Focused Assessment
A focused assessment is a detailed nursing assessment of a specific body system or complaint, performed after the initial comprehensive assessment to gather more information about a particular health concern or to monitor a known condition.
Exam Tip
LPNs perform focused assessments (targeted to specific complaints) but NOT comprehensive/initial assessments. Use PQRST for pain assessment. Report findings to the RN. Always reassess after interventions to evaluate effectiveness.
What Is a Focused Assessment?
A focused assessment is a targeted, in-depth evaluation of a specific body system, symptom, or complaint. Unlike a head-to-toe (comprehensive) assessment that evaluates all body systems, a focused assessment zeroes in on relevant areas based on the patient's presenting problem or changes in condition.
Focused vs. Comprehensive Assessment
| Feature | Focused Assessment | Comprehensive Assessment |
|---|---|---|
| Scope | One body system or complaint | All body systems |
| When performed | Ongoing, for specific concerns | On admission or at set intervals |
| Duration | Brief and targeted | Thorough, takes longer |
| Performed by | LPN or RN | RN (initial); LPN can collect data |
| Example | Assessing pain after medication | Full head-to-toe admission assessment |
Common Focused Assessments
| Complaint/Condition | What to Assess |
|---|---|
| Chest pain | VS, heart sounds, lung sounds, pain characteristics (PQRST), O2 saturation, skin color |
| Shortness of breath | Respiratory rate, lung sounds, O2 sat, accessory muscle use, position of comfort |
| Abdominal pain | Bowel sounds, tenderness, distention, last BM, nausea/vomiting |
| Fall | Neuro status, pain, ROM, VS, skin integrity, contributing factors |
| Post-surgical | Incision site, VS, pain level, I&O, drainage, circulation distal to site |
| Diabetic concern | Blood glucose, LOC, skin moisture, tremors, vision changes |
PQRST Pain Assessment
| Letter | Meaning |
|---|---|
| P | Provokes/Palliates: What makes it better or worse? |
| Q | Quality: What does it feel like? (sharp, dull, burning) |
| R | Region/Radiation: Where is it? Does it radiate? |
| S | Severity: Rate on 0-10 scale |
| T | Timing: When did it start? Constant or intermittent? |
LPN/LVN Role in Assessment
- LPNs perform focused assessments and collect data
- LPNs do NOT perform comprehensive (initial) assessments
- LPNs report findings to the RN for interpretation and care plan changes
- LPNs identify changes from baseline and report immediately
Exam Alert
Focused assessment questions appear in multiple NCLEX-PN categories. Know when to perform a focused assessment (change in condition, specific complaint, post-intervention monitoring). LPNs collect data through focused assessments but report findings to the RN. Use PQRST for pain assessment.
Study This Term In
Related Terms
Vital Signs
Vital signs are the fundamental measurements of basic body functions: temperature, pulse (heart rate), respirations (breathing rate), blood pressure, and pain (often called the "5th vital sign"). They provide critical data about a patient's physiological status and are assessed by all levels of nursing staff.
Nursing Process
The nursing process is a systematic, five-step problem-solving framework used by nurses to provide patient-centered care: Assessment, Diagnosis, Planning, Implementation, and Evaluation (ADPIE). It is the foundation of all nursing practice and the organizing framework for the NCLEX.
Glasgow Coma Scale (GCS)
The Glasgow Coma Scale (GCS) is a standardized neurological assessment tool that evaluates a patient's level of consciousness by scoring three responses: eye opening (1-4), verbal response (1-5), and motor response (1-6), for a total score of 3-15.
Scope of Practice (Nursing)
Scope of practice defines the legal boundaries of what a healthcare professional is authorized to do based on their education, licensure, and state Nurse Practice Act. For LPNs/LVNs, the scope includes basic nursing care, data collection, medication administration, and care plan implementation under RN or physician supervision.
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