Feb 23, 2024 NURS 6512 Week 1 Discussion: Building a Health History
NURS 6512 Week 1 Discussion: Building a Health History
NURS 6512 Week 1 Discussion Building a Health History
Building rapport with the patient
As advanced practice registered nurses (APRNs), it is imperative to obtain a thorough health history from the patient interview process. The history is vital to guiding the physical examination and to interpreting physical exam findings ( Ball et al., 2019). One way to effectively build a health history during the interview process is to develop a rapport or relationship with the patient. Establishing a positive patient relationship depends on effective communication built on courtesy, comfort, connection, and confirmation (Ball et al., 2019). Each patient is unique and must be treated as such. Communication and interview techniques for building a health history can differ with each patient based on age, learning abilities, and the patients’ reading level. The purpose of this discussion is to identify techniques in building a health history with an adolescent white male with no insurance seeking medical care for an STI.
Crucial factors of consideration
According to the World Health Organization (WHO), adolescence is the phase of life between childhood and adulthood, from ages 10 to 19. It is a unique stage of human development and an important time for laying the foundations of good health (2022). Even through the adolescent years, there are significant diseases/illnesses and injuries. During this phase, adolescents establish patterns of behaviour – for instance, related to diet, physical activity, substance use, and sexual activity – that can protect their health and the health of others around them, or put their health at risk now and in the future (WHO, 2022). During the adolescent phase, it is important to provide correct age-appropriate sexual activity information.
Assessment
The collection and analysis of information regarding an individual’s current and overall health is a health assessment and is provided by the patient subjectively (Ball et al., 2019). Considering this patient is coming to the appointment for concerns for an STI, it is imperative for the APRN to not be judgemental. This will allow the patient to feel comfortable sharing information such as signs and symptoms of the probable STI, number of partners, past history of an STI, and their gender identity. The physical assessment is just as important as obtaining a health history. Physical exams should include inspection, auscultation, percussion, and palpation of the patient to verify the patient’s report objectively (Ball et al., 2019). As part of the physical assessment, the APRN may also conduct a male genitalia examination and obtain cultures of fluid to test for certain STIs such as, chlamydia, gonorrhea, and syphilis. Labs may also be ordered to check for those certain STIs.
At the end of the examination, targeted needs would be beneficial to address. For example, this patient does not have medical insurance. Since the patient is an adolescent, one would assume they are on their parent’s medical insurance as a dependent. Sometimes, adolescents are too afraid and uncomfortable to tell their parents and/or guardians any reproductive issues. Oftentimes, adolescents come into clinics secretly and say they do not have medical insurance so their parents/guardians do not find out about the visit once billed.
Asking questions such as why don’t you have insurance? Do your parents/guardians have medical insurance? Do they know about your visit to the clinic today? Can help identify any patterns or concerns without being assumptive. Providing support and comfort can help alleviate any hesitancy in answering the above questions. Finding and establishing important resources can help make sure the patient is getting the care they need outside of the clinic.
Specific targeted questions
Asking appropriate questions and avoiding stereotypes is essential to providing care that is tailored to the individual patient (Ball et al., 2015). With this particular patient, sexual information should be obtained in a non-judgemental manner. Targeted questions such as 1) What brings you to the clinic today? 2) How many partners do you currently have? 3) What are your current sexual practices (anal, oral, vaginal)? 4) What protection do you use to prevent STIs? 5) Have you had any STIs in the past? 6) What are your symptoms? And when did they start? Utilizing the screening tool PACES would also be beneficial for this patient. PACES stands for parents/peers, accidents/alcohol/drugs, cigarettes, emotional issues, and sexuality/school (Ball et al., 2019). PACES identifies these categories specifically for adolescents because oftentimes they are what is important to this age group.
Conclusion
A successful health assessment and interview process between an APRN and their patients requires a good rapport/relationship as the foundation. Identifying considerations and tailoring specific targeted questions to individual patients can be beneficial. Patient-centered care is an important contributor to a positive patient care experience (Dang et al., 2017). Actively engaging and listening to each patient is important. This will help the patient feel more comfortable expressing their concerns and needs.
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.
Dang, B. N., Westbrook, R. A., Njue, S. M., & Giordano, T. P. (2017). Building trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative study. BMC medical education, 17(1), 1-10.
World Health Organization. (2022). Adolescent health. Retrieved from https://www.who.int/health-topics/adolescent-health#tab=tab_1
Building a Health History
My assignment is based on working with an 85-year-old white female living alone with no family in declining health. While working on this task, I assume the patient is my mother, and I interrogate him with empathy, knowing that she is an elderly person who is likely to be more isolated and lonelier than individuals living with their loved ones. Here, I need to create an interviewing strategy to employ in assessing this patient’s medical condition, taking into account his advanced age that his health is declining.
Communication is a difficult endeavor that requires empathy and courtesy, especially when dealing with senior individuals. It’s critical to observe, listen, and gather information when pertinent information is offered when speaking with these kinds of patients. To preserve a constant pace with the patient, the medical practitioner not only should go slowly and be very patient (Ball et al., 2019).
Furthermore, by observing, the healthcare professional can connect to and be brought into the environment of the elderly. It is critical to comprehend the participant’s reality and the circumstances that may impact their responses. It’s critical for health care professionals to establish a good connection with patients in the interview session to create a favorable interaction.
Struggling to Meet Your Deadline?
Get your assignment on NURS 6512 Week 1 Discussion: Building a Health History done on time by medical experts. Don’t wait – ORDER NOW!
Meet my deadline
The nurse tells the patient to introduce themselves to create familiarity and as the patient settles in the interview. Showing sincerity is vital while getting to know the social circle’s nature and the living condition of the patient. The questions could be personal, but they are meant to know the situation of the healthcare provider.
Effective communication is vital to constructing an accurate and detailed patient
NURS 6512 Week 1 Discussion Building a Health History
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 one of the following new patients:
76-year-old Black/African-American male with disabilities living in an urban setting
Adolescent Hispanic/Latino boy living in a middle-class suburb
55-year-old Asian female living in a high-density poverty housing complex
Pre-school aged white female living in a rural community
16-year-old white pregnant teenager living in an inner-city neighborhood
ORDER NOW FOR ORIGINAL PAPER NURS 6512 Week 1 Discussion: Building a Health History
To prepare for Building a Health History:
With the information presented in Chapter 1 in mind, consider the following:
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 age, gender, ethnicity, or environment?
What risk assessment instruments would be appropriate to use with each patient?
What questions would you ask each patient to assess his or her health risks?
Select one patient from the list above on which to focus for this Discussion.
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 26 of the course 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 Building a Health History
Post a description of the interview and communication techniques you would use with your selected 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.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two 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.
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 one of the following new patients:
76-year-old Black/African-American male with disabilities living in an urban setting
Adolescent Hispanic/Latino boy living in a middle-class suburb
55-year-old Asian female living in a high-density poverty housing complex
Pre-school aged white female living in a rural community
16-year-old white pregnant teenager living in an inner-city neighborhood
To prepare:
With the information presented in Chapter 1 in mind, consider the following:
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 age, gender, ethnicity, or environment?
What risk assessment instruments would be appropriate to use with each patient?
What questions would you ask each patient to assess his or her health risks?
Select one patient from the list above on which to focus for this Discussion.
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 26 of the course 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
Post a description of the interview and communication techniques you would use with your selected 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.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two 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.
NURS 6512 Week 8 discussion: Assessing Muscoskeletal Pain
The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provide the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.
In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
Case 1: Back Pain
A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?
Note: Please view the Week 8 Discussion area to view the image for Case Study 1.
Case 2: Ankle Pain
A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottowa ankle rules to determine if you need additional testing?
Note: Please view the Week 8 Discussion area to view the image for Case Study 2.
Case 3: Knee Pain
A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform?
Note: Please view the Week 8 Discussion area to view the image for Case Study 3.
To prepare:
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Note: Before you submit your initial post, replace the subject line (“Discussion – Week 8”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.
By Day 3
Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. Include how the patient X-ray helped you to refine the differential diagnosis.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
NURS 6512 Week 9 Discussion: Assessing Neurological Symptoms
Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.
In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
Case 1: Headaches
A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.
Case 2: Numbness and Pain
A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.
Case 3: Drooping of Face
A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.
To prepare:
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Note: Before you submit your initial post, replace the subject line (“Discussion – Week 9”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.
By Day 3
Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
NURS 6512 Week 10 Discussion: Assessing the Genitalia and Rectum
Patients are frequently uncomfortable discussing with health care professionals issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.
In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
Case 1: Rectal Bleeding
A 62-year-old male construction worker reports to your clinic after experiencing rectal bleeding for over 1 month. He has noticed small amounts of blood after every bowel movement. He had a colonoscopy 2 years ago with normal results. The patient has no fever, chills, dysuria, abnormal urinary f
Order a similar assignment, and have writers from our team of experts write it for you, guaranteeing you an A
