University:
West Coast University
Course:
NURS 103 | Fundamentals of Nursing
Academic year:

2021
Views:

495

Pages:

1
Author:

Ean Mason

Subjective vs. Objective Assessment Data The nursing assessment includes gathering information concerning the patient's individual physiological, psychological, sociological, and spiritual needs. It is the first step in the nursing process. The assessment identifies current and future care needs of the patient by allowing the formation of a nursing diagnosis. The nurse recognizes normal and abnormal patient physiology and helps prioritize interventions and care. Subjective and objective data collection are an integral part of this process. Subjective data, also referred to as symptoms. Collect information through communication. Are apparent only to the person affected and can be described or verified only by that person. Includes the client’s sensations, feelings, values, beliefs, attitudes, and perception of personal health status and life situation. The personal interpretation of the patient is the basis for gathering information. For example, subjective data is when a patient states “I am hurting.” Dizziness, pain, shortness of breath, itching, exhaustion, nausea, cough Objective data, also referred to as signs. Collected through observations by seeing, hearing, smelling, and touching. Are detectable by an observer or can be tested against an accepted standard. They can be seen, heard, felt, or smelled, and they are obtained by observation or physical examination. The behavior of the patient, test results, actions, physical examination, and measurements are also considered to be a part of such objective data. Tests/experiments and results fall under this category. For example, objective data is when the nurse observes that the patient is grimacing and holding on to his stomach. Height, weight, general appearance, blood pressure, heart rate, levels of consciousness. Examples of both subjective data (what the patient says) and objective data (what the nurse observes): A patient says she is shivering as the nurse observes her shaking in the chair. A patient says he has a fever as the nurse observes the elevated temperature on the thermometer. A patient says she has stomach pain as the nurse observes her clutching her abdomen.