NURS-6512N-48 Week 1: Discussion
BUILDING A HEALTH HISTORY
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s social determinants of health?
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
BY DAY 3 OF WEEK 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses.
BY DAY 6 OF WEEK 1
Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:
Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
Suggest additional health-related risks that might be considered.
Validate an idea with your own experience and additional research
Main Post
Communication Techniques
Building trust and encouraging effective communication with the patient are top facilitators to obtaining a complete and accurate health history (Ball, et al., 2019). Communication and interview techniques can differ between patients. For example, some patients may need information provided in very simple terms whereas others may have a more in-depth understanding of the diagnosis due to their education level or occupation. Communication techniques may differ if the patient is experiencing any barriers to communication such as anxiety, situational depression, or anger. Generally, I would use similar communication techniques with all patients by encouraging an open line of communication, having an open body language, and a positive attitude. I would explain information to the patient in laymen terms to avoid any assumptions that the patient may or may not have a high level of understanding of medical terms. Communications techniques would differ for patients with anger for example because I would use a more relaxed body language approach and avoid becoming defensive or argumentative with the patient (Ball, et al., 2019). I would use an empathetic tone in attempts to calm the patient and encourage communication and trust (Ball, et al., 2019).
Targeting Questions
For the 35-year-old male with a history of morbid obesity with disabilities in a rural setting, I would asked target questions to address all aspects of social determinants. As the patient is morbidly obese with disabilities living in a rural area, there are several social determinants that may contribute to this lifestyle such as stress, nutrition, exercise, home conditions, and occupation (Ball, et al., 2019). In building the health history, I would ask the patient about their level of stress, eating habits, and the availability of nutritious foods. I would also inquire about the amount and type of exercise the patient participates in on a weekly basis. Lastly, I would inquire about the patient’s living situation and sense of safety related to physical exercise and nutrition as well as the availability of healthcare. These targeted questions will assist in building the patient’s health history because it will provide insight to barriers of health the patient may experience. These questions will also help direct the patients care and goals for treatment.
Health Risk Assessment
Risk assessment instruments I would routinely use with all patients would include the screening of alcohol, tobacco, or substance abuse as well as depression. If the patient has a positive screening for alcohol, I will then use the TRACE model to identify the extent of the problem and discuss an appropriate treatment plan if desired (Ball, et al., 2019). I would also examine the patient’s family history to identify any genetic diagnosis that require close prevention monitoring such as cardiac disorders or diabetes. Questions regarding each patient’s diet, exercise, mental wellbeing, and stress can give the provider insight on potential health issues the patient may be at an increased risk for.
Based on the assigned patient, potential health-related risks that may affect this patient include the increased risk of depression related to obesity and disability. The patient is also at risk for cardiovascular disease due to his increased risk factors including obesity, sedentary lifestyle, poor nutrition, and lack of exercise (Fryar, et al., 2019). The extent of the patient’s disability may contribute to an increased health risk. For example, if the patient is unable to walk far distances and is mainly chair bound, the patient may be at an increased risk for pressure ulcers or skin breakdown.
Risk Assessment Instrument
A risk assessment I would use with this patient would be the 14-item resilience scale (RS-14) which is a tool that can be used to screen for depression. This patient would be at an increased risk for depression due to their history of morbid obesity and disabilities at a young age. This diagnosis may make the patient feel as if they are not a productive part of society and therefore increases their risk for depression. The RS-14 scale may identify anxiety, depression, or post-traumatic stress disorder and is more convenient to use than the longer risk assessments available (Miroševič, et al., 2019).
Five Target Questions
The five target questions I would ask the patient to assess their health risks and assist in building a health history include:
What does your diet look like on a typical day? Are there any barriers to obtaining nutritious foods?
Do you exercise on a routine basis? If yes, then continue with follow-up questions regarding how often and what type of exercise?
Do you have a family history of cardiovascular disease? Such as heart attacks, high blood pressure, or strokes?
Have you ever been checked for high blood pressure or diabetes?
Do you have any trouble completing daily activities? Do you require assistance to complete any specific activities?
I would target these questions to identify any social determinants the patient may experience that create a barrier to better health. After identifying determinants, I would work with the patient to identify solutions and resources to overcome any barriers.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Fryar, C., Fakhouri, T., Carroll, M., Frenk, S., & Ogden, C. (2019, November 9). The association of nativity/length of residence and cardiovascular disease risk factors in the United States. Science Direct. Retrieved November 29, 2022, from https://www.sciencedirect.com/science/article/pii/S0091743519303731
Miroševič, Š., Klemenc-Ketiš, Z., & Selič, P. (2019). The 14-item Resilience scale as a potential screening tool for depression/anxiety and quality of life assessment: A systematic review of current research. Family Practice, 36(3), 262–268. https://doi.org/10.1093/fampra/cmy081
LEARNING RESOURCES
The post NURS-6512N-48 Week 1: Discussion appeared first on Masterly Nursing Papers.
Need help with your own assignment?
Our expert writers can help you apply everything you've just read — to your actual assignment.
Get Expert Help Now →