19:43","modified_gmt":"2024-07-01T20:19:43","slug":"main-health-needs-reasons-for-seeking-care","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/main-health-needs-reasons-for-seeking-care\/","title":{"raw":"Main Health Needs (Reasons for Seeking Care)","rendered":"Main Health Needs (Reasons for Seeking Care)"},"content":{"raw":"The client\u2019s main health needs are referred to in a variety of ways depending on the environment or institution that you work in. At first point of contact, \u201cmain health needs\u201d are often referred to as \u201creasons for seeking care<\/strong>\u201d or \u201cmain concerns or issues.\u201d In an institution where the client is already admitted, \u201cmain health needs<\/strong>\u201d is more commonly used.\r\n\r\nWhichever term is used, it recognizes that clients are complex beings, with potentially multiple co-existing health needs, and often there is a pressing issue that requires most immediate care. This is not to suggest that other issues be ignored, but rather it allows providers, clients, and care partners to stay focused.\r\n\r\nMost often, providers will document in the client\u2019s own words what the main health needs are. Table 4<\/strong>\u00a0offers example questions to ask to determine a client\u2019s main health needs in different scenarios, along with sample responses.\r\n
\r\n

Clinical Tip<\/span><\/p>\r\n\r\n<\/header>\r\n

\r\n\r\nIt is important to avoid asking questions that begin with \u201cwhy,\u201d which may suggest to the client that they did something wrong or that they are to blame for what is happening to them.\r\n\r\n<\/div>\r\n<\/div>\r\n \r\n\r\nTable 4<\/strong>: Determining main health needs (reasons for seeking care)\r\n\r\n\r\n\r\n\r\n\r\n
\r\n

Client<\/strong><\/p>\r\n<\/td>\r\n

\r\n

Assessment<\/strong><\/p>\r\n<\/td>\r\n

\r\n

Sample Responses<\/strong><\/p>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

Presenting to a clinic or a hospital emergency or urgent care (first point of contact).<\/p>\r\n

<\/p>\r\n<\/td>\r\n

\r\n

Tell me about what brought you here today.<\/p>\r\n

Probes<\/strong><\/p>\r\n\r\n

    \r\n \t
  • \r\n

    Tell me more.<\/p>\r\n<\/li>\r\n \t

  • \r\n

    How is that affecting you?<\/p>\r\n<\/li>\r\n<\/ul>\r\n<\/td>\r\n

\r\n
    \r\n \t
  • \r\n

    \u201cI have a rash\u201d<\/p>\r\n<\/li>\r\n \t

  • \r\n

    \u201cI have been feeling quite depressed lately\u201d<\/p>\r\n<\/li>\r\n \t

  • \r\n

    \u201cI\u2019m having pain\u201d<\/p>\r\n<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n

\r\n

Already admitted, and you are starting your shift.<\/p>\r\n

<\/p>\r\n<\/td>\r\n

\r\n

Tell me about your main health concerns today.<\/p>\r\n

Probes<\/strong><\/p>\r\n\r\n

    \r\n \t
  • \r\n

    Tell me more.<\/p>\r\n<\/li>\r\n \t

  • \r\n

    How is that affecting you?<\/p>\r\n<\/li>\r\n<\/ul>\r\n<\/td>\r\n

\r\n
    \r\n \t
  • \r\n

    \u201cWhen will I be discharged?\u201d<\/p>\r\n<\/li>\r\n \t

  • \r\n

    \u201cI\u2019m really hungry, can I eat something today?\u201d<\/p>\r\n<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n \r\n

    Take Action<\/h2>\r\nAs a health professional, you need to identify whether a client\u2019s symptomology is considered: normal<\/strong>; abnormal<\/strong> and requiring intervention; or a critical finding<\/strong> that requires prompt intervention. Your subjective data assessment may be cut short if critical findings arise that require immediate intervention. In such a case, you focus on the critical finding and resume the complete subjective health assessment later, when appropriate. Some findings, even though normal, will require health promotion<\/strong> interventions.\r\n\r\nExamples of subjective data that are identified as critical findings<\/strong> and require prompt intervention<\/strong> include but are not limited to:\r\n
      \r\n \t
    • Chest pain.<\/li>\r\n \t
    • Severe difficulty breathing.<\/li>\r\n \t
    • Sudden change in vision or ability to speak.<\/li>\r\n \t
    • Sudden weakness or paralysis in a limb.<\/li>\r\n \t
    • Uncontrollable bleeding.<\/li>\r\n \t
    • Post-operative pain or vomiting not relieved by medication.<\/li>\r\n \t
    • Suicidal or homicidal ideation with a plan.<\/li>\r\n<\/ul>\r\n
      \r\n

      Points of Consideration<\/p>\r\n\r\n<\/header>\r\n

      \r\n\r\n\u201cDoor-handle conversations\u201d describe the situation of a client sharing something with a health professional just as they are about to leave the room (their hand is on the door handle as illustrated in Figure 5<\/strong>). Often it is at the last minute when clients gather the courage to speak about a health issue that they are embarrassed or feel shameful about. It may be about something that is stigmatized, or they feel they may be judged on. In these cases, it is important to make time for the client and listen in a non-judgmental manner.\r\n\r\n<\/div>\r\n<\/div>\r\n\r\n[caption id=\"attachment_677\" align=\"aligncenter\" width=\"499\"]\"A Figure 5<\/strong>: Door-handle conversation[\/caption]\r\n

      Test Yourself<\/h2>\r\n

      [h5p id=\"8\"]<\/p>","rendered":"

      The client\u2019s main health needs are referred to in a variety of ways depending on the environment or institution that you work in. At first point of contact, \u201cmain health needs\u201d are often referred to as \u201creasons for seeking care<\/strong>\u201d or \u201cmain concerns or issues.\u201d In an institution where the client is already admitted, \u201cmain health needs<\/strong>\u201d is more commonly used.<\/p>\n

      Whichever term is used, it recognizes that clients are complex beings, with potentially multiple co-existing health needs, and often there is a pressing issue that requires most immediate care. This is not to suggest that other issues be ignored, but rather it allows providers, clients, and care partners to stay focused.<\/p>\n

      Most often, providers will document in the client\u2019s own words what the main health needs are. Table 4<\/strong>\u00a0offers example questions to ask to determine a client\u2019s main health needs in different scenarios, along with sample responses.<\/p>\n

      \n
      \n

      Clinical Tip<\/span><\/p>\n<\/header>\n

      \n

      It is important to avoid asking questions that begin with \u201cwhy,\u201d which may suggest to the client that they did something wrong or that they are to blame for what is happening to them.<\/p>\n<\/div>\n<\/div>\n

       <\/p>\n

      Table 4<\/strong>: Determining main health needs (reasons for seeking care)<\/p>\n\n\n\n\n\n
      \n

      Client<\/strong><\/p>\n<\/td>\n

      		\n

      Assessment<\/strong><\/p>\n<\/td>\n

      		\n

      Sample Responses<\/strong><\/p>\n<\/td>\n<\/tr>\n

      \n

      Presenting to a clinic or a hospital emergency or urgent care (first point of contact).<\/p>\n

      \n<\/td>\n

      		\n

      Tell me about what brought you here today.<\/p>\n

      Probes<\/strong><\/p>\n

        \n
      • \n

        Tell me more.<\/p>\n<\/li>\n

      • \n

        How is that affecting you?<\/p>\n<\/li>\n<\/ul>\n<\/td>\n

      		\n
        \n
      • \n

        \u201cI have a rash\u201d<\/p>\n<\/li>\n

      • \n

        \u201cI have been feeling quite depressed lately\u201d<\/p>\n<\/li>\n

      • \n

        \u201cI\u2019m having pain\u201d<\/p>\n<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n

      \n

      Already admitted, and you are starting your shift.<\/p>\n

      \n<\/td>\n

      		\n

      Tell me about your main health concerns today.<\/p>\n

      Probes<\/strong><\/p>\n

        \n
      • \n

        Tell me more.<\/p>\n<\/li>\n

      • \n

        How is that affecting you?<\/p>\n<\/li>\n<\/ul>\n<\/td>\n

      		\n
        \n
      • \n

        \u201cWhen will I be discharged?\u201d<\/p>\n<\/li>\n

      • \n

        \u201cI\u2019m really hungry, can I eat something today?\u201d<\/p>\n<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

         <\/p>\n

        Take Action<\/h2>\n

        As a health professional, you need to identify whether a client\u2019s symptomology is considered: normal<\/strong>; abnormal<\/strong> and requiring intervention; or a critical finding<\/strong> that requires prompt intervention. Your subjective data assessment may be cut short if critical findings arise that require immediate intervention. In such a case, you focus on the critical finding and resume the complete subjective health assessment later, when appropriate. Some findings, even though normal, will require health promotion<\/strong> interventions.<\/p>\n

        Examples of subjective data that are identified as critical findings<\/strong> and require prompt intervention<\/strong> include but are not limited to:<\/p>\n

          \n
        • Chest pain.<\/li>\n
        • Severe difficulty breathing.<\/li>\n
        • Sudden change in vision or ability to speak.<\/li>\n
        • Sudden weakness or paralysis in a limb.<\/li>\n
        • Uncontrollable bleeding.<\/li>\n
        • Post-operative pain or vomiting not relieved by medication.<\/li>\n
        • Suicidal or homicidal ideation with a plan.<\/li>\n<\/ul>\n
          \n
          \n

          Points of Consideration<\/p>\n<\/header>\n

          \n

          \u201cDoor-handle conversations\u201d describe the situation of a client sharing something with a health professional just as they are about to leave the room (their hand is on the door handle as illustrated in Figure 5<\/strong>). Often it is at the last minute when clients gather the courage to speak about a health issue that they are embarrassed or feel shameful about. It may be about something that is stigmatized, or they feel they may be judged on. In these cases, it is important to make time for the client and listen in a non-judgmental manner.<\/p>\n<\/div>\n<\/div>\n

          \"A
          Figure 5<\/strong>: Door-handle conversation<\/figcaption><\/figure>\n

          Test Yourself<\/h2>\n

          \n

          \n