Conducting a Focused Data Collection

To confirm or rule out diagnoses that are under consideration, additional cues may be collected by focusing questions to obtain data for one or more diagnoses. With the preoperative patient mentioned above, for example, the nurse might ask the patient how she feels about the surgical procedure. The answer to a broad question such as this can yield data to support many possible diagnoses in the psychosocial realm. If the patient mentions fear of death or fear of the unknown in relation to the surgery, the nurse can begin to confirm fear as the diagnosis and eliminate some of the other possibilities such as anxiety. When the nurse conducts a medical history and physical examination, biological reasons for the fast rate of breathing can also be confirmed or ruled out. A focused data collection concludes when the nurse synthesizes available data and selects one or more of the diagnoses being considered, rules out all of the diagnoses being considered, or revises the diagnoses being considered to incorporate new ones. If a diagnosis under consideration is supported through focused data collection, the next step is to validate the diagnosis. If all of the diagnoses are ruled out or not confirmed, new diagnoses are considered or the nurse concludes that there is no diagnosis. If new diagnoses are considered, a focused data collection continues until the revised set of diagnoses are confirmed or ruled out through supporting evidence (cues).