Objective vs. Subjective data

[sunkissed75, CNA]

hey everyone!

we had a case study in class today where we had to decide what info was objective and what info was subjective. i won't go into the whole case study, but after taking the assignment up in class the teacher put info i thought would be subjective under the objective colomn.

this is from the case study:

"the nasal examination reveals a slightly reddened color of the nose, with some tenderness noted across the bridge of the nose."

"both frontal and maxillary sinuses transilluminate; the frontal sinus area is slightly tender to palpation."

the areas i bolded i had put under the subjective category because tenderness is a form of pain...pain is 'subjective'. the teacher suggested that if the person grimaced that would indicate objective. true...but the case study didn't say that. is it possible to 'feel' that an area is tender? if the frontal and maxillary sinuses didn't transilluminate then that could possibly mean the frontal sinus was tender because that would indicate a sinus filled with pus...but it did transilluminate! and even then, i still think tenderness is something the clt feels...not something the nurse can observe!

i guess i just want to know if i'm right!!

thanks for your help, guys!!!!

[RNTutor, BSN, RN]

Lol, I am with you on this one...I always consider pain subjective! But if there is a physical sign of pain that I can observe...such as grimacing, moaning, flinching, etc...then I consider that objective.

That being said, better go with what the teacher tells you for exams! :)

[sunkissed75, CNA]

thanks for your help. the thing i am finding with nursing school is that a lot of it is your own interpretation! even during exams...you pick the best answer! my best answer and another person's best answer may be completely different than what the teacher is looking for. just recently there was a thread started on here with an example of a question and there were so many different 'right' answers!! and each answer was backed up with reasoning for choosing that particular answer. i don't know...hopefully next semester there's a class on mind reading!!!

[AOx1]

You are correct. Subjective is something the patient says, objective is something you observe. She is correct in stating that if the patient grimaced/flinched/pulled away/etc that this would be an observation, but based on what you wrote, this data is subjective. Tenderness is a qualitative observation. We ask the patient to describe their pain (ex- sharp, dull, tender, etc).

This is an important distinction. For example, lets say someone has chronic pain. They have had this pain for years. Someone who is not accustomed to chronic pain may assume that if someone is truly in pain, they would not be able to sleep. However, this is not necessarily the case. This is why we don't rely on observation alone if there are other parameters to consider (of course, sometimes the patient is non-verbal and you must rely on objective observations). Pain will often have assessment data in both categories.

Good for you! You are doing well at identifying which data belongs in which category.

[sunkissed75, CNA]

Thanks LiveToLearn! I won't lie...it feels good that I'm right! More importantly though, I am so excited I am really starting to learn and understand what I'm being taught!!

[projectsarah]

Hey houlihan75, I feel the same way about needing a mind reading class for the teachers! Glad to know I'm not the only one! I just finished my first semester and at the end I started to really understand it all of the sudden. Isn't it awesome?

[RNTutor, BSN, RN]

Hey houlihan75, I feel the same way about needing a mind reading class for the teachers! Glad to know I'm not the only one! I just finished my first semester and at the end I started to really understand it all of the sudden. Isn't it awesome?

That IS awesome!! I love it when students have that "light bulb" moment in their semester. What do you think helped create that moment for you? What advice would you give other nursing students who want to achieve the same thing you have?

[projectsarah]

The advice I would give to my fellow nursing students is to DON'T GIVE UP! You have to just keep working on it and thinking about it even though it makes no sense to you at the beginning. When you get frustrated and confused that's good because that means your almost there! One day your teacher will stop sounding like she is talking Greek and you will truly understand it and you will feel so wonderful about yourself! You can do it! Alot of peer support also helped me so much!!

[headliner1889]

objective is something that you can see, feel, or smell. you can SEE the reddened areas and you can FEEL the tenderness. therefore i think both are objective

[RNTutor, BSN, RN]

Well, the patient can feel the tenderness, but as a nurse you can't feel the tenderness. So I would still think it is subjective, since the distinction is made from the nurse's point of view.

[sunkissed75, CNA]

objective is something that you can see, feel, or smell. you can see the reddened areas and you can feel the tenderness. therefore i think both are objective

i completely agree that seeing that an area is red is objective...and that point did in fact go under the objective colomn. however, what does 'tender' feel like. if i am palpating the nose while the pt is unconsious...how can i 'feel' that it is tender? will it feel mushy or spongy? will it feel hard or soft? for instance a sprained ankle...you can 'feel' that it's swollen. you can 'see' that it's swollen...but only the pt can tell you if it's tender. to me tender is a feeling and therefore subjective. if the pt had no feeling in their legs, would the ankle still be considered tender?

just thinking out loud....