NURS 6512 Assignment 2: Digital Clinical Experience (DCE): Health History Assessment

NURS 6512 Assignment 2: Digital Clinical Experience (DCE): Health History Assessment

NURS 6512 Assignment 2: Digital Clinical Experience (DCE): Health History Assessment

Hypertension is one of the health problems in the elderly populations. Hypertension increases the risk of health problems that include heart failure, stroke and renal failure. The risk for hypertension in the elderly populations is attributed to factors that include obesity, physical inactivity, smoking and alcohol abuse. Therefore, this essay examines the factors associated with hypertension, sensitive issues and targeted questions for EB, who has hypertension.

Hypertension is associated with a number of socioeconomic factors. One of them is ethnicity. The risk of hypertension is increased in individuals from ethnic minorities such as African Americans in the US. The client in the case study is black, which increases her risk for developing hypertension. The other socioeconomic factor is income. The level of income influences the affordability of care that the patient needs. Level of income also determines the patient’s ability to utilize health promotion interventions in the community that can be explored for optimum health and management of hypertension (Kanwar et al., 2019).

The presence of social support for the client in the case is another socioeconomic factor influencing the health of the client in the case study. Since the client is single, she might be lacking the social and emotional support she needs for the optimum management of hypertension. Therefore, the lack of social support might have predisposed the patient to poor adherence to the treatment regime for the hypertension. The last socioeconomic factor that influences the management of hypertension and risk factors in the patient is level of knowledge or awareness. The effective management of hypertension requires the adept understanding of the patient on its management. The patient in the case study appears to have low level of understanding about the management of hypertension (Ahammed et al., 2020). Therefore, there could be an effect of level of education or awareness on the management of the disease.

There exist lifestyle factors that predispose the patient to hypertension and its poor management. The risk for hypertension is elevated in individuals who engage in minimal physical activity. There is also the enhanced risk for the disease in obesity and engaging in unhealthy dietary habits such as high intake of salt, alcohol and fats (Diaz Keith M. et al., 2017). Therefore, it is important to educate the patient about the lifestyle and behavioral modifications that are needed for the effective management of hypertension and its complications.

The nurse should consider sensitive issues in assessing the client. One of the sensitive issues is her values and beliefs related to the medical management of hypertension. The nurse should elicit information from the client concerning her attitude towards conventional management of hypertension. African American patients place more emphasis on the use of alternative and complementary medicine in disease management than conventional methods. The nurse should therefore obtain information concerning her attitude, values and beliefs concerning the medical management of hypertension. This will aid in the determination of barriers to the effective management of hypertension. The other sensitive issue that the nurse should explore in patient assessment is the lifestyle and behavioral interventions that the patient uses for managing hypertension. As shown above, the effective management of hypertension requires interventions that include living healthy lifestyle such as engaging in moderate physical activities, minimizing salt intake in diet, alcohol intake and smoking (Galiè et al., 2019). Consequently, the patient should be educated on the interventions that are effective for the management of hypertension.

Targeted Questions

The nurse should ask the patient the following targeted questions:

  1. What are your beliefs and attitude towards the use of medicines for the management of hypertension?
  2. What interventions do you use to manage the symptoms of hypertension?
  3. What do you think are some of the factors that hinder you from adhering to the treatment prescribe for the management of hypertension?
  4. What is the nature of your typical diet in a day?
  5. Do you think that you have adequate support in your society that enables you to manage effectively your condition?




Ahammed, B., Maniruzzaman, Md., Talukder, A., & Ferdausi, F. (2020). Prevalence and Risk Factors of Hypertension Among Young Adults in Albania. High Blood Pressure & Cardiovascular Prevention.

Diaz Keith M., Booth John N., Seals Samantha R., Abdalla Marwah, Dubbert Patricia M., Sims Mario, Ladapo Joseph A., Redmond Nicole, Muntner Paul, & Shimbo Daichi. (2017). Physical Activity and Incident Hypertension in African Americans. Hypertension, 69(3), 421–427.

Galiè, N., Channick, R. N., Frantz, R. P., Grünig, E., Jing, Z. C., Moiseeva, O., Preston, I. R., Pulido, T., Safdar, Z., Tamura, Y., & McLaughlin, V. V. (2019). Risk stratification and medical therapy of pulmonary arterial hypertension. European Respiratory Journal, 53(1).

Kanwar, M., Raina, A., Lohmueller, L., Kraisangka, J., & Benza, R. (2019). The Use of Risk Assessment Tools and Prognostic Scores in Managing Patients with Pulmonary Arterial Hypertension. Current Hypertension Reports, 21(6), 45.


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Replies to Neelam Rautela


Elderly abuse is not only infliting physical pain on the elderly. There was a 90 year old man who was admitted to the hospital where I work last month. His children exhausted his inheritance including estate, and Medicaid program. Before he was brought to the hospital, his children and other family members visited him daily to check on him. They instilled a video camera in his home. The camera that was instilled became their nightmare. One day the patient needed to get up, he could not reach his walker, his children refused to help him, while trying to reach his walker he fell down and broke his ribs. This patient was brought to the hospital, few days later he died. It was through the video that the government found out what really happened to the patient, now the government is after his children

Feb 25, 2022, 11:22 PM


Replies to Mayreth Gonzalez Pena

Hi Mayreth,

Thank you for sharing the experience. Elderly patients get financially exploited by their family members. According to the study performed by (Conrad et al., 2019) cross-sectional data were collected on 948 cases with yes/no substantiation decisions where 357 cases had no abuse in elder mistreatment investigations. Hypotheses were tested using odds ratios, bivariate, and multiple linear regression analyses including a control for victim vulnerability. Of 948 alleged victims, 42 (4.4%) exhibited signs of substance use problems. Among the 323 alleged perpetrators, 87 (26.9%) were reported to have substance use problems. Substance use problems by alleged perpetrators were associated with financial exploitation, physical abuse, and emotional abuse.



Conrad, K. J., Liu, P. J., & Iris, M. (2019). Examining the Role of Substance Abuse in Elder Mistreatment: Results from Mistreatment Investigations. Journal of interpersonal violence34(2), 366–391.