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. 2015 Sep 29;39(4):264–272. doi: 10.1097/SGA.0000000000000153

TABLE 2. Comparison of Original and Revised Nursing Assessment Toolsa.

Original Nursing Assessment Tool Revised Nursing Assessment Tool
I—Demographic Information () Gender
  1. female

  2. male

Gender: __________
() Marital status
  1. single

  2. married

  3. divorced

  4. separated

  5. widowed

Marital Status: ____________
II—Data of Hospitalization () Origin
  1. home

  2. asylum

  3. basic health unit

  4. emergency unit

  5. other: _________

Origin from: () home () long-stay institution for the elderly () basic health unit () emergency unit () other: ________
Reason for hospitalization:____________________________________________ Reason for hospitalization:______________________________________________________________________________________________________________
III—Lifestyle Practice physical activity? () Yes () No Variable included in the category “physical activity and mobility”
Need help for hygiene? () Yes () No Variable included in the category “hygiene”
Feeding habits (frequency, amount, timing, type of food preference, intolerance): ______________________ Variable included in the category “nutrition/hydration”
Hydration habits (frequency, amount, timing, type of food preference, intolerance): ______________________ variable included in the category “nutrition/hydration”
Urinary elimination (frequency, quantity and characteristics): ________________ variable included in the category “elimination”
Intestinal elimination (frequency, quantity and characteristics): _________ variable included in the category “elimination”
IV—Psychobiological Needs: Oxygenation Inspection: Breathing: () nasal oxygen catheter Inspection: Breathing: () nasal cannula
IV—Psychobiological Needs: Circulation Blood Products:
() Red cells. Volume:______
() Albumin: ___ U Frequency:___
() Other: _____________________
Last Paracentesis: ___/___/_____
Indication: () Relief () Diagnosis
Volume drained: _____ L
Appearance: __________________
IV—Psychobiological Needs: Nutrition/hydration Weigh: ____ kg Current weight: ____ kg
Usual weight: _____ kg
Percentage of weight loss: ____%
Triceps skinfold thickness: ____ cm
Circumference of the middle region of the arm: _____ cm
IV—Psychobiological Needs: Elimination Water balance in 24 hours: ____ ml
() positive fluid wave
() negative fluid wave
() shifting dullness

Note. The bold are the changes and/or inclusions made in the nursing assessment tool.

aNot all the changes and/or inclusions made in the nursing assessment tool are shown in this table.