Module 1: Introduction & Overview of NP Role in LTC
1.7.4 Health Assessment and Diagnosis
The NP works collaboratively with clients to identify & mitigate health risks, promote understanding of health issues & support healthy behaviours and includes:
- Performs a focused/comprehensive health assessment usings & adapting tools and techniques based on client needs & life stage
- Performs a complete/focused health history appropriate to situation including physical, psychosocial, emotional, ethnic, cultural & spiritual dimensions
- Performs a complete/focused physical examination & identifies & interprets normal/abnormal findings
- Synthesizes health assessment information using critical inquiry & clinical reasoning to diagnoses health risks & states of health/illness
- Formulates differential diagnoses through integration of client information & evidence informed practice
- Anticipates & diagnosis emergent, urgent & life threatening situations
- Orders and/or performs screening & diagnostic investigations, interprets results using evidence informed clinical reasoning & critical inquiry & assumes responsibility for follow up
- Diagnosis diseases, disorders, injuries & conditions & identifies health needs, while considering client’s response to health/illness
- Communicates with clients about health assessment findings and/or diagnosis, including outcomes & prognosis[1]
- Canadian Nurses Association, 2010 ↵