Week 1 Discussion - NURS 6512 Building a Health History

Week 1 Discussion – NURS 6512 Building a Health History

In every healthcare setting there are many differences when it comes to preferences and ethics and being familiar with what area you are working with is important to provide the best outcomes for these patients. It is important to be familiar with living situations and environments of which people to live in order to ask the right health assessment questions not only for routine visits but for symptoms as the environment and ethnical beliefs can affect some of this NURS 6512 Building a Health History Discussion.

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Health risk assessments are used to help put emphasis on health promotion and disease prevention (Wu & Orlando, 2015). With the lack of time that providers are getting with patients as things continue to grow and change, this can be a barrier to be able to provide all of the information that is needed. However with the change there can be impacts such as technological ways of communicating with these patients on the important things (Wu & Orlando, 2015). It is also important to obtain family history as this will impact the stress on disease prevention and health promotion if there are family genetics of such diseases as cancers and cardiovascular concerns (Lushniak, 2015). By knowing more about their cultural belief values and dynamics of their nationality, one can present appropriate questions more accurately that would pertain to the individual NURS 6512 Building a Health History Discussion.

I chose the 26-year-old Lebanese female living in graduate-student housing. It is important to realize that this scenario has likely had many cultural influences throughout life, yet has expanded into college and learned more along the way. In all situations of health risk assessment scenarios questions that would need to occur would include lifestyle behaviors, emotional health, and current health conditions (What is a Health Risk Assessment?, 2020). Health related risks in this scenario would include that the patient is a younger population of which addressing lifestyle can sometimes be harder in this group. 100% honesty in this group is not something that may be there. Another risk to take into consideration would be the lack of knowledge of family history as this age does not typically stay up to date on that type of thing. An assessment tool that I would probably use in this scenario would be to use a questionnaire done on paper prior to the visit to allow for her to ask her family pertinent information on the questions of which will prevent lack of knowledge or information if done in the clinic appointment. NURS 6512 Building a Health History Discussion

Questions:

1.) Do you or any of your family members (including parents and grandparents) have any heart disease, cancers, blood disorders, high blood pressure, diabetes, or other medical issues?

2.) Do you smoke, drink alcohol, or use illicit drugs? If so what type and how often?

3.) Do you have any periods of where you feel down, depressed, sad, etc?

4.) Have you had any wellness screening done within the last 5 years including GYN exam, laboratory workup, etc?

5.) What are your lifestyles behavior including hours of sleep, hours of work, type of work, normal amount of activity and level in a day, and normal nutritional status?

References:

Lushniak, B. D. (2015). Surgeon General’s Perspectives: Family Health History: Using the Past to Improve Future Health. Public Health Reports, (1), 3.

What Is a Health Risk Assessment? (2020). Retrieved from https://www.pdhi.com/ncqa/what-is-a-health-risk-assessment/

Wu, R. R., & Orlando, L.A. (2015). Implementation of Health Risk Assessments with Family Health History: Barriers and Benefits. Postgraduate Medical Journal, (1079), 508-513 NURS 6512 Building a Health History Discussion

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 healthcare 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. NURS 6512 Building a Health History Discussion

This week, you will consider how social determinants of health such as age, gender, ethnicity, and environmental situation impact the health and risk assessment of the patients you serve. You will also consider how social determinants of health 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 social determinants of health
Analyze health-related risk
Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information

Learning Resources

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. NURS 6512 Building a Health History Discussion

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? NURS 6512 Building a Health History 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 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. NURS 6512 Building a Health History Discussion

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!

Week 1 Discussion

COLLAPSE

For this week’s discussion, I wanted to select the patient that I have had the least amount of clinical experience with. Therefore, I’ve selected the 4 y.o. biracial male patient currently living with his grandmother in a high-density public housing complex. As a Case Manager, my role is centered around assisting patients with navigating public resources and obtaining referrals for care/services, however, clinically I do not have much experience with children at all.

Because this patient is so young, my interview would rely heavily on building trust with him and his grandmother as she will be my primary source for information. It would be important to gather a complete health history as well as a social history with specific focus on who lives with the patient and his grandmother, if he is in school or daycare and how many days a week he attends. It is also important to note family relationships as they pertain to the patient, who his primary caregiver is, what active medical issues he has and his immunization history.

As this family currently resides in a high-density public housing unit, I would assess their access to sanitation supplies and personal protective equipment to slow the spread of COVID-19. Public housing residents are uniquely susceptible to COVID-19 because many people work still and are essential workers and have to work through the lockdown (Anderson, 2020). NURS 6512 Building a Health History Discussion

Starting at age 7 years, children can be dependable reporters on aspects of their health (Ball, Dains, Flynn, Solomon & Stewart, 2019). Although this patient is 4, he can still contribute to his assessment if asked age appropriate direct questions. I will rely on his grandmother for the majority of the assessment and health history.

The 5 Questions I would Ask My Patient:

Who is here with you today?

Does anything hurt? Can you point to where?

What do you like to do during the day? What’s your favorite thing to do?

Can you go to the bathroom by yourself or do you still need help sometimes? Do you have accidents?

Is there anyone that makes you feel scared at home?

These are direct, important questions that will help me to understand my patient from his 4 y.o. point of view. For instance, it is explained that he lives with his grandmother, however, he may view her as a mother or other figure. It is important to regard her just as he does.

References:

Anderson, C. (2020). Mutual aid fund provides COVID-19 supplies to public housing residents. UWIRE Text.

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.

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Read a selection of your colleagues’ responses. NURS 6512 Building a Health History Discussion

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.

Great questions to ask a four-year-old child. I love working with pediatric populations because they will let the provider know how they actually feel. There are other questions I would ask this child to get an idea of how the living environment is – if your stuffed animals could talk, what would they say? What makes you happy? What makes you sad? In addition, I would further assess the child’s condition by examining the child to see how well he appears; how is he interacting with his grandmother; what are some of the cues that tell the provider that there may be a suspicion for child neglect or abuse. According to Bell and Condren (2016), communication with children and adolescents is an area that requires special attention. As clinicians, it is our duty ensure that the information being relayed is provided at a level that can be understood, to ensure patient safety as well as keep a child engaged in their own medical care and decision making. NURS 6512 Building a Health History Discussion

Bell, J., & Condren, M. (2016). Communication Strategies for Empowering and Protecting Children. The Journal of Pediatric Pharmacology and Therapeutics, 21(2), 176-184. NURS 6512 Building a Health History Discussion