Health Assessment week 1 response

Please respond to post in one of the following ways and use the readings as some of the resources all references have to be less than 4 yrs old 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

Resources
ntroduction Resources Discussion Looking Ahead Week in Review

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NURS 6512: Advanced Health Assessment and Diagnostic Reasoning
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A photo of a female nurse from the neck down. She is holding a patient’s medical history folder.
Week 1: Building a Comprehensive Health History
According to a 2011 Gallup poll, nurses are ranked as the most trusted professionals in the United States. One of the most admired nursing skills is the ability to put patients at ease. When patients enter into a health care setting, they are often apprehensive about sharing personal health information. Caring nurses can alleviate the hesitance of patients and encourage them to be forthcoming with this information.

The initial health history interview can be an excellent opportunity to develop supportive relationships between patients and nurses. Nurses may employ a variety of communication skills and interview techniques to foster strong bonds with patients and to effectively facilitate the diagnostic process. In conducting interviews, advanced practice nurses must also take into account a range of patient-specific factors that may impact the questions they ask, how they ask those questions, and their complete assessment of the patient’s health.

This week, you will consider how factors such as age, gender, ethnicity, and environmental situation impact the health and risk assessment of the patients you serve. You will also consider how these factors influence your interview and communication techniques as you work in partnership with a patient to gather data to build an accurate health history.

Learning Objectives
Students will:
Analyze communication techniques used to obtain patients’ health histories based upon age, gender, ethnicity, or environmental setting
Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
Photo Credit: Hero Images/Hero Images/Getty Images

Learning Resources
Required Readings
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 1, “The History and Interviewing Process” (pp. 1–21)

This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.

Chapter 26, “Recording Information” (pp. 616–631)

This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.
Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

Chapter 1, “Medicolegal Principles of Documentation” (pp. 1–12 and abbreviations, pp. 18)

Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)
Note about Uploading Media:

Please refer to the Kaltura Media Uploader page located in the course navigation menu.. The documents on this page provide guidance on how to upload media for your Health Assessment Videos assignments for this course.

Deck, L., Akker, M., Daniels, L., DeJonge, E. T., Bulens, P., Tjan-Heijnen, V., L Van Abbema, D. & Buntinx, F. (2015). Geriatric screening tools are of limited value to predict decline in functional status and quality of life: results of a cohort study. BMC Family Practice, 16(30), 1–12. doi 10.1186/s12875-015-0241-x. Retrieved from http://bmcfampract.biomedcentral.com/articles/10.1186/s12875-015-0241-x

Wu, R. R. & Orlando, L. A. (2015). Implementation of health risk assessments with family health history: barriers and benefits. Post Grad Medical Journal, 91 (1079), 508–513. doi:10.1136/postgradmedj-2014-133195. Retrieved from http://pmj.bmj.com/content/91/1079/508

Lushniak, B. D. (2015). Surgeon General’s perspectives: Family health history: Using the past to improve future health. Public Health Reports, 130(1), 3–5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245280/

Jardim. T. V., Sousa, A., Povoa, T., Barroso, W., Chinem, B., Jardim, L., Bernardes, R., Coca, A., & Jardim, P. (2015). The natural history of cardiovascular risk factors in health professionals: 20-year follow-up. BMC Family Practice, 15(1111), 1–7. doi 10.1186/s12889-015-2477-8. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642770/

Optional Resources
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw- Hill Medical.

Chapter 2, “History Taking and the Medical Record” (pp. 15–33)
Olyuwaytins post

7 hours ago Oluwatoyin Adeniyi
Discussion – Week 1
COLLAPSE

Oluwatoyin Adeniyi

Week 1 Initial Post

08/27/2018

Building a Rapport while Conducting a Health History

Establishing a positive relationship with the patient is built on courtesy and good communication (Seidel et. al, 2015). Effective communication between a provider and patient is important to build rapport with that patient. Constantly evaluate the patient’s words and behavior; the history is built on the patient’s perspective, not yours (Seidel et. al, 2015). Patient must be able to feel comfortable with their health care provider, ask them questions about their life outside of why they’re here with you. Get them talking about their hobbies, their interests, their friends, and family. Most people love talking about themselves, it lets them take their minds off their discomfort, make them smile, and think about happy things, and it also provides an opportunity as an advanced nurse practitioner to find important information about their health history.

Patient scenario selected is a 16-year-old white pregnant teenager living in an inner-city neighborhood.

Interview and Communication Techniques

The interview is the basis for forming a disease prevention and therapeutic partnership with the patient based on honesty, empathy, mutual trust, and respect(Seidel et. al, 2015). As an advanced nurse practitioner, your personality and behavior during the interview will have an impact on its outcome. Listen very carefully so that you can appreciate what you are told and also what you are not told i.e information that is withheld perhaps because the patient does not want to tell you or cannot tell you (Seidel et. al, 2015). Some of the communications techniques to take into consideration when interviewing patients are flexibility, specificity, clarity, subtlety, acceptance, and empathy. Be flexible by asking open-ended questions in the beginning for example “ how have you been feeling since I last saw you?” (Seidel et. al, 2015).

When building the health history of a 16-year-old white pregnant teenager living in an inner-city neighborhood, an individualized approach is needed in obtaining information appropriate to the age and concerns of the pregnant. The very young adolescent may be concerned with the changes that pregnancy will bring to her body and friendships compared to the older woman that is concerned about the genetic risks of the pregnancy (Seidel et. al, 2015). It is important to know that adolescent is “reluctant to talk and have a clear need for confidentiality” (Seidel et. al, 2015). Do not force conversation; an advanced nurse practitioner can begin to talk about what is happening in their day-to-day experiences. If a parent is present during the interview, it is very important to respect the patient privacy/confidentiality and ask the parent to step aside first in other to get the important information. Find out if the patient has access to Women, Infants, and Children (WIC), food stamp, and transportation to prenatal care.

Risk Assessment

Risk assessment encompasses identifying from the history and physical examination of those conditions that threaten the well-being of the mother and/ or fetus (Goldstein, & Glueck, 2016). The selected patient is an adolescent/teenager. The risk assessment tool is used more as a questionnaire to determine how at risk a specific female is for teenage pregnancy, based on her personal answer. Seidel et al (2015) suggested the use of open-ended questions when interviewing an adolescents and recommended the use of two mnemonics when assessing the risks of adolescents ; HEEADSSS, (Home environment, Education, Eating, Activities, Drugs, Sexuality, Suicide, Safety), and PACES (Peers, Alcohol, Cigarettes, Emotional issues, Sexuality). An adolescent may not have such a strong desire for children and may not be in the correct circumstance for children and therefore may be reluctant to receive the appropriate amount of prenatal care. We should emphasize the risk of harming the fetus and the mother herself, teens do not plan for the future in relation to caring for themselves as well as their unborn fetus. We should determine the nutritional history, the use of harmful substances before, during, and after pregnancy, as well as any domestic violence that may be occurring.

Targeted Questions to ask a 16-year-old pregnant patient

How are things going at home?
Are you in school? If yes how are things at school?
Tell me a little about your friends and family?
Are you worried about HIV or other sexually transmitted diseases?
Are you worried about this pregnancy?
What are you’re concerned about with the pregnancy?
Finally, an advanced nurse practitioner should let the adolescent aware that respect and confidentiality are guaranteed for them.

References

Goldstein, F., & Glueck, D. (2016). Developing rapport and therapeutic alliance during

telemental health sessions with children and adolescents. Journal of Child and Adolescent Psychopharmacology, 26(3), 204-211. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1089/cap.2015.0022

Seidel, H.M, Ball, J.W., Dains, J.E., Flynn, J. A., Solomon, B.S., & Stewart, R. W., (2015).

Mosby’s guide to physical examination (8th ed.). St.Louis, MO: Elsevier Mosby

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