Sample Answer for NURS 6512 Building a Comprehensive Health History Essay Included After Question
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.
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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.
Submission and Grading Information
Grading Criteria
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 5, “Recording Information”
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. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
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A Sample Answer For the Assignment: NURS 6512 Building a Comprehensive Health History Essay
Title: NURS 6512 Building a Comprehensive Health History Essay
Taking a comprehensive health history of a patient is crucial in sourcing relevant and intimate information about the patient, and allowing the patient and the nurse to establish a healthy therapeutic relationship. Based on the assigned case study, interviewing the 76-year-old black male patient will be focused on collecting his previous medical history based on his disabilities in addition to his present health status, and family and social history. Given the patient’s advanced age, it will be necessary to utilize appropriate communication techniques such as the use of open-ended questions, active listening, and allowing the patient to only tell his story once (Ball et al., 2019). The above communication techniques will help the patient respond freely without getting frustrated, fatigued, or bored, given his disabilities.
For the assessment of the 76-year-old patient, it will be necessary to utilize several risk assessment tools including the 4-item falls-risk screening tool, Global Assessment of Functioning (GAF) Scale, Karnofsky Performance Status and Instrumental Activities of Daily Living Scale (Lawton IADL) among others (Pashmdarfard & Azad, 2020). The fall risk screening tool is crucial given the patient’s disabilities, to ensure appropriate caution is taken. The Karnofsky Performance Status and Lawton IADL are necessary for assessing the patient’s functional ability, given his living condition in the urban setting.
During the interview, the following targeted questions will be presented (Ghimire & Dahal, 2021):
- Can you tell me about your disabilities?
- How do your disabilities impact your ability to take care of yourself?
- Tell me about any incidences of falls or situations in which you have injured yourself from falling?
- Can you identify the comorbid that you are currently managing?
- What medications are you currently taking?
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.
Ghimire, K., & Dahal, R. (2021). Geriatric Care Special Needs Assessment. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK570572/
Pashmdarfard, M., & Azad, A. (2020). Assessment tools to evaluate Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in older adults: A systematic review. Medical journal of the Islamic Republic of Iran, 34, 33. DOI:10.34171/mjiri.34.33
A Sample Answer 2 For the Assignment: NURS 6512 Building a Comprehensive Health History Essay
Title: NURS 6512 Building a Comprehensive Health History Essay
I enjoyed reading your post. I agree that open-ended communication is the best interviewing technique for adolescents. Adolescents are already unwilling to share information willingly, and then you add the issue of an STI, making them more uncomfortable. It is crucial to have a confidentiality talk with them. Gogineni et al. (2021) report that the growing number of STIs in youth makes education and confidentiality important as the number of adolescents who seek reproductive health services continues to decline. The barriers to accessing these services include cost or insurance coverage, embarrassment, and concerns about notifying their parents. Providers should encourage positive communication about sexual health between parents and their children and educate adolescents on confidentiality rules between minor patients and providers (Gogineni et al., 2021).
These barriers threaten this age group’s health and well-being, especially since STIs such as chlamydia can be asymptomatic. Leichliter (2017) states that persons aged 15-25 on a parent’s insurance plan would not seek sexual and reproductive health care due to concerns that parents might find out. As you mentioned in your post, asking the patient about having time to talk alone is vital, as this study also says those who had alone time with the provider were more likely to receive a sexual risk assessment (Leichliter, 2017). Because adolescents often will not seek help, it is vital to include education and resources for access to care, such as free clinics and places like Planned Parenthood that offer fee-for-service since most adolescents would rather not use their parent’s insurance for these services.
I also agree that the best screening tool for adolescents is the HEEADSS risk assessment. Ball et al. (2023) also suggest the use of CRRAFT. This screening tool targets risky behaviors such as substance abuse and peer pressure. PACES is another guide that includes risky behaviors and incorporates sexuality, emotional issues, parents, and school (Ball et al., 2023, p. 31).
Mona M.
References
Ball, J., Dains, J. E., A, J., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s physical examination handbook: An interprofessional approach (10th ed., p. 31). Elsevier.
Gogineni, V., Waselewski, M. E., Jamison, C. D., Bell, J. A., Hadler, N., Chaudhry, K. A., Chang, T., & Mmeje, O. O. (2021). The future of STI screening and treatment for youth: A national survey of youth perspectives and intentions. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-12091-y
Leichliter, J. S. (2017). Confidentiality issues and use of sexually transmitted disease services among sexually experienced persons aged 15–25 years — United States, 2013–2015. MMWR. Morbidity and Mortality Weekly Report, 66(9). https://doi.org/10.15585/mmwr.mm6609a1
A Sample Answer 3 For the Assignment: NURS 6512 Building a Comprehensive Health History Essay
Title: NURS 6512 Building a Comprehensive Health History Essay
The interview focuses on constructing a comprehensive health history for a 4-year-old African-American male residing in a rural community. Effective communication strategies tailored to the patient’s age, ethnicity, and environmental context are crucial in gathering accurate information. Seidel et al. (2020) highlight that factors such as age, gender, race, and ecological setting significantly influence a patient’s health condition. To engage the 4-year-old patient, child-friendly communication techniques should be employed, including the use of age-appropriate language, active listening, and non-threatening body language, in addition to play-based interactions aided by toys or drawings, as suggested by Perry and Hockenberry (2021).
Tailoring questions to the patient’s social determinants of health is essential. Inquiring about daily routines, favorite foods, cultural practices, access to outdoor areas, and daily interactions helps gather pertinent information. Moreover, incorporating a risk assessment instrument specific to the patient’s circumstances is crucial. The Pediatric Environmental Health Toolkit’s (PEHT) questionnaire, as proposed by the Centers for Disease Control and Prevention (CDC), proves relevant in evaluating environmental factors that might affect the child’s health in a rural context.
The assessment of potential health risks considers the patient’s age-related developmental stage, potential exposure to agricultural chemicals and water contaminants in the rural setting, and the influence of his African-American ethnicity on genetic predispositions and cultural health practices. To foster effective communication and build trust, utilizing straightforward language, visual aids, and play-based communication methods is pivotal. Active listening and cultural sensitivity are foundational in addressing potential disparities in health beliefs and practices.
In conclusion, the PEHT questionnaire’s focus on environmental factors aligns with the patient’s rural living situation, making it an appropriate risk assessment tool. Through inquiries tailored to his context, such as outdoor activities, pet interactions, water quality, and exposure to local industries, the questionnaire assists in identifying potential health risks. These combined communication techniques and risk assessment strategies enable the nurse to construct a comprehensive health history for the 4-year-old patient, promoting effective care tailored to his unique needs and circumstances.
References:
Centers for Disease Control and Prevention. (n.d.). Pediatric Environmental Health Toolkit.
They were retrieved from https://www.cdc.gov/Links to an external site..
Perry, S. E., & Hockenberry, M. J. (2021). Wong’s Nursing Care of Infants and Children (11th
Ed.). Elsevier.
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2020).
Seidel’s Guide to Physical Examination (9th ed.). Elsevier