1. student response 1
Case B 14-year-old biracial male living with his grandmother in a high-density public
housing complex.To start, we should always keep in mind how personal their experience
with us can be. They can be coming to us with many issues as far as health both physical and
mental, socioeconomic issues, potential unsafe living situations, and many other stresses
that life can throw at people. These are all important things that should be discussed
besides the chief complaint. We must assess home situations, access to care, social
situations, etc. It is important to make sure that we are being personable and not just going
through the motions.We should always knock before coming into the room, introduce
yourself and get your patient’s name, make sure that the room has good lighting and is a
temperature that is comfortable to the patient, discuss what has brought them in, and
discuss what their understanding of the problem is (Ball, Dains, Flynn, 2019). This will show
the patient that you care and that you seem them as an individual rather than just another
patient for the day. This also instills confidence and makes them more likely to open up to
you about different issues. It is always important to include the patient in their care rather
than just discussing only your thoughts with them while dismissing their thoughts.
Including the patient in their care is known as patient-centered care and is an important
part of providing safe and high quality care (Santana, Manalili, Jolley, Zelinsky, Quan, Lu,
2018). That is the reasoning behind using the listed techniques.I think for the risk
assessment instrument, I would use IHELLP. It stands for income, housing, education, legal
status, literacy, and personal safety. Since my patient is only 14 and living with a
grandmother in a public housing complex, I would have concerns about access to care and
resources as well as their living situation and education. This would allow me to explore
things like employment status, whether or not the patient has any health coverage or is on
any kind of assistance, whether or not they are in safe housing, if they have any substance
use disorders, proper education, and safe living situations (Berman, Patel, Belamarich,
Gross, 2018). I would be interested in the patient’s chief complaint as well, but we must
assess home situations also. We must ensure that our patients are in good hands and
properly cared for both in and outside of the office or hospital setting.It is difficult to
narrow it down to just five targeted questions, but if I had to ask only five, they would be the
following.Do you feel safe at home?How do you cope with stress?How do you feel about
your time spent in school?Do you feel you have good access to care and resources?How do
you view your health and what are your expectations for care?I would hope that this would
give me an idea of what the patient’s life is like as far as education, safety, concerns,
2. resources, how they see themselves, and what their goals are as far as health. There would
be much more to discuss. Sometimes patients of this age can have an especially difficult
time expressing themselves or feel nervous about discussing certain topics or even seeking
help. Great care would be needed as well as a delicate approach and close attention to all
verbal and non-verbal cues.ResourcesBall, J. W., Dains, J. E., & Flynn, J. A. (2019). Seidel’s
Guide to Physical Examination (9th Edition). Elsevier Health Sciences
(US). https://mbsdirect.vitalsource.com/books/9780323481953Berman, R. S., Patel, M. R.,
Belamarich, P. F., & Gross, R. S. (2018). Screening for Poverty and Poverty-Related Social
Determinants of Health. Pediatrics in review, 39(5), 235–246.
https://doi.org/10.1542/pir.2017-0123Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S.,
Quan, H., & Lu, M. (2018). How to practice person-centred care: A conceptual
framework. Health expectations : an international journal of public participation in health
care and health policy, 21(2), 429–440. https://doi.org/10.1111/hex.12640
