1. Post- Chrismene
Respond to at least two of your colleagues who were assigned a different patient than you.
Critique your colleague’s targeted questions, and explain how the patient might interpret
these questions. Explain whether any of the questions would apply to your patient, and
why. Main Post CASE STUDY 2 AG is a 54-year-
old Caucasian male who was referred to the clinic to establish care after a recent
hospitalization after having a seizure related to alcohol withdrawal. He has hypertension
and a history of alcohol and cocaine abuse. He is homeless and is currently living at a local
homeless shelter. He reports that he is out of his amlodipine 10 mg which he takes for
hypertension. He reports he is abstaining from alcohol and cocaine but needs to smoke
cigarettes to calm down since he is not drinking anymore.The Communication TechniquesA
nurse practitioner chooses to use the RESPECT Modell to communicate with the patient to
stay productive and patient-centered in all her communication with the patient. RESPECTS
stand for (Rapport, Empathy, Support, Partnership, Explanation, Cultural Competence, and
Trust) (Ball, Dains, Flynn, Solomon, & Stewart, 2019). The nurse practitioner establishes
rapport by seeking the patient’s point of view to avoid being judgmental. She asked the
question of how the patient wanted to be addressed. The nurse practitioner shows empathy
by asking the patient how he becomes homeless to understand how she can help him get his
life back in order. The nurse practitioner supports the patient by asking him about his
financial situation to direct him to the proper agency. The patient is at risk for cardiac
diseases, lung cancer, and stroke, so the nurse practitioner partnered with the patient to
help him stop smoking (Ball et al., 2019).The nurse practitioner needs to explain to the
patient to know what cigarette smoking does to the body. Nicotine is a sympathomimetic
medicine that releases catecholamines, increases heart rate and cardiac contractility,
constricts cutaneous, and coronary blood vessels, and rapidly increases blood pressure
(Benowitz, 2009). It is crucial to present the patient with evidence-based practice to
address health risks across cultures, and it is essential to assure the patient that what he
said will be kept confidential to establish trust (Ball et al., 2019).The Risk Assessment
InstrumentThe CAGE questionnaire is a precise tool that has been used for many years to
screen patients for addictive behaviors. The GAGE questions have been modified to apply to
smoke behavior. The CAGE questions are as following: 1) Have you ever felt the necessity to
cut down or control your smoking, but had trouble doing so? 2) Do you ever get angry or
annoyed with people who criticize your smoking or demanding you quit smoking? 3) Do
you feel guilty regarding your smoking or about something you did while smoking? And 4)
2. Do you ever smoke within half an hour of waking up (Eye-opened)? The patient is screen
positive to two yes responses. The CAGE instrument is used because it is nonthreatening. A
study showed that the CAGE questionnaire was used in a medical outpatient embedded in a
self-administered questionnaire regarding health habits. Most of the patients did not know
that they were filling out an assessment for addictions. The patient must be willing to stop
smoking for treatment to be effective (American Family Physician,
2000). Targeted Questions1) How do you want to be
addressed?2) How are you feeling?3) How may we help you?4) How do you become
homeless and tell us about your financial situation?5) Do you need help getting your
prescription refill?6) When was the last time you drink alcohol or use cocaine?7) When
was the last time you check your blood pressure and take your amlodipine
medication?8) When was the last time you had a seizure episode?9) When do you start
smoking and how many packs do you smoke a day?10) How can we help you to stop
smoking? 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.). St. Louis, MO: Elsevier Mosby.Benowitz, N. L. (2009).
Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics. Annual
review of pharmacology and toxicology, 49, 57–71.
doi:10.1146/annurev.pharmtox.48.113006.094742American Family Physician. (2000).
Assessing Nicotine Dependence. Retrieved from
https://www.aafp.org/afp/2000/0801/p579.html
