NURS 6512 Discussion: Building a Patient Health History -

Sample Answer for NURS 6512 Discussion: Building a Patient Health History 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.

Photo Credit: Sam Edwards / Caiaimage / Getty Images

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.
NURS 6512 Discussion Building a Patient Health History
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.

A Sample Answer For the Assignment: NURS 6512 Discussion: Building a Patient Health History

Title: NURS 6512 Discussion: Building a Patient Health History

You have a thorough discussion post on your assigned case for building a health history. Great job on providing a detailed and specific list of points to collect health information. Let me supplement some ideas to your discussion to foster even more learnings in building up health history of patients.

In addition to the communication and interview techniques variation, dealing with an 80-year-old or any geriatric patient living in a remote area requires cultural sensitivity. As a Nurse practitioner, we should understand and respect the patient’s cultural and personal beliefs which may influence their health behaviors.

You have provided great points for Targeted Questions based on Social Determinants of Health (SDOH), and Risk Assessment Instruments and Questions particular to this case. In addition to the very useful tools you mentioned for risk assessment, I would like to suggest considering fall-risk evaluation given the patient’s age and living conditions. The Elderly Mobility Scale (EMS), presented in Chapter 5 of Seidel’s Guide to Physical Examination, would be a suitable risk assessment instrument for this patient.

Utilizing the additional fall risk assessment tools, these are some target-specific inquiries that could be added with your set of questions:

“Do you have any chronic conditions, such as heart disease, diabetes, or cancer?“
“How often do you visit a healthcare provider for check-ups or treatment?“
“Have you noticed any changes in your mobility or balance recently?“
“Are you exposed to any chemicals or machinery in your work on the farm?“

I think I have exhausted my knowledge pool and research in providing adjunctive learning opportunities in this discussion post. Thank you for your post and I hope I was able to help with the discussion. May we be able to connect in the future!

Reference:

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed., Ch 2 & 5). St. Louis, MO: Elsevier Mosby.

Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level. British Journal of Nursing, 30(4), 238–243. https://doi.org/10.12968/bjon.2021.30.4.238

Links to an external site.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed., Ch. 2, pp. 19-29). Philadelphia, PA: F. A. Davis.

Walden University. (n.d.). Social determinants of health. Retrieved November 27, 2023, from https://academicguides.waldenu.edu/Library/sdoh

A Sample Answer 2 For the Assignment: NURS 6512 Discussion: Building a Patient Health History

Title: NURS 6512 Discussion: Building a Patient Health History

“The patient is a 21-year-old Filipino female college student living in a dorm wanting to know what birth control is and what are good options for her. She is working as a part time waitress in an overnight bar during weekends.”

When building a health history with this patient, as a Nurse Practitioner, it’s important to establish a comfortable and non-judgmental environment. The patient’s age, cultural background, and lifestyle may influence her comfort level in discussing sensitive topics like sexual health and birth control. This is how my communication and interview techniques may vary in dealing with this patient:

Using open-ended questions to encourage her to share more information.
Being culturally sensitive. Understanding that her cultural background may influence her views on birth control, as a Filipino myself, I know most of my countrymen as conservatives, so I will be more active in listening to her concerns and passive in suggesting to her some methods based on her preferences.
Ensuring confidentiality to make her feel safe and comfortable.
Using simple, clear language to explain medical terms and procedures.

Social determinants of health are conditions in the environments in which people live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks (Walden University, n.d.). In this case, the patient’s age, occupation, and living conditions are important factors.

I will ask about her work schedule and how it might affect her ability to consistently use certain types of birth control.
I will discuss her living conditions. If she has a roommate, privacy might be a concern for methods like the birth control shot.
I will inquire about her financial situation. Some methods are more cost-effective than others.

Risk assessment would involve asking questions about the following:

Sexual Activity. I would ask about her sexual activity to assess risk of sexually transmitted infections (STIs).
Menstrual Cycle. I would Inquire about her menstrual cycle to determine the best type of birth control.
Overall Health. I would foster a discussion about her medical history. Some health conditions or medications can affect the effectiveness of certain birth control methods.

These are some potential questions:

How often do you engage in sexual activity?
Do you use protection during sexual activity?
Have you ever been tested for STIs?
What is your menstrual cycle like?
Do you have any health conditions or are you on any medications?

Based on the patient’s age, gender, ethnicity, and environmental setting, the following health-related risks should be taken into consideration:

Sexual Health Risks: As a sexually active young woman, she is at risk for sexually transmitted infections (STIs) and unplanned pregnancy (CDC, n.d.).
Occupational Risks: Working as a waitress in an overnight bar may expose her to secondhand smoke, alcohol, and potentially unsafe situations (Jones, 2022).
Mental Health Risks: The stress of balancing school, work, and personal life can lead to mental health issues such as anxiety and depression (CDC, n.d.).
Ethnicity-Related Risks: As a Filipino woman, she may have a higher risk for certain genetic conditions, such as Thalassemia (Payne, & Fanarjian, 2014).

The Gordon’s Functional Health Patterns assessment tool from Chapter 5 of the Seidel’s Guide to Physical Examination can be used for this patient. This tool assesses multiple aspects of health, including perception of health, nutritional status, sleep patterns, and sexual health, which are all relevant to this patient (Ball, & et al., 2023). These are the target-specific questions that will be highly asked based on the model.

Can you describe your current sexual activity and the methods of contraception you are using, if any?
Do you have regular menstrual cycles? Have you noticed any changes recently?
Do you have any concerns about your sexual health or reproductive health?
How often are you exposed to secondhand smoke at your workplace?
How do you manage stress from school and work? Have you noticed any changes in your mood or behavior?

These questions will help assess her health risks and begin building a health history. It is also important to approach these topics with sensitivity and respect for her privacy.

References:

Centers for Disease Control and Prevention (CDC). (n.d.). Sexual risk behaviors. Retrieved January 27, 2023, from https://www.cdc.gov/healthyyouth/sexualbehaviors/index.htm

Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level. British Journal of Nursing, 30(4), 238–243. https://doi.org/10.12968/bjon.2021.30.4.238

Links to an external site.

Jones, R. (2022, October 14). 7 important worker safety considerations in the bar and brewery industry. occupational health & safety. https://ohsonline.com/articles/2022/10/14/7-important-worker-safety.aspx

Links to an external site.

Payne, C. & Fanarjian, N. (2014, October). Seeking causes for race-related disparities in contraceptive use. https://journalofethics.ama-assn.org/article/seeking-causes-race-related-disparities-contraceptive-use/

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed., Ch. 2, pp. 19-29). Philadelphia, PA: F. A. Davis.

Walden University. (n.d.). Social determinants of health. Retrieved November 27, 2023, from https://academicguides.waldenu.edu/Library/sdoh

Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.