Effective communication is vital to constructing an accurate and d.docxgidmanmary
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.
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.
Resources
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. (2019). Seidel's guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
· Chapter 1, “The History and Interviewing Process”
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 Informat ...
The Profile4-year-old biracial male living with his grandmother lourapoupheq
The Profile
4-year-old biracial male living with his grandmother in a high-density public housing complex.
Discussion
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.
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 differe ...
Fatmata Diaby
26-year-old Lebanese female
COLLAPSE
History Taking and Risk Assessment
Developing an appropriate rapport is necessary when evaluating patient’s health needs as well as their risk assessment for the development of various debilitating conditions. An effective patient-practitioner rapport has been linked to improved patient health-care outcomes. A health care professional should have the intellectual capacity to internalize their patient’s feelings and emotional concerns aiming at maintaining the appropriate respect for their individual patients. In the case scenario provided, the patient is a 26-year-old Lebanese female living in a graduate-student housing requiring a health risk assessment. The initial step that should be taken by the health care professional is to introduce themselves to the patient to eliminate any possible ambiguity about their current care giver. The next step is to commence a rapport while making sure to maintain sociocultural sensitivity for extraction of precise and optimal details that will promote the formulation of an appropriate treatment plan for the patient. Use of open-ended questions is integral when obtaining a thorough history as it avoids omission and clinician-based bias (Tanwani, 2016). Empathy is exercised during practice as it allows the patient to feel understood and facilitates promotion of an effective patient-clinician rapport. Listening is a communication skill commonly overlooked but has a crucial role when attempting to narrow in on a diagnosis following an elaborate history of presenting illness.
Health Risk Assessment Instrument of Choice
The patient is a 26-year-old student living in the graduate-student housing. She is currently of child bearing age and is prone to contracting sexually transmitted diseases. This evokes the need for a Sexually transmitted disease (STD) risk assessment which involves diseases such as Human immunodeficiency virus infections among other STDs. Obtaining a sexual history from patients can at times seem challenging but should be carried out thoroughly with empathy and a non-judgmental attitude. Patient-practitioner confidentiality should also be assured for comfort and ease of assessment (Barrow, Ahmed, Bolan & Workowski, 2020). Women of child bearing age that are engaged in sexual intercourse should be frequently screened for STDs via history taking and physical examination. Moreover, culture and socioeconomic status play a major role in STD acquisition predisposition as various individuals have different practices as well as beliefs.
Targeted Questions
Specific sexual history questions should be asked in reference to the patient’s health assessment. The frequency and modes of sexual pleasure should be documented alongside the number of sexual partners involved with the patient. Multiple sexual partners are highly associated with a higher risk of STD acquisition. In addition, multiple sexual practices can greatly increase the risk of developing.
Effective communication is vital to constructing an accurate and d.docxgidmanmary
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.
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.
Resources
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. (2019). Seidel's guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
· Chapter 1, “The History and Interviewing Process”
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 Informat ...
The Profile4-year-old biracial male living with his grandmother lourapoupheq
The Profile
4-year-old biracial male living with his grandmother in a high-density public housing complex.
Discussion
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.
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 differe ...
Fatmata Diaby
26-year-old Lebanese female
COLLAPSE
History Taking and Risk Assessment
Developing an appropriate rapport is necessary when evaluating patient’s health needs as well as their risk assessment for the development of various debilitating conditions. An effective patient-practitioner rapport has been linked to improved patient health-care outcomes. A health care professional should have the intellectual capacity to internalize their patient’s feelings and emotional concerns aiming at maintaining the appropriate respect for their individual patients. In the case scenario provided, the patient is a 26-year-old Lebanese female living in a graduate-student housing requiring a health risk assessment. The initial step that should be taken by the health care professional is to introduce themselves to the patient to eliminate any possible ambiguity about their current care giver. The next step is to commence a rapport while making sure to maintain sociocultural sensitivity for extraction of precise and optimal details that will promote the formulation of an appropriate treatment plan for the patient. Use of open-ended questions is integral when obtaining a thorough history as it avoids omission and clinician-based bias (Tanwani, 2016). Empathy is exercised during practice as it allows the patient to feel understood and facilitates promotion of an effective patient-clinician rapport. Listening is a communication skill commonly overlooked but has a crucial role when attempting to narrow in on a diagnosis following an elaborate history of presenting illness.
Health Risk Assessment Instrument of Choice
The patient is a 26-year-old student living in the graduate-student housing. She is currently of child bearing age and is prone to contracting sexually transmitted diseases. This evokes the need for a Sexually transmitted disease (STD) risk assessment which involves diseases such as Human immunodeficiency virus infections among other STDs. Obtaining a sexual history from patients can at times seem challenging but should be carried out thoroughly with empathy and a non-judgmental attitude. Patient-practitioner confidentiality should also be assured for comfort and ease of assessment (Barrow, Ahmed, Bolan & Workowski, 2020). Women of child bearing age that are engaged in sexual intercourse should be frequently screened for STDs via history taking and physical examination. Moreover, culture and socioeconomic status play a major role in STD acquisition predisposition as various individuals have different practices as well as beliefs.
Targeted Questions
Specific sexual history questions should be asked in reference to the patient’s health assessment. The frequency and modes of sexual pleasure should be documented alongside the number of sexual partners involved with the patient. Multiple sexual partners are highly associated with a higher risk of STD acquisition. In addition, multiple sexual practices can greatly increase the risk of developing.
Response Post #1Culture is defined as customary beliefs, soc.docxwilfredoa1
Response Post #1
Culture is defined as customary beliefs, social forms, and material traits of a racial, religious, or social group (Webster, 2019). Competence suggests having the capacity to function effectively as an individual and an organization within the context of cultural beliefs, behaviors, and needs presented by consumers and their communities (CDC, 2015). In healthcare, it is very important to be aware of different culture backgrounds. It helps with not only being able to communicate effectively but also knowing what diseases, sickness, etc. that the person is at greatest risk for. For example, in the treatment of depression, compared with white Americans, black and Latino patients are actually less likely to receive treatment (Ball et al., 2019).
The patient I was given is a 14 year old biracial male living with his grandmother in a high-density public housing complex. For the purpose of obtain a health history with this particular patient it is important to consider everything about this patient. The patients age, sex, ethnicity, living conditions, etc. will all need to be taken into account. This particular age group are reluctant to talk and have a definite need for confidentiality (Ball et al., 2019). It is important that adolescent patients be given the opportunity to speak to you privately about concerns or issues that they may have (Ball et al., 2019). It is meaningful that you let the patient know the limits of confidentiality and that if any information provided suggests that an adolescence safety or others safety may be at risk, that its grounds to “break” confidentiality (Ball et al., 2019). Prior to the office visit, there a previsit questionnaires and screeners that the patient can fill out and this sometimes helps allow the patient to write down concerns or have a choice of concerns (Ball et al., 2019). Then based off the answers, it can help you ask appropriate questions during the interviewing process.
Based off of the patients age, ethnicity, and living conditions I would use the HEEADSSS screening tool. This screening tool assess the home environment, education/employment, eating, activities, drugs, sexuality, suicide/depression, and safety from injury and violence (Ball et al., 2019). Questions that can be asked needs to be open ended questions such as …
Tell me about where you live?
How are you liking school?
What do you like to do, any activities in school or out of school?
Do you ever hang out with your friends outside of school? What do you like to do? Are you ever in situations that make you uncomfortable? Have you ever tried drugs or alcohol?
In order to assess for suicide/depression, there are screening tools. The screening questions may include asking about sleep disorders, appetite/eating behavior change, feelings of “boredom”, emotional outbursts and highly impulsive behavior, hopeless/helpless feeling, history of family with depression or suicide, suicidal ideation, history of psychosocial/em.
THIS DISCUSSION IS DIVIDE IN TWO PARTS –1. MAIN DISCUSSION PGrazynaBroyles24
**THIS DISCUSSION IS DIVIDE IN TWO PARTS –
1. MAIN DISCUSSION POST BY WEDNESDAY 9/1/2021 BEFORE 8:00 PM EST
2. TWO REPLIES BY FRIDAY 09/03/2021 BEFORE 8:00 PM EST
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.
· 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.
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
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.
· 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 risk 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.
DISCUSSION – INSTRUCTIONS
Patient Assigned:
· 55-year-old Asian female living in a high-density public housing complex
1. Post a summary of the interview and a description of the communication techniques you would use with your assigned patient.
2. Explain why you would use these techniques.
3. Identify the risk assessment instrument you selected and justify why it would be applicable to the selected patient.
4. Provide at least five targeted questions you would ask the patient.
5. Use at least 3 references.
6. Review the Grading Rubric
**THIS DISCUSSION IS DIVIDE IN TWO PARTS
–
1.
MAIN DISCUSSION POST BY
WEDNESDAY
9
/1/2021
BEFORE 8:00 PM EST
2.
TWO REPLIES BY FRIDAY
09/03
/2021 BEFORE 8:00 PM EST
Discussion: Building a Health History
·
Effective communication is vital to constructing an accurate and detailed patient history. A
patient’s health or i ...
Rosemary Frasso's presentation from the
Penn Urban Doctoral Symposium
May 13, 2011
Co-sponsored with Penn’s Urban Studies program, this symposium celebrates the work of graduating urban-focused doctoral candidates. Graduates present and discuss their dissertation findings. Luncheon attended by the students, their families and their committees follows.
Building a Health History Thorough and accurate pediatric histor.docxcurwenmichaela
Building a Health History
Thorough and accurate pediatric history is a challenging and very important to children's wellbeing that allows nurses and patients to establish a nurse-patient therapeutic relationship. History building is also essential in the interpretation of physical examination (Ball et al., 2019). Completing a comprehensive health history and physical examination is a tool used to document patient medical history, physical examination findings, and diagnosis (Sullivan, 2019). Using good communication skills to obtain this information is very important as communication creat a positive patient relationship. In other to develop this positive patient relationship, the nurse practitioner needs to build on courtesy, connection with the patient/guardian, ensure comfort and provide an opportunity for confirmation of what has been discussed to ensure understanding (Ball et al., 2019). Performing an assessment and history taking in children can bring upon anxiety, so practitioners should try to ease the anxiety by making sure the child is in the room with the parent, especially preschoolers (Ball et al., 2019).
Interview and Communication Techniques
Children in rural areas face risk factors that are particular to their demographic features. Children living in rural areas are more at risk for health and developmental conditions. Performing an assessment and history taking in children can bring upon anxiety, so practitioners should try to ease the anxiety by making sure the child is in the room with the parent, especially preschoolers (Ball et al., 2019). Gaining confident and building practitioner-patient–caregivers relationship that is based on trust is very important as it facilitates with data collection (Mărginean et al., 2017). The practitioner should be empathetic as this will improve communication, be an active listener and observer to pick up any cues that patients might not share like grimacing, use open-ended questions. The use of questionnaire is encouraged too where the parent fills it out and by freely writing down patient concerns without having to answer the questions in person (Ball et al., 2019).
Risk Assessment Tool
According to Chung et al. (2016), 20 percent of US children live in poverty in rural, urban, and suburban, so it is critical to know the social determinant of the health of children to assess them better and provide safe and appropriate care needed (Chung et al., 2016). This social determinant includes family financial support, child maltreatment, and child education. Chung et al. (2016), also continues to explain that children who live in poverty are exposed to adverse childhood experiences like toxic stress, developmental delay, and health conditions like asthma and heart diseases. Rural people are usually poor and experience healthcare disparities. According to the center for disease control and prevention (2016), younger children are more likely to experience fatal abuse and neglect than older .
Case studyTJ, a 32-year-old pregnant lesbian, is being seen for .docxtroutmanboris
Case study
TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over-the-counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.
May 2012, Alice Randall wrote an article for
The New York Times
on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
Consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.
To prepare:
Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering pertinent information?
Post
a 3-4 page explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.
Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Seidel's guide to physical examination: An interprofessional appr.
Final ExamSpend up to the next 2 hours to complete the following.docxcharlottej5
Final Exam
Spend up to the next 2 hours to complete the following task, to the best of your ability. This exam is worth 100 points. There is no specific word count requirement.
Topic: Vitamin C - https://vitamincfoundation.org/squares/
Your submission should be in the form of written paragraphs, but you will not be evaluated on the quality of writing beyond the minimum necessary to understand what you are communicating. Your submission does not need to be as structured as the analysis assignments submitted during the semester. You should answer parts 1-5 of the task individually, each in paragraph form. Number each answer to correspond to parts 1-5, and then references at the end.
1. In one paragraph, summarize the product or service and describe what it is supposed to do.
2. In one paragraph, identify and clearly state at least one scientific claim being made about the product or service.
3. Identify and clearly describe at least two sources that are purported to support the claim. Each source should be described in a single paragraph (i.e., two paragraphs total). You must provide references for these sources (as well as any other that you use to complete the other tasks) at the end of your document, in the same format that you have been using throughout the semester.
4. Briefly evaluate the quality of the sources and whether or not the sources appear to support the claim. This section may be anywhere from one to several paragraphs long, as needed.
◦ State whether or not you believe the claim is justified, correct, and/or relevant based on your overall evaluation. This evaluation must take into account the sources you identified and evaluated (in steps 3 and 4).
◦ You may utilize sources that do not support the claim in your overall evaluation (i.e., sources in addition to the two from step 3).
◦ Your evaluation should explicitly consider at least two logical fallacies. These may be fallacies that you believe are present, or ones that could have been an issue but that you determined were not.
5. Based on your review of the product or service, summarize in one paragraph when use of the product or service might be beneficial: who might benefit and under what circumstances.
You are free to draw on prior knowledge, your textbook, and electronic resources, but should indicate when you have done so by using the same referencing methods utilized during the semester.
You may not use other humans. Communication in any form (verbal, physical, or electronic) with another human being during this exam will be considered academic misconduct and result in an automatic grade of zero. The sole exception is if you have an urgent issue that you communicate to an instructor. Your instructors will not provide assistance with this exam or the resources you utilize to complete it.
Your final document should be uploaded to the Assignments link provided through Brightspace. After verifying that the document has successfully uploaded, you are free to lea.
Effective communication is vital to constructing an accurate and detIlonaThornburg83
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.
Patient is a 38-year-old Native American pregnant female living on a reservation
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.
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
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.
· Chapter 1, “The History and Interviewing Process”
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.
· Chapter 2, "The Comprehensive History and Physical Exam" (pp. 19–29)
Deckx, L., van den Akker, M., Daniels, L., De Jonge, E. T., Bulens, P., Tjan-Heijnen, V. C. G., … 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.
...
Why does teen pregnancy and sexually transmitted diseases remain hig.docxvelmakostizy
Why does teen pregnancy and sexually transmitted diseases remain high in the U.S.
What can healthcare providers do that decrease the rate of teen pregnancy and STD’s in the US?
* These questions should be researched and incorporated in the body of the paper and answered.
This is my introduction already done.
Adolescent Sex
Teen pregnancy and sexually transmitted diseases continue to be an important healthcare issue in the 20
th
century.
Although teen pregnancy rates have dropped there are still concerns and healthcare problems that are associated with teen pregnancy.
Often times they are afraid to discuss sex with their parents and deny will deny being sexually active at all.
There are problems that manifest with
adolescent pregnancy for the mother and often times the infants as well.
The high school drop out rate among pregnant high school students is approximated at about
70 percent and is cited as the number reason teens drop out prior to graduation
.
There is also an estimated $7 billion revenue cost associated with teen pregnancy in the United States alone.
[KD2]
The risk of young people engaging in early sexual intercourse is largely due to the lack of sexual education, peer pressure and social influences.
Chlamydial infection, gonorrhea, HIV/AIDS, primary and secondary syphilis, and hepatitis B virus infection are amid the highest reported STDs with chlamydia noted as the most dominate which is likely due to the fact that there is more vigorous testing.
Some of the other noted STDs are genital herpes, trichomoniasis, Chancroid, and HPV.
Often times and without any signs or symptoms present more than one pathogen is involved with sexually transmitted diseases. Typically the only environments in which there remain viable pathogens is the bodily fluids from the genitourinary tract requiring there to be intimate contact for them to be acquired.
Although it affects men and women chlamydia is predominately seen in young women and is the most common nationally known sexually transmitted disease in the U.S.
Bodily fluids from the genitourinary tract are typically the environments in which there remain viable pathogens, so intimate contact is generally required to obtain STDs.
Chlamydia infections are asymptomatic in most women and can be transmitted during childbirth with the
potential of a newborn developing pneumonia as a complication.
If it is not treated
chlamydia can spread to the uterus and fallopian tube creating further health problems and permanent damage to the reproductive system.
Teaching abstinence is the most affective way to prevent pregnancy and STDs but sexuality and curiosity of sex begins at a young age and exploration into sexuality is a natural part of personal development.
I feel it is our
[KD3]
role and responsibility as healthcare providers to provide adolescents and teens with the information and risk factors involved with having sex.
They need to be educated on contraceptives, pregnancy and S.
Response Post #1Culture is defined as customary beliefs, soc.docxwilfredoa1
Response Post #1
Culture is defined as customary beliefs, social forms, and material traits of a racial, religious, or social group (Webster, 2019). Competence suggests having the capacity to function effectively as an individual and an organization within the context of cultural beliefs, behaviors, and needs presented by consumers and their communities (CDC, 2015). In healthcare, it is very important to be aware of different culture backgrounds. It helps with not only being able to communicate effectively but also knowing what diseases, sickness, etc. that the person is at greatest risk for. For example, in the treatment of depression, compared with white Americans, black and Latino patients are actually less likely to receive treatment (Ball et al., 2019).
The patient I was given is a 14 year old biracial male living with his grandmother in a high-density public housing complex. For the purpose of obtain a health history with this particular patient it is important to consider everything about this patient. The patients age, sex, ethnicity, living conditions, etc. will all need to be taken into account. This particular age group are reluctant to talk and have a definite need for confidentiality (Ball et al., 2019). It is important that adolescent patients be given the opportunity to speak to you privately about concerns or issues that they may have (Ball et al., 2019). It is meaningful that you let the patient know the limits of confidentiality and that if any information provided suggests that an adolescence safety or others safety may be at risk, that its grounds to “break” confidentiality (Ball et al., 2019). Prior to the office visit, there a previsit questionnaires and screeners that the patient can fill out and this sometimes helps allow the patient to write down concerns or have a choice of concerns (Ball et al., 2019). Then based off the answers, it can help you ask appropriate questions during the interviewing process.
Based off of the patients age, ethnicity, and living conditions I would use the HEEADSSS screening tool. This screening tool assess the home environment, education/employment, eating, activities, drugs, sexuality, suicide/depression, and safety from injury and violence (Ball et al., 2019). Questions that can be asked needs to be open ended questions such as …
Tell me about where you live?
How are you liking school?
What do you like to do, any activities in school or out of school?
Do you ever hang out with your friends outside of school? What do you like to do? Are you ever in situations that make you uncomfortable? Have you ever tried drugs or alcohol?
In order to assess for suicide/depression, there are screening tools. The screening questions may include asking about sleep disorders, appetite/eating behavior change, feelings of “boredom”, emotional outbursts and highly impulsive behavior, hopeless/helpless feeling, history of family with depression or suicide, suicidal ideation, history of psychosocial/em.
THIS DISCUSSION IS DIVIDE IN TWO PARTS –1. MAIN DISCUSSION PGrazynaBroyles24
**THIS DISCUSSION IS DIVIDE IN TWO PARTS –
1. MAIN DISCUSSION POST BY WEDNESDAY 9/1/2021 BEFORE 8:00 PM EST
2. TWO REPLIES BY FRIDAY 09/03/2021 BEFORE 8:00 PM EST
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.
· 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.
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
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.
· 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 risk 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.
DISCUSSION – INSTRUCTIONS
Patient Assigned:
· 55-year-old Asian female living in a high-density public housing complex
1. Post a summary of the interview and a description of the communication techniques you would use with your assigned patient.
2. Explain why you would use these techniques.
3. Identify the risk assessment instrument you selected and justify why it would be applicable to the selected patient.
4. Provide at least five targeted questions you would ask the patient.
5. Use at least 3 references.
6. Review the Grading Rubric
**THIS DISCUSSION IS DIVIDE IN TWO PARTS
–
1.
MAIN DISCUSSION POST BY
WEDNESDAY
9
/1/2021
BEFORE 8:00 PM EST
2.
TWO REPLIES BY FRIDAY
09/03
/2021 BEFORE 8:00 PM EST
Discussion: Building a Health History
·
Effective communication is vital to constructing an accurate and detailed patient history. A
patient’s health or i ...
Rosemary Frasso's presentation from the
Penn Urban Doctoral Symposium
May 13, 2011
Co-sponsored with Penn’s Urban Studies program, this symposium celebrates the work of graduating urban-focused doctoral candidates. Graduates present and discuss their dissertation findings. Luncheon attended by the students, their families and their committees follows.
Building a Health History Thorough and accurate pediatric histor.docxcurwenmichaela
Building a Health History
Thorough and accurate pediatric history is a challenging and very important to children's wellbeing that allows nurses and patients to establish a nurse-patient therapeutic relationship. History building is also essential in the interpretation of physical examination (Ball et al., 2019). Completing a comprehensive health history and physical examination is a tool used to document patient medical history, physical examination findings, and diagnosis (Sullivan, 2019). Using good communication skills to obtain this information is very important as communication creat a positive patient relationship. In other to develop this positive patient relationship, the nurse practitioner needs to build on courtesy, connection with the patient/guardian, ensure comfort and provide an opportunity for confirmation of what has been discussed to ensure understanding (Ball et al., 2019). Performing an assessment and history taking in children can bring upon anxiety, so practitioners should try to ease the anxiety by making sure the child is in the room with the parent, especially preschoolers (Ball et al., 2019).
Interview and Communication Techniques
Children in rural areas face risk factors that are particular to their demographic features. Children living in rural areas are more at risk for health and developmental conditions. Performing an assessment and history taking in children can bring upon anxiety, so practitioners should try to ease the anxiety by making sure the child is in the room with the parent, especially preschoolers (Ball et al., 2019). Gaining confident and building practitioner-patient–caregivers relationship that is based on trust is very important as it facilitates with data collection (Mărginean et al., 2017). The practitioner should be empathetic as this will improve communication, be an active listener and observer to pick up any cues that patients might not share like grimacing, use open-ended questions. The use of questionnaire is encouraged too where the parent fills it out and by freely writing down patient concerns without having to answer the questions in person (Ball et al., 2019).
Risk Assessment Tool
According to Chung et al. (2016), 20 percent of US children live in poverty in rural, urban, and suburban, so it is critical to know the social determinant of the health of children to assess them better and provide safe and appropriate care needed (Chung et al., 2016). This social determinant includes family financial support, child maltreatment, and child education. Chung et al. (2016), also continues to explain that children who live in poverty are exposed to adverse childhood experiences like toxic stress, developmental delay, and health conditions like asthma and heart diseases. Rural people are usually poor and experience healthcare disparities. According to the center for disease control and prevention (2016), younger children are more likely to experience fatal abuse and neglect than older .
Case studyTJ, a 32-year-old pregnant lesbian, is being seen for .docxtroutmanboris
Case study
TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over-the-counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.
May 2012, Alice Randall wrote an article for
The New York Times
on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
Consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.
To prepare:
Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering pertinent information?
Post
a 3-4 page explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.
Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Seidel's guide to physical examination: An interprofessional appr.
Final ExamSpend up to the next 2 hours to complete the following.docxcharlottej5
Final Exam
Spend up to the next 2 hours to complete the following task, to the best of your ability. This exam is worth 100 points. There is no specific word count requirement.
Topic: Vitamin C - https://vitamincfoundation.org/squares/
Your submission should be in the form of written paragraphs, but you will not be evaluated on the quality of writing beyond the minimum necessary to understand what you are communicating. Your submission does not need to be as structured as the analysis assignments submitted during the semester. You should answer parts 1-5 of the task individually, each in paragraph form. Number each answer to correspond to parts 1-5, and then references at the end.
1. In one paragraph, summarize the product or service and describe what it is supposed to do.
2. In one paragraph, identify and clearly state at least one scientific claim being made about the product or service.
3. Identify and clearly describe at least two sources that are purported to support the claim. Each source should be described in a single paragraph (i.e., two paragraphs total). You must provide references for these sources (as well as any other that you use to complete the other tasks) at the end of your document, in the same format that you have been using throughout the semester.
4. Briefly evaluate the quality of the sources and whether or not the sources appear to support the claim. This section may be anywhere from one to several paragraphs long, as needed.
◦ State whether or not you believe the claim is justified, correct, and/or relevant based on your overall evaluation. This evaluation must take into account the sources you identified and evaluated (in steps 3 and 4).
◦ You may utilize sources that do not support the claim in your overall evaluation (i.e., sources in addition to the two from step 3).
◦ Your evaluation should explicitly consider at least two logical fallacies. These may be fallacies that you believe are present, or ones that could have been an issue but that you determined were not.
5. Based on your review of the product or service, summarize in one paragraph when use of the product or service might be beneficial: who might benefit and under what circumstances.
You are free to draw on prior knowledge, your textbook, and electronic resources, but should indicate when you have done so by using the same referencing methods utilized during the semester.
You may not use other humans. Communication in any form (verbal, physical, or electronic) with another human being during this exam will be considered academic misconduct and result in an automatic grade of zero. The sole exception is if you have an urgent issue that you communicate to an instructor. Your instructors will not provide assistance with this exam or the resources you utilize to complete it.
Your final document should be uploaded to the Assignments link provided through Brightspace. After verifying that the document has successfully uploaded, you are free to lea.
Effective communication is vital to constructing an accurate and detIlonaThornburg83
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.
Patient is a 38-year-old Native American pregnant female living on a reservation
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.
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
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.
· Chapter 1, “The History and Interviewing Process”
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.
· Chapter 2, "The Comprehensive History and Physical Exam" (pp. 19–29)
Deckx, L., van den Akker, M., Daniels, L., De Jonge, E. T., Bulens, P., Tjan-Heijnen, V. C. G., … 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.
...
Why does teen pregnancy and sexually transmitted diseases remain hig.docxvelmakostizy
Why does teen pregnancy and sexually transmitted diseases remain high in the U.S.
What can healthcare providers do that decrease the rate of teen pregnancy and STD’s in the US?
* These questions should be researched and incorporated in the body of the paper and answered.
This is my introduction already done.
Adolescent Sex
Teen pregnancy and sexually transmitted diseases continue to be an important healthcare issue in the 20
th
century.
Although teen pregnancy rates have dropped there are still concerns and healthcare problems that are associated with teen pregnancy.
Often times they are afraid to discuss sex with their parents and deny will deny being sexually active at all.
There are problems that manifest with
adolescent pregnancy for the mother and often times the infants as well.
The high school drop out rate among pregnant high school students is approximated at about
70 percent and is cited as the number reason teens drop out prior to graduation
.
There is also an estimated $7 billion revenue cost associated with teen pregnancy in the United States alone.
[KD2]
The risk of young people engaging in early sexual intercourse is largely due to the lack of sexual education, peer pressure and social influences.
Chlamydial infection, gonorrhea, HIV/AIDS, primary and secondary syphilis, and hepatitis B virus infection are amid the highest reported STDs with chlamydia noted as the most dominate which is likely due to the fact that there is more vigorous testing.
Some of the other noted STDs are genital herpes, trichomoniasis, Chancroid, and HPV.
Often times and without any signs or symptoms present more than one pathogen is involved with sexually transmitted diseases. Typically the only environments in which there remain viable pathogens is the bodily fluids from the genitourinary tract requiring there to be intimate contact for them to be acquired.
Although it affects men and women chlamydia is predominately seen in young women and is the most common nationally known sexually transmitted disease in the U.S.
Bodily fluids from the genitourinary tract are typically the environments in which there remain viable pathogens, so intimate contact is generally required to obtain STDs.
Chlamydia infections are asymptomatic in most women and can be transmitted during childbirth with the
potential of a newborn developing pneumonia as a complication.
If it is not treated
chlamydia can spread to the uterus and fallopian tube creating further health problems and permanent damage to the reproductive system.
Teaching abstinence is the most affective way to prevent pregnancy and STDs but sexuality and curiosity of sex begins at a young age and exploration into sexuality is a natural part of personal development.
I feel it is our
[KD3]
role and responsibility as healthcare providers to provide adolescents and teens with the information and risk factors involved with having sex.
They need to be educated on contraceptives, pregnancy and S.
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Risk Assessment In Antenatal Health Care Discussion Paper.docx
1. Risk Assessment In Antenatal Health Care Discussion Paper
Risk Assessment In Antenatal Health Care Discussion PaperDiscussion ResponseThis is an
insightful piece! You have written an excellent post on the case of a 38-year-old Native
American Pregnant Female, which is well-detailed. To be honest, I think you have some
excellent focused questions for this client, and I think they are appropriate since they are
open-ended. When conducting patient interviews, using open-ended questions is the
recommended approach to employ designed to motivate clients to reveal deeper details
about themselves. As nurses, we may obtain more information through open-ended
inquiries in order to provide a more thorough and accurate examination. Avoiding medical
terminology, utilizing an expansive area devoid of bulky things like furniture, and using a
neutral voice tone are all recommended (Ball et al., 2019). Eye contact is regarded by
Americans as an indication of attentive listening and, in many cases, honesty and
transparency. Conversely, in some cultures, especially Native American, Middle Eastern,
Asian, and Hispanic, eye contact is considered impolite or unpleasant, and the absence of
eye contact does not always imply that someone is not actively listening. The ability to
communicate with and care for patients in culturally diverse populations enhances cultural
competency in healthcare providers. After completing the interview, there ought to be
sufficient proof that the client's issues have been thoroughly examined Risk Assessment In
Antenatal Health Care Discussion Paper.ORDER A PLAGIARISM-FREE PAPER HEREThe
Rotterdam Reproductive Risk Reduction (R4U) scorecard, which is an instrument used by
experts to evaluate pregnant women's risk during the first prenatal appointment, may also
be appropriate for this specific patient (Voss et al., 2015). It will give you the opportunity to
identify medical and non-medical variables contributing to bad pregnancy outcomes
regarding underlying illnesses, stressors, lifestyles, employment status, health, and social
economics. When used in conjunction with other tools, this instrument assists the clinician
in personalizing patient care and identifying issues that may jeopardize the patient’s health
and that of the fetus Risk Assessment In Antenatal Health Care Discussion
Paper.ReferencesBall, 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.).Vos, A. A.,
Van Veen, M. J., Birnie, E., Denktas, S., Steegers, E. A., & Bonsel, G. J. (2015). An instrument for
broadened risk assessment in antenatal health care including non-medical
issues. International Journal of Integrated
Care, 15(1). https://doi.org/10.5334/ijic.1512 This is the initial Discussion Assignment
instructions Effective communication is vital to constructing an accurate and detailed
2. 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. 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 Risk Assessment In Antenatal Health Care Discussion Paper.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. 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. RUBRIC FOR 1ST RESPONSE 17 (17%) - 18 (18%)
"Response exhibits synthesis, critical thinking, and application to practice settings. Provides
clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of Learning Objectives. Communication is
professional and respectful to colleagues. Responses to faculty questions are fully answered,
if posed. Response is effectively written in standard, edited English. MAIN DISCUSSION
POST Communication Generally speaking, effective communication not only relays
information appropriately to the recipient, it also requires a response. Successful dialogue is
critical for patient coordination and good patient care. The way a provider communicates
with a patient will vary on an individual basis due to several reasons. Language itself along
with emotional status, significantly impacts how people interpret information. Age, gender,
and context also effect understanding. Communication barriers subsist between cultures
caused by semantics or by connotations. Bearing in mind tone of voice and body language is
3. also crucial, as these aspects can and will set the mood within the environment. Social
Determinants of Health and Health History Prenatal care is dependent on the dedication of
the patient to both their own health and fetal health, along with the willingness to be in
partnership with the provider (Ball et al., 2019)Risk Assessment In Antenatal Health Care
Discussion Paper.Factors that will likely influence the patient's approach to pregnancy
include: previous childbirths/experience with childrearing; the patient's relationships; the
patient's desire for children; and, current life circumstances. When conducting the initial
interview, it is imperative to obtain a past history, assess health practices, identify potential
risk factors, and assess the patient's knowledge, expectations, and perceptions of pregnancy
(Ball et al., 2019). The health of a person or community is greatly dependent on access to
social and economic opportunities, support and resources, quality of education, safety and
cleanliness, and positive social relationships (Johnson, 2020). Social determinants within
the Alaskan Indian/American Native (AI/AN) population are troubling, with 72% of the
population earning a high school diploma compared with a national average of 85%
(National Center for Educational Statistics, 2019 as cited in Johnson, 2020). In this
particular case, inquiring about the patient’s educational and work background could be
telling of educational status. This would in turn assist me in "getting on the patient's level"
of understanding, so that she would be more comfortable with the interview. The AI/AN
population are among the most economically impoverished populations in the nation
(Weinstein et al. 2017 as cited in Johnson, 2020). With this disparity in income comes an
impact on general health and well-being. Some Native American tribes have been noted to
have poorer health outcomes and a shorter life expectancy than the national average
(Johnson, 2020). Also, access to care is a large disparity noted within the Native American
population. This could be due to lack of healthcare providers, a lack of unreliable
transportation, and household instability. Poor housing may not directly affect the patient's
access to prenatal care, but a potentially chaotic household (more than four members), a
young maternal age, and being unmarried (can be indicative of less support) may negatively
influence consistency of prenatal care (Johnson, 2020)Risk Assessment In Antenatal Health
Care Discussion Paper.If any of these particular instances are relevant to the patient,
discussing and educating the patient on potential resources to facilitate continuity of care
would be appropriate; an example of this would include gaining the patient access to public
transportation (if applicable) or looking into more cost efficient routes so that the patient
can continue receiving care. Risk Assessment Tools When it comes to patient care, there are
a variety of risk assessment tools available. Among them include the TACE model and CAGE
questionnaire used to assess for alcohol abuse; and, the Brief Screening Tool for Domestic
Violence (it includes not only physical violence, but verbal as well) (Ball et al, 2019). The
tools available for adolescents include: the HEEADSSS assessment (used to understand
adolescent behavior and asses for risk-taking behaviors); the PACES assessment (discusses
parents, peers, accidents, alcohol/drugs, cigarettes, emotional issues, school, and sexuality);
and the CRAFFT assessment tool (acronym for Car, Relax, Alone, Forget, Friends, and
Trouble; it is relevant to drug and alcohol use in adolescence) (Ball et al.2019). The risk
assessment tool that I feel would be most appropriate for the 38-year-old pregnant, Native
American patient would be the Pregnancy Risk Assessment Monitoring System (PRAMS). It
4. is a tool utilized by the Centers for Disease Control and Prevention (CDC) as an initiative to
reduce infant mortality, low birth weight, and promote safe motherhood (Schulman et al.,
2018). Implemented in 1987 due to the sudden halt in the decline of infant mortality rates,
the United States continues to have the highest rates among developed countries. Within
the AI/AN population, the infant mortality rate is even higher than the national average as
indicated by 9.21 deaths per 1,000 live births (Johnson, 2020); the national average is that
of 5.79 deaths per 1,000 live births (Ely & Driscoll, 2019 as cited in Johnson, 2020). Another
study indicated that the rates of maternal morbidity and mortality were twice as high
among AI/AN women than non-Hispanic white women (Kozhimmanil et al., 2020 as cited in
Johnson, 2020). Health Related Risks There are many potential health risks to consider
regarding the specified patient. As mentioned previously, there are several health
disparities within the AI/AN population. Based on the patient's age and ethnicity alone, she
is at risk for preterm labor (Raglan et al., 2015). Also, depending on her
marital/relationship status, research shows that unmarried women are associated with
greater risk for preterm delivery. Several medical conditions further increase a woman's
risk of preterm labor, and AI/AN women have higher rates of diabetes, chronic
hypertension, and pregnancy-induced hypertension (Raglan et al., 2015)Risk Assessment In
Antenatal Health Care Discussion Paper.ORDER NOWObesity is also highly prevalent among
the AI/AN population, along with poor nutrition due to limited access to fresh foods and
lower than average levels of physical activity and fitness. It is also of extreme importance to
note that disparities exist, even among AI/AN people with access to public healthcare; they
emerge due to mistrust of providers, along with perceived racial discrimination and
disrespect towards religious beliefs (Raglan et al., 2015). Targeted Questions 1. Is this your
first pregnancy? Tell me how you are feeling about this pregnancy. 2. When was your last
menstrual cycle? 3. Do you suffer from any long-term health problems such as diabetes or
high blood pressure? Are you taking any medications, including over-the-counter
medication, herbal supplements, or vitamins? 4. Are you currently working? If not, tell me
more about your day to day routine; I would like to know more. 5. Is the biological father
involved? If not, I would like to know more about your support system. References Fibuch,
E., & Robertson, J. J. (2019). Bringing value: Honing the fine art of communication. Physician
Leadership Journal, 6(1), 64-67. 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. Johnson, M. B. (2020). Prenatal Care for American Indian
Women. MCN: The American Journal of Maternal/Child Nursing, 45(4), 221–227.
https://doi.org/10.1097/nmc.0000000000000633 National Center for Educational
Statistics. (2019, May). Public high school graduation rates.
https://nces.ed.gov/programs/coe/indicator_coi.asp Weinstein, J. N., Geller, A. M., Negussie,
Y., & Baciu, A. (Eds.). (2017). Communities in action: Pathways to health equity. The
National Academies Press. Raglan, G. B., Lannon, S. M., Jones, K. M., & Schulkin, J. (2015).
Racial and Ethnic Disparities in Preterm Birth Among American Indian and Alaska Native
Women. Maternal and Child Health Journal, 20(1), 16–24. https://doi.org/10.1007/s10995-
015-1803-1 Shulman, H. B., D'Angelo, D. V., Harrison, L., Smith, R. A., & Warner, L. (2018).
The Pregnancy Risk Assessment Monitoring System (PRAMS): Overview of Design and
5. Methodology. American journal of public health, 108(10), 1305–1313.
https://doi.org/10.2105/AJPH.2018.304563 Ely, D. M., & Driscoll, A. K. (2019). Infant
mortality in the United States, 2017: Data from the period linked birth/infant death file.
National Vital Statistics Reports, 68(10), 1-19. Kozhimannil, K. B., Interrante, J. D., Tofte, A.
N., & Admon, L. K. (2020). Severe maternal morbidity and mortality among indigenous
women in the United States. Obstetrics & Gynecology, 135(2), 294-300. https://
doi.org/10.1097/AOG.0000000000003647 Risk Assessment In Antenatal Health Care
Discussion Paper
