NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Walden University NURS 6512 Week 1 Discussion: Building a Health History Sample Essay-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6512 Week 1 Discussion: Building a Health History Sample Essay assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Whether one passes or fails an academic assignment such as the Walden University NURS 6512 Week 1 Discussion: Building a Health History Sample Essay depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

The introduction for the Walden University NURS 6512 Week 1 Discussion: Building a Health History Sample Essay is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

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How to Write the Body for NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

After the introduction, move into the main part of the NURS 6512 Week 1 Discussion: Building a Health History Sample Essay assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6512 Week 1 Discussion: Building a Health History Sample Essay Included After Question

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.

Photo Credit: Sam Edwards / Caiaimage / Getty Images

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s social determinants of health?
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
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.

A Sample Answer 2 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Communication and Interview Techniques

It is essential for a health care provider to build a relationship with their patients and to gain their utmost trust before beginning any kind of treatment. Communication is a key factor in beginning a plan of care and interviewing a patient. It is vital to build rapport with an individual, which will make it easier to communicate with each patient, considering all the various components that can affect the patient’s general health (Tulane, 2021). Building a health history is very patient specific and requires us to get to know the patient’s preferences and gaining their trust would make the process exceptionally efficient.

Due to the patient being a 35-year-old white male who lives in a rural setting and has certain health considerations such as morbid obesity and disabilities, we need to approach this patient with respect for their autonomy. Giving the patient a feeling of empowerment over their health choices is essential because this patient has already had to deal with disabilities and challenges in their life. By involving this patient in their health care plan, along with giving them capability to make their own decisions will allow them directly to state their needs, preferences, and most importantly this will help them build a connection with us as their health care provider (Tulane,2021). When communicating with any patient it is extremely important to make them feel comfortable because most individuals are uncomfortable when they are dealing with any medical conditions or disabilities (Tulane,2021). When speaking to patients it is necessary to use language that is straightforward and clear, avoiding using medical language which tends to confuse any individual that isn’t in the medical field. Also, when communicating with the patient it is important to explain anything that the patient hasn’t understood and to constantly ask the patient if they have understood what has happened thus far in the interview because of possible inadequate health knowledge. Giving the patient enough time to comprehend what has been discussed is another key factor in the communication process (Tulane,2021). Allowing the patient enough time to communicate is important because the patient might have a disability that is affecting their speaking or communication. Adapting to their pace of communication is important as a medical professional and creating an environment that makes the patient feel safe is essential because some individuals that have disabilities lack confidence and feel humiliated due to their disability. Considering all the necessities the patient will need during the interview will make an environment that is comfortable and efficient for the patient.

Target Questions Based on Social Determinants of Health

When asking the patient questions, it should be clear and straightforward questions that will open further topics for discussion that can help benefit their health. The questions that I would ask are, “Would you please describe the healthcare facilities that are available in your area and if you’ve faced any challenges accessing any healthcare services at all due to the location you live in?” “Do you have any support at home to help you with your daily activities and are there any community resources in the area you live in?” “Has your health condition or disabilities had any affect on your employment or education and are there any accommodations that we can assist in finding for you to make things easier or more efficient daily?” “What does your daily diet consist of and is their anything challenging you in accessing foods that are beneficial to your health?” “Is there any difficulty in you being physically active in your environment and what resources are available to you for physical activity?”

Selected Risk Assessment Instrument

In this case the proper assessment instrument to use would be the Edmonton Obesity Staging System. The Edmonton Obesity Staging System is a staging system that is used extensively to deal with weight-associated health conditions for individuals that are dealing with obesity (Kodsi et al., 2022). The reason that this system is appropriate for this patient is that it assesses the health-related risk that is associated with obesity and due to this patient having a history of morbid obesity, it can help assess the bearing of obesity on his health, give directed intervention, and guarantee wide-ranging care (Kodsi et al., 2022). Providing efficient communication for this patient can help him tackle his disability with the best possible treatment. I would some additional questions once we were more comfortable with one another, such as, “How has obesity affected your daily life?” “Does obesity limit your everyday activities?” “Does any other disabilities affect your daily activities?” “Are there any psychological challenges that obesity has caused in your life?” Due to this patient being so young, he can definitely make lifestyle changes that can help increase his quality of life.

Summary of the Interview

For this interview to be efficient, an approach that is focused on the patient is essential and will provide the best results. Due to the patient having morbid obesity and disabilities the communication between health care provider and patient should be one that is focused on understanding one another and comfort. Gaining the trust of this patient will ensure the best possible results and build an outstanding rapport between patient and provider. Open communication is essential to have a great understanding of what the patient needs, and the provider requires from the patient.

References

Kodsi, R., Chimoriya, R., Medveczky, D., Grudzinskas, K., Atlantis, E., Tahrani, A. A., Kormas, N., & Piya, M. K. (2022, February 24). Clinical use of the Edmonton Obesity Staging System for the assessment of weight management outcomes in people with class 3 obesity. MDPI. https://www.mdpi.com/2072-6643/14/5/967

Tulane School of Public Health. (2021, September 29). Effective communication in health care. Tulane School of Public Health. https://publichealth.tulane.edu/blog/communication-in-healthcare/

A Sample Answer For 3 the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Building rapport with the patient

As advanced practice registered nurses (APRNs), it is imperative to obtain a thorough health history from the patient interview process. The history is vital to guiding the physical examination and to interpreting physical exam findings ( Ball et al., 2019). One way to effectively build a health history during the interview process is to develop a rapport or relationship with the patient. Establishing a positive patient relationship depends on effective communication built on courtesy, comfort, connection, and confirmation (Ball et al., 2019).

Each patient is unique and must be treated as such. Communication and interview techniques for building a health history can differ with each patient based on age, learning abilities, and the patients’ reading level. The purpose of this discussion is to identify techniques in building a health history with an adolescent white male with no insurance seeking medical care for an STI.

Crucial factors of consideration

According to the World Health Organization (WHO), adolescence is the phase of life between childhood and adulthood, from ages 10 to 19. It is a unique stage of human development and an important time for laying the foundations of good health (2022). Even through the adolescent years, there are significant diseases/illnesses and injuries. During this phase, adolescents establish patterns of behaviour – for instance, related to diet, physical activity, substance use, and sexual activity – that can protect their health and the health of others around them, or put their health at risk now and in the future (WHO, 2022). During the adolescent phase, it is important to provide correct age-appropriate sexual activity information.

Assessment

The collection and analysis of information regarding an individual’s current and overall health is a health assessment and is provided by the patient subjectively (Ball et al., 2019). Considering this patient is coming to the appointment for concerns for an STI, it is imperative for the APRN to not be judgemental. This will allow the patient to feel comfortable sharing information such as signs and symptoms of the probable STI, number of partners, past history of an STI, and their gender identity. The physical assessment is just as important as obtaining a health history.

Physical exams should include inspection, auscultation, percussion, and palpation of the patient to verify the patient’s report objectively (Ball et al., 2019). As part of the physical assessment, the APRN may also conduct a male genitalia examination and obtain cultures of fluid to test for certain STIs such as, chlamydia, gonorrhea, and syphilis. Labs may also be ordered to check for those certain STIs.

At the end of the examination, targeted needs would be beneficial to address. For example, this patient does not have medical insurance. Since the patient is an adolescent, one would assume they are on their parent’s medical insurance as a dependent. Sometimes, adolescents are too afraid and uncomfortable to tell their parents and/or guardians any reproductive issues. Oftentimes, adolescents come into clinics secretly and say they do not have medical insurance so their parents/guardians do not find out about the visit once billed.

Asking questions such as why don’t you have insurance? Do your parents/guardians have medical insurance? Do they know about your visit to the clinic today? Can help identify any patterns or concerns without being assumptive. Providing support and comfort can help alleviate any hesitancy in answering the above questions. Finding and establishing important resources can help make sure the patient is getting the care they need outside of the clinic.

Specific targeted questions

Asking appropriate questions and avoiding stereotypes is essential to providing care that is tailored to the individual patient (Ball et al., 2015). With this particular patient, sexual information should be obtained in a non-judgemental manner. Targeted questions such as 1) What brings you to the clinic today? 2) How many partners do you currently have? 3) What are your current sexual practices (anal, oral, vaginal)? 4) What protection do you use to prevent STIs? 5) Have you had any STIs in the past? 6) What are your symptoms? And when did they start? Utilizing the screening tool PACES would also be beneficial for this patient. PACES stands for parents/peers, accidents/alcohol/drugs, cigarettes, emotional issues, and sexuality/school (Ball et al., 2019). PACES identifies these categories specifically for adolescents because oftentimes they are what is important to this age group.

Conclusion

A successful health assessment and interview process between an APRN and their patients requires a good rapport/relationship as the foundation. Identifying considerations and tailoring specific targeted questions to individual patients can be beneficial. Patient-centered care is an important contributor to a positive patient care experience (Dang et al., 2017). Actively engaging and listening to each patient is important. This will help the patient feel more comfortable expressing their concerns and needs.

References

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.

Dang, B. N., Westbrook, R. A., Njue, S. M., & Giordano, T. P. (2017). Building trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative study. BMC medical education, 17(1), 1-10.

World Health Organization. (2022). Adolescent health. Retrieved from https://www.who.int/health-topics/adolescent-health#tab=tab_1

Effective quality care begins with obtaining a detailed medical history for the patient. This, therefore, requires developing a therapeutic relationship with the patient to foster trust, which allows the patient to divulge information to build an accurate health history.

A Sample Answer 4 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Brief summary of interview

The patient in the scenario is an 80-year-old white male with angina who lives on a farm 80 miles away from a healthcare center. The patient present with a complaint of worsening chest pain and a feeling of heavy weight on his chest. He reports a squeezing pain and tightness in the chest that worsen when he does activities around his farm but goes away with rest. Past medical history includes type 2 diabetes, hyperlipidemia, and hypertension.

He reports he takes Metformin, Atorvastatin, and lisinopril medication in the morning and evening. He is allergic to penicillin. The patient reports both parents are deceased, but his mother was hypertensive and died from a stroke at 70 years old, while his father had diabetes. The patient reports he smokes 1/2 pack of cigarettes daily, chew tobacco and drinks 1-2 beers with dinner.

Communication technique

Every patient is different, and as such special consideration and care should be taken to identify and address factors that can affect the ability to gather information from the patient. The patient in the scenario is an elderly male, and with older patients, careful attention should be given to the communication techniques used. According to Ball et al. (2019), Communication can be more difficult with the older patient due to the changes in cognitive abilities and sensory deficits.

Therefore, in the interview with this patient, communication techniques include speaking clearly and slowly. This allows the patient to gain a better understanding of what is being asked and be able to provide answers. Additionally, identifying if the patient has a hearing deficit and which ear is the stronger side allows for better positioning to ensure the patient can still see the provider’s face and have easier hearing. Sitting close to the patient and providing a quiet area for the interview can enhance the communication process.

Older adults may have difficulties with memories or get confused easily, therefore, it is important to use short open-ended questions that are uncomplicated and free from medical jargon when assessing the patient. It also helps the gain collateral information from a relative or caregiver of the patient once permission is obtained, as this can gain greater accuracy and yield more information.

Risk assessment instrument

One risk assessment instrument applicable for this patient is obtaining a personal and social history. Personal and social history helps to obtain information on the patient’s lifestyle habits. This includes nutrition and diet patterns, smoking, and alcohol use, along with self-care habits such as exercise. This assessment instrument must be included as these lifestyle factors are major contributors to the patient’s angina condition.

According to Ruan et al. (2018), risk factors such as smoking, alcohol drinking, fruit/vegetable intake (diet), and physical activity (exercise) influence the risk of angina across different ethnic groups. Furthermore, the information is crucial to treating the patient’s condition as he reports smoking and alcohol use. Therefore, providers must establish a baseline of these lifestyle factors to suggest and plan for modifications that can improve the patient’s condition. Significant priority should be placed on optimizing lifestyle factors in addition to preventive medications to reduce complications associated with angina (De Lemos, 2021.)

As patient’s get older it is important to have good access to health care resources as their health is at greater risk to deteriorate. The personal and social history consist of the assessment of the patient’s access to care. The patient in the scenario lives far away from the health center. It is important then to assess the patient’s ability to access transportation for care, his regular pattern in seeking care and identify and address any worry the patient might have in regards to his access to care to manage his existing conditions and his present complaint of angina.

Target questions to be addressed to the patient includes:

1)What is the reason for your visit? When did these symptoms start, and is there anything that makes it worse or better?

Do you have any existing medical conditions? Does anyone else in your family has/had these conditions?

Do you smoke/chew tobacco? If yes, what do you smoke, and how much per day?

Do you drink alcohol? How much per day?

How physically active are you on an average day?

What type of diet do you follow at home and outline your average meal for the day.

How often do you seek medical attention and follow up with your doctor?

Explain any alternative therapy or home herbs used to manage presenting symptoms?

References

Ball, J. W., Danis, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination: An Interprofessional Approach. St. Louis, MO: Elsevier, Inc.

De Lemos, J. A. (2021). Diagnosis and management of stable angina. JAMA, 325(17), 1765. https://doi.org/10.1001/jama.2021.1527

Links to an external site.

Ruan, Y., Guo, Y., Zheng, Y., Huang, Z., Sun, S., Kowal, P., Shi, Y., & Wu, F. (2018). Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-5653-9

Welcome to the course! We have lots to cover in these 11 weeks. This course will be the foundation for all other clinical courses. In this course as in all courses you must turn in all assignments to get a passing grade. Please be sure to do so in a timely fashion.

This week we are working on building a health history. For this week we have a discussion to participate in. Here is how you will know what case to work on.

We will go based on the first letter of your last name.

NURS 6512 Week 1 Discussion Building a Health History Sample Essay A/B/C/D/E/F: Case B 14-year-old biracial male living with his grandmother in a high-density public housing complex

G/H/I/J/K/L: Case C 38-year-old Native American pregnant female living on a reservation

M/N/O/P/Q/R: Case E Adolescent Hispanic/Latino boy living in a middle-class suburb

S/T/U/V/W/X/Y/Z: Case G Pre-school-aged white female living in a rural community

A Sample Answer 5 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

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A/B/C/D/E/F: Case B 14-year-old biracial male living with his grandmother in a high-density public housing complex

Discussion: Building a Health History

The patient in this scenario is a 14-year-old biracial male. The first step in interacting with the patient is to build a trustworthy rapport with the patient and determine his fluency in communication and speaking the English language, as any language barriers can hinder the effectiveness of the communication, it is important to ensure the client understands the language of communication (Brooks et al., 2019). Effective communication is required needed in any patient-healthcare provider interaction. The language assessment is important in making communication easier.

Communication Techniques

Furthermore, the use of verbal techniques will be ensured in the communication process (Wang et al., 2018). However, caution will be taken not to offend the client in the conversation. The meaning and interpretation of the non-verbal techniques tend to vary from one cultural group to another (Sullivan, 2019). Therefore, considering that the client is from another cultural group and young, understanding their values would be necessary to reduce the conflicts in the communication process. I will also be empathetic to the client (Ball et al., 2019).

Subsequently, active listening is also important when interacting with the patient. Listening actively help

NURS 6512 Week 1 Discussion Building a Health History Sample Essay

the healthcare provider to capture important information about the patients and their possible health needs (LeBlond et al., 2014). On the other hand, some clients may be too talkative and so the healthcare provider must be able to control and ensure that the relevant information is obtained from the interaction. Controlling the conversation also helps in managing the time used in the interaction. The HEEADSSS risk assessment tool will be used when interviewing the patient because it will help in understanding the client’s home environment and education experiences among other areas of interest.

Target Interview Questions

Whom do you live with at home?
What is your relationship with the parents and siblings?
What is it that makes you happy about your family?
Who is your best friend?
What do you like doing during your free time?

Conclusion

Finally, communication is important in the interaction between the patient and the healthcare providers. Both verbal and non-verbal communication matters in the interaction. Cultural values vary from one patient to another and this could be a major hindrance to effective interaction between the patient and the healthcare providers. Therefore, the nurses must demonstrate cross-cultural competencies and interact with their clients accordingly without judging them or looking down upon their cultural values.

References

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.

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383-391. https://doi.org/10.1016/j.colegn.2018.09.007

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw- Hill Medical.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Wang, Y., Wan, Q., Lin, F., Zhou, W., & Shang, S. (2018). Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. International Journal of Nursing Sciences, 5(1), 81-88. https://doi.org/10.1016/j.ijnss.2017.09.007

A Sample Answer 6 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

WK 1 Discussion: Building a Health History

The main question post for this discussion entails building a health history regarding a pre-school-aged white female living in a rural community. I would use a patient-centered care approach with techniques that included courtesy, comfort, connection, and confirmation during the interview to develop a rapport with the parent(s) and the patient (Ball et al., 2019). The discussion will focus on communication techniques, social determinants of health considerations, risk assessment tools, and targeted questions to improve the patient and the family’s wellbeing.

Communication and Interview Techniques

I would review the pre-visit questionnaire and identify who was attending the patient before entering the exam room. Of note, if the person accompanying the child were not the parent, then I would check with my mentor the policies and procedures for my primary care setting. I would also review the patient’s History of Present Illness, Past Medical History, Surgeries, Allergies (medications, food, and environment), Current, Present, and Past Medications, and Family Health History.

The patient should be close to or held by the parent in a pediatric centered room that elicits reassurance for the pediatric patient. The room temperature should be comfortable. The furniture would be placed so that there were no barriers between the patient, parent(s), and myself (Ball et al., 2019). Decreasing physical barriers during the interview can facilitate a comfortable and engaging experience for the patient and parent(s).

I would knock before entering the room and introduce myself as a registered nurse and a student family nurse practitioner, working closely with an experienced mentor.

I would address the parent by their last name and ask how they would prefer I address their child (i.e., nickname). I would then say hello to the patient in a kind tone of voice and tell her that I am happy to meet her. My questions would be open-ended and non-leading, and I would courteously wait for them to answer the questions (Malloy & Stolzenberg, 2019).

Considerations of Social Determinants of Health

My patient is a pre-school-aged white female living in a rural community. One of my concerns would be access to health care providers. Nielson et al. (2019) report that 20% of Americans live in rural settings, but only 10% of primary care providers (PCP)provide medical service to these areas. Nielson et al. also report that the shortage of PCPs is expected to reach 25,000 by 2025 in rural communities.

Another consideration would be access to urgent care or acute care facilities within a reasonable geographical area. Is the child exposed to lead paint if the houses are old? Does the child have access to clean water? Is there a grocery near them with access to fresh fruits and vegetables? Is there a good school district for the patient? Are there parks and sidewalks and safe places for the child to play? How old are the parents? What is the educational background of the parents? The age and educational background of the parents would be significant in terms of assessing health literacy. The parents’ religious or spiritual beliefs are also important considerations.

Questions Posed to Assess Health Risks

My first question would be addressed to the parents, and I would ask what brought you in today? The following questions would revolve around the chief concern of the parents, and I would paraphrase their concern(s) and ask them if I understand their concerns. Once I established their chief concern(s), I would ask them what is their most important concern today? What do you think is going on with your child (if there is a concern)? How do you feel your child is doing? Tell me about your child? What kind of activities does she do during the day?

Potential Health Risks Based on Patient’s Age, Gender, and Ethnicity

The patient is considered vulnerable because she is of pre-school age and is dependent on caregivers. She does not have an adult’s cognitive or physical abilities and needs her primary caregivers’ protection. The patient may not be able to verbalize if someone is abusing or neglecting them.

The patient is also female and may be more vulnerable to sexual abuse (Melmer & Gutovitz, 2020). Health care providers have an ethical responsibility to protect their patients. The patient is white and should be screened for common genetic anomalies that affect white populations, such as Cystic Fibrosis.

Risk Assessment Tool

The Safe Environment for Every Kid (SEEK) risk assessment tool would be mailed to the parents after the first interview. I would respectfully address any concerns raised once I reviewed the completed questionnaire (American Academy of Pediatrics, 2021). Using a risk assessment tool will help to assess the strengths and weaknesses of the parents or caregivers. Early identification of risks to the pediatric patient can be mitigated by providing the parents with educational resources the parents could use when necessary.

Targeted Risk Assessment Questions

The targeted questions that I would ask the parents would involve risk assessments: Is your child current with their vaccinations? Does your child have a car seat, and are you comfortable with how it works? What type of childproofing do you use for your home? When was the last time your child saw a dentist? How is potty training going? How would you describe your child’s sleeping pattern? How would you describe your child’s eating habits?

How often does your child attend daycare or pre-school? How often do you read to your child? How much time does your child spend watching television or on computer devices? Does she have any difficulties pronouncing words? Does anyone besides the parents take care of your daughter?

I would assess if the pre-school child is meeting developmental milestones based on her age. Lastly, I would summarize the chief concern with the parent(s) and ask if there are any other questions or concerns for me before they leave. The parents would be given a written patient/parent educational handout after the visit (American Academy of Pediatrics, n.d.).

Conclusion

Building a health history with a pediatric patient involves cooperation with the family and building a strong rapport based on respect and dignity. One of the most important aspects of becoming a successful family nurse practitioner is listening to the patient (and parents) and learning. Open-ended questions that are not leading allow a greater depth of building the patient’s history. Summarizing the visit with the patient and the parent is a helpful tool that improves communication. Risk assessment tools help to prioritize a plan of care for the patient (and their family).

References

American Academy of Pediatrics. (n.d.). Bright futures tool kit, 2^nd edition new.

https://brightfutures.aap.org/materials-and-tools/tool-and-resource-kit/Pages/default.aspx

American Academy of Pediatrics. (2021). Screening tools.

https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Screening/Pages/Screening-Tools.aspx

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 (9^th ed.). Elsevier Mosby.

Malloy, L.C., & Stolzenberg, S.N. (2019, March). Editorial perspective: Questioning kids:

applying the lessons from the developmentally sensitive investigative interviewing to the research context. Journal Child Psychology Psychiatry, 60(30), 325-327. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017956/

Melmer, M.N., & Gutovitz, S. (2020, November 20). Child sexual abuse and neglect. In:

StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470563/

Nielson, M., D’Agostino, D., & Gregory, P. (2017). Addressing rural health challenges head

on. Missouri Medicine, 114(5), 363-366.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140198/

A Sample Answer 7 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

RE: WK 1 Discussion: Building a Health History

Good afternoon and thank you for your thoughtful and detailed post for your assigned patient. Dealing with children of any age while trying to obtain a full and accurate health assessment and history, most especially because you are not dealing only with the child, but with the entire family structure and culture. As noted by Ball et al., to practice with cultural competence requires the provider be mindful of not only their patients’ heritage and ethnicity, but also their socio-economic situation and cultural backgrounds (2019).

Of course living in a rural area does not necessarily mean any given person lives in poverty, which would be a stereotype culturally competent practitioners would do well to avoid (Ball et al., 2019). Further, the rural population is anything but homogenous, with African-American, Hispanic/Latino, Asian and Native American populations all growing in these settings throughout the U.S. (Warshaw, 2017).

In addition, while practicing in a rural setting does not necessarily mean all of one’s patients may be economically disadvantaged, there do exist very real and difficult barriers to treatment for this population (Neilson, D’Agostino & Gregory, 2017) These barriers can include the vast geographic distances some must travel to obtain appropriate care, the lack of specialty medical personnel/interventions available at a “reasonable” distance; and the subsequent (and potentially quite substantial) delays in care experienced directly because of these barriers (Nielson, D’Agostino & Gregory, 2017).

In this particular scenario, a primary care provider may consider “bundling” services for this preschool patient insofar as possible, to include vaccinations, taking the time to field any and all questions from the family, to provide the family with written education concerning age-appropriate milestones for the child as they grow and what they may reasonably expect next, as well as treatment for whatever condition it was that brought them in with the child in the first place (Nielson, D’Agostino & Gregory, 2017).

In addition, there are specific delivery models that may be available to these rural residents and to which they may be referred, to include freestanding emergency departments (FSEDs), a community health worker (CHW) who acts as a liaison between providers and the rural population to help meet those healthcare needs, and telehealth usage where internet access is available to name a few potential initiatives (Rural Health Information Hub (RHIH), 2019).

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S. and Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Nielson, M., D’Agostino, D. and Gregory, P. (2017). Addressing Rural Health Challenges Head On. The Journal of the Missouri State Medical Association, 114(5). 363-366.

Rural Health Information Hub (RHIH). (2019). Healthcare Access in Rural Communities. Retrieved from https://www.ruralhealthinfo.org/topics/healthcare-access

Warshaw, R. (October 2017). Health Disparities Affect Millions in Rural U.S. Communities. American Association of Medical Colleges. Retrieved from https://www.aamc.org/news-insights/health-disparities-affect-millions-rural-us-communities

Main Response: 38-year-old Native American pregnant female living on a reservation (Building a health history interview)

A Sample Answer 8 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Interview Summary:

Patient is welcomed in to the exam room and introductions were made, myself as a student NP and confirmed her appropriate title and preference of address. It is agreed we will address each other by first name. She is a 38-year-old Native American female. She confirms she is pregnant and living on a reservation. To ensure comfort, technology is utilized minimally and not placed between the patient and myself. She is given ample time to express her concerns and provide explanations when needed. She explains her chief concern or reason for the appointment. As this is our first meeting, we must build a thorough health history.

We review the history of her pregnancy (involvement of partner, support system, feelings about pregnancy, childbirth, and parenting) and any associated concerns as well as the evolving history surrounding her chief complaint. We discuss her past medical history, family history, and personal and social history. Her past medical history includes any medications (including OTC, vitamins, herbal remedies) she may be taking, illnesses of childhood/young adulthood, emotional/mental health history, immunization records, surgical procedures and injuries, allergies, and screenings. Familial history includes that of parents, siblings, grandparents, aunts, and uncles.

Personal and social history includes relationship status, work status, home environment, hobbies, self-care, sexual history, and history of substance use. Additionally, we explore any cultural/religious preferences that may affect her medical care, pregnancy, childbirth, and childrearing. This also includes access to health care either within, or outside of, the reservation. A review of systems is completed including health specifically during the pregnancy. The patient was given the opportunity to verify all retrieved and recorded information. She was included in developing her plan of care moving forward and is agreeable to this plan.

Interview Technique:

Patient-centered communication and care involves focusing on how the patient experiences their wellness/illness as opposed to taking a disease-centered, provider-driven approach (Martyn et al., 2013). It is important to enter in to the patient/provider relationship with the patient and their experience as the focus. To ensure this happens, questions must be open-ended (if possible), and patients should be given time to think and answer thoroughly.

Given the opportunity to express their thoughts, feelings, and concerns of their health or illness, patients are more likely to feel emotionally supported, maintain adherence to regimens, report satisfaction with their healthcare experience, and show improvements in physiologic health and recovery (Martyn et al., 2013). While patients may not have the medical expertise to diagnose and treat themselves, they are the experts of their own bodies, thoughts, and feelings. Their input, in the form of subjective information, is pertinent to correct diagnosis and treatment.

HRAs:

One risk assessment instrument that may be used for this patient is the Health Practices in Pregnancy Questionnaire-II. This is a tool that was developed to identify prenatal health practices that may affect the outcome of pregnancy including pre-pregnancy health status, attitude towards pregnancy and childbirth and babies (Lindgren, 2005).

This is a validated self-report tool that can be used with all pregnant patients. While many HRA (health risk assessment) tools exist, the benefit really comes from what the medical provider that administers it does with the information. According to Oremus et al. (2011), the feedback and recommendations seemed are the supporting factors that lead to behavioral changes.

Questions:

Since I don’t have any information on why the patient has made the appointment, I am going to try to discover as much about her as I can.

What concerns brought you in to see me today?
How have you and your immediate community/family responded to the pregnancy? Do you have support?
From where have you received medical attention/advice/care? Have you had any prenatal care thus far?
Do you have any family history of alcoholism, diabetes mellitus, cardiovascular disease, hypertension, cancer? Have you or any family members had difficult pregnancies?
What was your health status prior to the pregnancy?
What medications are you taking now? Where you taking any others prior to your pregnancy?
What is the date of your last menses/estimated due date?

References:

Lindgren, K. (2005). Testing the health practices in pregnancy questionnaire-II. Journal of

Obstetrics, Gynecology, and Neonatal Nursing, 34(4), 465-472.

Doi: 10.1177/0884217505276308

Martyn, K., Munro, M., Darling-Fisher, C., Ronis, D., Villarruel, A., Pardee, M., Faleer, H., &

Fava, N. (2013). Patient centered communication and health assessment in youth.

Nursing Research, 62(6), 383-393. Doi: 10.1097/NNR0000000000000005

Oremus, M., Hammill, A., & Raina, P. (2011). Health risk appraisal [Internet]. Agency for

Healthcare Research and Quality. https://www.ncbi.nlm.nih.gov/books/NBK254031/

Case Study: Adolescent Hispanic/Latino boy living in a middle-class suburb.

How would your communication and interview techniques for building a health history differ with each patient?

According to Slade (2021), interviewing is a practical approach to collecting essential information involving a patient’s personality and character. In the medical career, interviews are an essential component for gathering data on a one-on-one basis. To have effective communication with this patient, knowing that he is from the Hispanic/Latino ethnic population, firstly, I will want to know his primary language and if the boy is fluent in speaking English.

If the patient cannot communicate and comprehend English language fluently, I will engage a professional interpreter from my organization outside a family member. Understanding that effective communication can safeguards patients from possible damage occurring from a misunderstanding (Ali M, 2020).

Additionally, because my patient is an adolescent, I will seek parental consent for the patient to be treated privately unless indicated otherwise by the patient himself. Afterward, I will communicate with the patient using age-appropriate terminology. I will encourage the patient to disclose all necessary concerns and assure him that confidentiality of information will be maintained.

How might you target your questions for building a health history based on the patient’s social determinants of health?

A clear understanding of the patient social history would be beneficial to evaluate the patient’s social determinant of health. Since the patient social determinants of health are his non-medical components that influence his health results. This is the environments in which patient are born, live, age, work and grow and the system shape the conditions of daily life (WHO, 2021).

I will assess patient information about parental involvement, education, availability of foods, sleep patterns, extracurricular activities, home stability, and time spent at home, which may help determine the patient social determinants affecting his health. Also, it can help to discover risky behavior that may impact patient health negatively.

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?

Some of the questions that would be appropriate to assess these patient’s health risks would include a question that assesses his involvement in risky behavior. These include factors as poor school performance, low self-esteem, Peer pressure, Lack of intimacy to parents, Poor school performance, Lack of involvement in school extracurricular activities, Vulnerability to advertising, the internet, or social media (Ball et al., 2019) ‘The result of this assessment may be beneficial to identify adolescent for specific behaviors. Therefore, further attention may require if the patient is found to be at risk.

Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

Dijk et al. (2020) stated that individuals reveal behavioral changes through adolescence and young adulthood and experience numerous life transitions. Due to the age of this patient, he is at risk for risk behavior such as drug abuse, alcohol, sexual misconduct, and suicide. Therefore, it will be beneficial to assess and educate the patient about this topic in a non-judgmental manner.

Risk assessment tools

The HEADSSS is an assessment tool used for adolescent assessment to address factors such as home, education, activities, drug, sex, and suicide for this high-risk population group. (Martin & Ingram, 2018).

Targeted questions

What is the chief complaint that you have for this appointment?
What medical conditions do you currently have or have been told that you have before this visit?
Who lives in your home?
Being an adolescent, you may be exposed to substances. Do you use any tobacco products, drink alcohol, or use drugs?
Are you currently in a relationship?
Do you ever think about harming yourself?

References

Ali M, N. T. (2020, August 28). Benefits of Effective Communication in Nursing: Communication Skills 1. Nursing Times. https://www.nursingtimes.net/clinical-archive/assessment-skills/communication-skills-1-benefits-of-effective-communication-for-patients-20-11-2017/.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Physical Examination: An Interprofessional Approach. Elsevier Health Sciences.

Dijk, M. P. A. V., Hale, W. W., Hawk, S. T., Meeus, W., & Branje, S. (2020, May 13). Personality Development from Age 12 to 25 and its Links with Life Transitions. Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1002/per.2251.

Slade, S. (2021, May 4). Interview Techniques. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK526083/.

WHO. (2021). Social determinants of health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1.

Martin N., and Ingram L. (2018) HEADSSS ASSESSMENT. Retrieved November 27, 2019 from https://teachmepaediatrics.com/community/holistic-care/headsss-assessment

S/T/U/V/W/X/Y/Z: Case G Pre-school-aged white female living in a rural community

Discussion week 1 main post

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This interview will be done on a pre-school-aged white female living in a rural community. Due to the patient’s age, the parent/caregiver will be asked the interview questions. To gather adequate information there are communication skills required for the provider to use that will address the health of the child. Strategies to use in the interview include open-ended questions, attentive listening, using simple words, and positive non-verbal body language.

Effective communication involves a wide amount of factors. Hutchison (2020) explained that communication can be hidden in verbal messages or conveyed by facial expressions or gestures. Insightful questions are better gathered when the patient is fully engaged in the interview.

Using specific tones and speech that are geared towards the child’s learning ability is very important. Medical jargon must be avoided to lessen the frustrations and missed information needed to gain insight into the child’s likes and dislikes. It is important not to become paternalistic or use an authoritarian approach. When starting the interview, the Practitioner must professionally introduce her/himself to the parent and child using all of the above strategies to gain trust and confidence in the parent and child.

Good lighting in a quiet place is preferred to enhance privacy. Keep the parent informed of the intent of the interview with open-ended questions. Encourage feedback throughout the interview for clarity. Fawcett and Rhynas (2012) expressed the importance of obtaining a precise and full health assessment to lead to accurate diagnosis and appropriate treatment.

The obesity risk assessment tool will be used for the interview to gather detailed insight into the child’s eating status. Townsend et al. (2018) explained that these risk assessment tools assist professionals with programmatic needs for the child. Nutritional agencies benefit from the information gathered to determine how to meet the patient’s needs more adequately. This tool can further assist with the early identification of needed nutritional counseling.

Questions about the child should be directed to the parent/caregiver to gather the best baseline information. Some questions to ask are as follows:

1. What concerns do you have about your child’s eating habits?
2. Have your child experienced any allergic reactions to medications or foods?
3. Have your child experienced any illnesses?
4. What concerns you the most about your child’s health?
5. Do you have any concerns about not having enough food in your home?

Practitioners are well equipped to gather information during a health history interview. Using non-medical terms with professional behavior assists a Practitioner with obtaining personal insight into the patient’s concerns and needs. Including the patient’s parent/caregiver gives a patient-centered focus concept.

Children living in rural communities are at higher risk for developmental delays and nutrition disadvantages related to lack of access to adequate health care and financial obstacles. Identifying risks early in the child’s health history interview is essential to positive outcomes. When the parent of the patient is fully involved in the child’s care, outcomes are geared towards a healthy lifestyle.

References

Fawcett, T., & Rhynas, S. (2012). Taking a patient history: the role of the nurse. Nursing Standard, 26(24), 41–46.

Hutchison, L. M. (2020). SECTION II: Critical Abilities in Professional Nursing Practice: CHAPTER 6: Effective Communication. Advancing Your Career: Concepts of Professional Nursing (7th Edition), 7th, 99–118.

Townsend, M. S., Shilts, M. K., Styne, D. M., Drake, C., Lanoue, L., & Ontai, L. (2018). An Obesity Risk Assessment Tool for Young Children: Validity With BMI and Nutrient Values. Journal of Nutrition Education and Behavior, 50(7), 705–717. https://doi.org/10.1016/j.jneb.2018.01.022

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

Photo Credit: Sam Edwards / Caiaimage / Getty Images

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s social determinants of health?
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
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

Judah, thank you for contributing to the discussion; your post was very informative. As nurse practitioners, we must ensure that our patients are comfortable and have a trusting relationship to discuss their health concerns. We can ensure that the interview setting is private, away from distractions and interruptions, and that our attitude is nonjudgemental. We should be aware of our attitudes, beliefs, and values but not let our biases interrupt the interview process (Ball et al., 2023).

The patient’s culture and upbringing may influence how she relates to the provider and to what extent she will disclose certain health information. As an NP, when we experience patients from other cultural backgrounds, we should ask open-ended questions to facilitate discussion to understand how their cultural beliefs would influence health decisions. I agreed with your reasoning when you stated, “The patient’s age, cultural background, and lifestyle may influence her comfort level in discussing sensitive topics like sexual health and birth control.” This is why the trusting relationship we create with our patients is vital. Your interview techniques are all valid; in addition to what you stated, I would like to add closing the door to ensure privacy.

As for the social determinants of health, such as where we live, work, and access to healthcare, all can affect our healthcare choices. In this case, as you rightly stated, there is a possibility of non-compliance with medication due to lack of privacy being a college student and poor follow-up with appointments as the demands of school and work take precedence over health needs. There is a high incidence of anxiety among college students, and some of the SDOH are contributing factors, such as food insecurities and lack of social support and safety (Johnson, 2022). Based on these factors, some of the questions I would, besides my initial introductory questions I would target:

Sleep: How well do you sleep at night? On average, how many hours do you get?

Food security: Are you able to afford food and the necessities?

Security: Living on campus, what are you most fearful of?

What coping strategies do you use when faced with stress from school and work?

Along with Gordon’s Functional Health Assessment, an appropriate tool, adding the GAD-7 and the PHQ-9, is also an option for this patient. According to Hall et al. (2021), it is noteworthy to assess how depression and anxiety are manifested in women of Filipino and Indonesian descent, as few studies are available to examine how these communities experience depressive symptoms (Hall et al., 2021).

Aging, I agree with you that breaching the subject of alcohol, substance use, and any other sensitive subject, such as mental health issues related to depression and anxiety, should be done with tact and discretion to avoid unwillingness to disclose this health information. Thanks again for the well-written post that voiced your views that can speak to the culture of the patient.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Developing a Relationship with the Patient. In Seidel’s Guide to Physical Examination: An Interprofessional Approach 10th ed (p. 13). St Louis : Elsevier.

Hall, B. J., Patel, A., Lao, L., Liem, A., Mayawati, E. H., & Tjipto, S. (2021). Structural validation of The Patient Health Questionnaire-9 (PHQ-9) among Filipina and Indonesian female migrant domestic workers in Macao: Structural Validation of PHQ-9. Psychiatry Research, https://doi.org/10.1016/j.psychres.2020.113575.

Links to an external site.

Johnson, K. F. (2022). Symptoms of Anxiety in College Students and the Influence of Social Determinants of Health. Journal of College Student Psychotherapy, 339-354, https://doi.org/10.1080/87568225.2020.1827114.

Main Discussion Post

Interview Summary: Case E Adolescent Hispanic/Latino boy living in a middle-class suburb

Patient Name: Anthony Rodriquez

Sex: Male

Age: 14-year-old

D.O.B: December 15, 2009

Chief Complaint: Right lower quadrant pain with nausea, vomiting, and elevated temperature

History of presenting Illness: 14-year-old Latino boy came to the ED with his mother, complaining of lower right abdominal pain with nausea and vomiting and a high fever of 39.8 C. He rated the pain as 5/10 and described the pain as dull and aching. He stated the pain began 2 days ago but has worsened today. No other complaints.

Description of Communication technique

The communication technique I would use is offering open-ended questions when possible. For instance, “How are you feeling today? What do you think is causing your illness? What is the understanding of your illness? What can I do for you today? Do you have financial concerns? Do you have any questions for me? (Ball, Dains, Flynn, Solomon & Stewart, 2019).”

In many Latino cultures, open-ended questions are used to encourage the patient to express or verbalize their thoughts without shame or judgment. According to the University of Washington Medical Center (2007), in Latino cultures, open-ended questions can act as a guide to identifying culturally appropriate care for patients.

Most Latinos believe in herbal remedies versus the traditional medicines that are most often used in the Western region. Bauer and Guerra, (2014) postulate knowledge of this medicinal preference can further guide the provider in selecting the most appropriate treatment therapy plans and facilitate treatment compliance. Additionally, the patient’s mother’s input on health decisions would also be taken into great consideration since in the Latino cultures it is the mother who is the primary decision maker, and in this case, the patient is also a minor therefore requiring consent from an adult is a required for medical interventions.

Another communication technique is the teach-back technique. According to the Centers for Disease Control and Prevention (CDC,2023), research showed this method of communication can be highly effective to ensure communication is clearly understood by all those who are involved in the patient’s care. The teach-back method can also identify if there have been any misunderstandings. Additionally, an interpreter can be used if the patient and/or his mother are not fluent in English.

Risk Assessment Instrument

The risk assessment tool I would use for the adolescent patient is HEEADSSS. This risk assessment tool covers all areas of possible concern that can affect most adolescents and will require sensitivity on the NP’s part to facilitate an open discussion. In this situation, the patient’s mother may be excused to allow the patient to express his thoughts and concerns without judgment from his mother. According to Ball et al (2019), HEEADSSS refers to H- home environment, E-Education, E-Eating habits, A-Activities, affect, ambitions, anger, D-Drugs, S-Sexuality, S-Suicide/depression, and S-safety, injury or violence.

According to the Journal of Early Adolescence (2009), in some Latino family settings, children or adolescents may not be allowed to speak freely due to some traditional cultural norms. In such instances, the use of illicit drugs, sexual activities, depression, and violence can become prevalent (Davidson & Cardemil, 2009). Hence, using this assessment tool can be helpful in identifying possible challenges.

References

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.

Bauer, I. & Guerra, J.J. (2014). Improving Health Among Immigrant Populations: Physicians’ Knowledge and Communication about Traditional, complementary, and alternative medicine use among Latino Patients at Kaiser Permanente, Oakland Ca. Journal of Field Actions, vol. 10. Retrieved from https://journals.openedition.org/factsreports/55Links to an external site.

Centers for Disease Control and Prevention (2023). Communication Strategies. Retrieved from https://www.cdc.gov/healthliteracy/researchevaluate/comm-strategies.htmlLinks to an external site.

Tatiana, M., Esteban V.D., Frances C. L. (2009). Parent-Child Communication and Parental Involvement in Latino Adolescents. Journal of Early Adolescence. Retrieved from http://online.sagepub.coLinks to an external site.m. DOI 10.1177/0272431608324480. Vol 29

The University of Washington Medical Center (2007). Communicating with your Latino Patient. Retrieved from

https://www.lacrosseconsortium.org/uploads/content_files/files/Latino%20Culture.pdfLinks to an external site.

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!

The patient is a 14-year-old biracial male living with his grandmother in a high-density public housing.

Communication and interview techniques to build a health history differ with each patient depending on the patient’s ability to communicate, the patient’s willingness to communicate, and the depth of illness the patient has experienced in their lifetime. Interview techniques should include considerations for speaking in the chosen or primary language of the patient, whether that involves the use of an interpreter or slowing the pace of currently spoken language. Additionally, avoidance of “why” when asking questions and sticking to open-ended questions should provide more opportunities for obtaining answers to achieve a full health history.

As the opportunity arises, using the patient’s answers to dive deeper into questions where needed is also a good habit to have. Considerations to the patient’s ability to hold a conversation should also be made, while some patients can speak for long periods, others may not have the ability due to respiratory limitations of comprehension problems. The patient’s age and education status are also a consideration. Avoiding the use of jargon, both medical and current, is a necessity to avoid assumptions and confusion.

Social determinants of health are the conditions of the places people live, work and play. These conditions can affect health and quality of life. The access or lack of access to health care and the quality of the health care they do have access to play a role in the patient’s actual health status. According to the World Health Organization, social determinants of health determine the health inequities in populations (U.S. Department of Health & Human Services, 2021).

Target questions based on the patient’s social determinants should include housing arrangements and location, education opportunities, crime rates in the neighborhood, access to food sources and types of food sources available, and access to the hospital, environmental information.

The risk assessment instruments appropriate for this patient include assessments for abuse, suicide/mental health status, alcohol and substance abuse, faith and spirituality are all appropriate assessments for patients. Assessment questions used to assess health risks should include those questions that give the patient the ability to answer honestly about their lifestyle. The responses to the questions should be short and appropriate to the situation.

The wording in the questions should be succinct and clear on what is being asked. Because the patient is a 14-year-old living with a grandparent rather than his biological parents in high-density public housing (those living areas that are typically urban with buildings having large number of units and populations), the questions should allow the patient to provide a picture into what they believe their health to be, what their social situation is, what the status of the environment is in their living arrangement, how safe their home is, what their social support system consists of, and the use of drugs and alcohol. Additional measures must be taken to elicit responses to abuse, mental health status, and risk for alcohol and drug abuse.

The risk assessment instrument selected for this 14-year-old biracial male is the HITS Screening Tool. This tool is utilized to screen patients at risk for domestic violence. The WHO defines domestic violence as “any action that causes physical, psychological or sexual damage or is against the person’s freedom” (Shirzadi, 2019).

The HITS tool has four screening questions and speaks to the time frame of over the last 12 months. The questions ask about physical abuse, insulting or talking down, threatening or physical harm, and screaming or cursing at the person. According to Shirzadi, a study showed domestic violence could be ignored or excused for ‘cultural reasons’ but that the HITS tool does not include questions regarding sexual abuse (Shirzadi, 2019).

Five targeted questions asked of this patient to assess his health risks and build a health history are as follows:

In general, how would describe your current health?
In the last 30 days, have you used any type of tobacco?
In the past year how many times have you used an illegal drug, prescribed drug for non-prescribed reasons, or alcohol?
Describe your daily stress and anxiety level?
How would you describe your social and emotional support system?

Of course, there are so many more questions to add to this risk and health history assessment to elicit the responses needed to obtain an appropriate health history; these are only five potential questions to help establish a baseline health history on this patient.

References

Abuelezam, N. E.-S. (2018, September 11). The health of Arab Americans in the United States: An updated comprehensive literature review. Frontiers in Public Health, 6(262), 262. doi:https://doi.org/10.3389/fpubh.2018.00262

Shirzadi, M. F. (2019, December 4). Psychometric properties of HITS screening tool (hurt, insult, threaten, scream) in detecting intimate partner violence in Iranian women. Shiraz E-Medical Journal, 21(3). doi:10.5812/semj.91924

U.S. Department of Health & Human Services. (2021, September 3). Social determinants of health: Know what affects health. Retrieved from Center for Disease Control and Prevention: https://www.cdc.gov/socialdeterminants/index.htm

For this discussion, I was assigned case E, the adolescent Hispanic/Latino boy living in a middle-class suburb. Initially, the Provider should confirm that the patient speaks English; if not, appropriate accommodations should be made for an interpreter. Communication and interviews for building a health history with the adolescent population should be performed with respect, confidentiality, and flexibility (Ball et al., 2019).

If a parent or guardian accompanies them, they should be informed at the beginning of the appointment that they may be asked to step out. This allows the patient to discuss concerns privately (Ball et al., 2019). It will also enable them to build trust with their Provider and discuss sensitive issues they may not feel comfortable telling their parents about (Ball et al., 2019). It should be made clear that there are limitations to confidentiality, which may be broken if there are safety concerns (Ball et al., 2019).

Pre-visit questionnaires are a helpful tool that may be used to gather chief concerns by allowing the patient to write them down and then give them to the Provider (Ball et al., 2019). This may help with any concerns or questions the adolescent may find embarrassing or shameful.

The Provider should use open-ended questions to build the adolescent’s health history. Understanding the patient’s living situation, school activities, employment, and social environment are vital to evaluate areas that may identify risky behaviors. Concerning this patient’s Hispanic/latino ethnicity, it is essential for the Provider to understand his cultural beliefs, values, and characteristics (Murray et al., 2022). It is also important not to assume that this patient has the cultural views that are stereotyped as Hispanic/Latino.

The Provider must demonstrate cultural humility and display and genuine interest in understanding their belief system (Ball et al., 2019). There is an increased risk of suicide among Hispanic/Latino adolescents due to cognitive and emotional vulnerabilities, difficulty coping, social disconnection, and acquired ability to perform (Murray et al., 2022).

The risk assessment instrument applicable to this patient population is HEEADSSS. This instrument addresses the significant areas for risks for adolescents, including home environment, education, employment, eating, activities, drugs, sexuality, suicide/depression, and safety (Ball et al., 2019). This technique is initiated with open-ended, nonjudgmental questions and advances to more sensitive topics such as sexuality, depression, and thoughts of suicide (Sacks & Westwood, 2003).

A Sample Answer For the Assignment:
Title:

According to Sacks & Westwood (2003), some target questions that a Provider should ask:

How are things at home? Tell me about your living situation. Do you feel safe at home? How is school? Tell me about your friends. Do you do outside-of-school activities? Do you work? How is your diet? Are you happy with your appearance? Have you ever tried any drugs? Are you dating? Are you sexually active? Have you ever been a victim of violence? Do you feel more down than happy? Have you ever thought of hurting yourself?

Each answer may transition into another discussion giving a clearer picture of the patient’s life and health history (Sacks & Westwood, 2003).

Ball, J., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination: An interprofessional approach. Elsevier.

Murray, T., Roges, E., & Henry, M. (2022, July 28). Using cuento to support the behavioral health needs of Hispanic/latinos. SAMHSA. https://www.samhsa.gov/blog/using-cuento-support-behavioral-health-needs-hispanic-latinos

Sacks, D., & Westwood, M. (2003). An approach to interviewing adolescents. Paediatrics & Child Health, 8(9), 554–556. https://doi.org/10.1093/pch/8.9.554

Thank you for your very informative and well-composed post. You did an excellent job of identifying highly pertinent questions necessary for an effective health history. I would like to suggest an additional assessment that I think would be extremely useful in this particular clinical case. This patient is a Native American living on a reservation, and a woman. Unfortunately, this places her into a high risk category for domestic violence of all types, sexual assault, and likely lacking in resources to allow for safe and secure pregnancy and domesticity.

Research indicates that Native American women are more likely to be victims of violent crime than any other demographic in the United States, and that 70% of sexual assaults on Native women go unreported, meaning that the number is likely much higher. Studies demonstrate that 70% of these violent crimes are perpetrated by persons of another race (not Native), also making Native women the largest target for interracial violent crime (Crossland et al., 2013).

It is imperative that advanced practice providers familiarize themselves with their patients’ cultural background and potential health risks that may be specific to that population, and that they screen their patients accordingly. The risk screening tool HITS would be an appropriate and effective tool in this clinical case. This assessment asks “In the past year, how often has your partner: Hurt you physically? Insult or talk down to you?

Threaten you with physical harm? Scream or curse at you?” (Ball et al., 2019). This assessment could be instrumental in protecting the health and safety of both the patient and her family, including her unborn child. The provider should also include in his health screening a physical assessment for indications of physical abuse, as with all other patients seen. Thank you again for your excellent post!

References

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.). Elsevier Mosby.

Crossland, C., Palmer, J., & Brooks, A. (2013). Nij’s program of research on violence against american indian and alaska native women. Violence Against Women, 19(6), 771–790. https://doi.org/10.1177/1077801213494706

Unfortunately, this places her into a high risk category for domestic violence of all types, sexual assault, and likely lacking in resources to allow for safe and secure pregnancy and domesticity. Research indicates that Native American women are more likely to be victims of violent crime than any other demographic in the United States, and that 70% of sexual assaults on Native women go unreported, meaning that the number is likely much higher. Studies demonstrate that 70% of these violent crimes are perpetrated by persons of another race (not Native), also making Native women the largest target for interracial violent crime (Crossland et al., 2013).

References

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.). Elsevier Mosby.

To build a strong therapeutic relationship between the patient and the nurse, it is essential to obtain relevant and personal information about the patient by taking a thorough health history. According to the case study that was assigned, the 72-year-old man who was admitted to your Intensive care unit after having a severe stroke was rendered unconscious and unable to communicate. But, his wife claimed in an interview that they don’t have any advanced directives. But, she was certain that her husband would prefer not to live that way.

Their daughter, however, was convinced that her father would have preferred to be kept alive if there was a prospect for a positive outcome. The use of proper communication skills, such as the use of open-ended questions, active listening, empathy, and enabling the patient to only tell his tale once, will be required given the patient’s serious condition (Ball et al., 2019). The aforementioned communication strategies will enable the client to respond without becoming angry, frustrated, worn out, or bored.

The National Institutes of Health Stroke Scale (NIHSS) will be used because the patient has already experienced a severe stroke that has rendered him nonresponsive and unable to communicate. The scale evaluates hemi-inattention, extraocular motions, visual fields, limb strength, facial muscle function, sensory abilities, coordination, communication, and speech (Zöllner et al., 2020). The NIHSS is suitable for this patient because it will improve patient care by serving as an initial evaluation tool and by aiding in the planning of post-acute care disposition (Alkhouli & Friedman, 2019).

While the patient is unconscious, his wife will serve as the historian. The following specific inquiries will be displayed (Masci et al., 2019):

Could you explain your husband’s medical history?
What other medical conditions is your husband dealing with?
Does your husband currently take any medications?
Does anyone in the family experience comparable cardiovascular issues?
When was the last time your husband visited for a check-up or follow-up assessment?

References

Alkhouli, M., & Friedman, P. A. (2019). Ischemic Stroke Risk in Patients With Nonvalvular Atrial Fibrillation. Journal of the American College of Cardiology, 74(24), 3050–3065. https://doi.org/10.1016/j.jacc.2019.10.040

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.

Masci, A., Barone, L., Dedè, L., Fedele, M., Tomasi, C., Quarteroni, A., & Corsi, C. (2019). The Impact of Left Atrium Appendage Morphology on Stroke Risk Assessment in Atrial Fibrillation: A Computational Fluid Dynamics Study. Frontiers in Physiology, 9. https://doi.org/10.3389/fphys.2018.01938

Zöllner, J. P., Misselwitz, B., Kaps, M., Stein, M., Konczalla, J., Roth, C., Krakow, K., Steinmetz, H., Rosenow, F., & Strzelczyk, A. (2020). National Institutes of Health Stroke Scale (NIHSS) on admission predicts acute symptomatic seizure risk in ischemic stroke: a population-based study involving 135,117 cases. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-60628-9

A Sample Answer For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Building a Health History

The case concerns an 85-year-old female living in a long-term care facility. She has marked cognitive decline, renal failure, and CHF, and her physician mentioned she was in her last days. The patient cries in agony after being pricked and can hardly tolerate the lab draws to check her INR. She inquires if continual monitoring of the INR is necessary. This paper will explain interview and communication techniques to use and identify a risk assessment tool for this patient.

Summary of the Interview and Communication Techniques

When interviewing a patient with a terminal illness, I would employ open-ended discussions without structured questions. This would allow the patient to provide content on which I would create further questions. I would begin the interview by asking her to talk about her thoughts during this period of her life. I would also ask her about her experience with the terminal illness and how it affects her identity (Auriemma et al., 2021).

In addition, I would ask about her current quality of life, personal goals, hopes, worries, fears, memories, attitude, and emotions toward dying. Communication techniques include carefully phrasing questions, which results in more accurate responses. I would ask one question at a time to avoid bombarding the patient, which could discourage her from responding (Ball et al., 2021). Furthermore, I would use complex reflection statements to clarify what the patient meant or felt when talking.

Risk Assessment Instrument

The Beck Hopelessness Scale (BHS) can assess three primary aspects of hopelessness: loss of motivation, feelings about the future, and expectations. It can also assess suicidal thoughts and attempts (Balsamo et al., 2020). BHS applies to this patient since she seems hopeless about her condition and does not consider continuation of treatment as necessary.

Targeted Questions

How would you describe your current quality of life?
What goals do you wish to accomplish before passing?
What hopes do you have about your life?
What uncertainties do you have surrounding your condition and its progress?
What is your most pleasant and meaningful memory?

Conclusion

Open-ended questions would be used to ask the patient about her perceptions of life, experience with the disease, quality of life, goals, and memories. I would phrase questions for more accurate responses and use complex reflection statements. The Beck Hopelessness Scale can assess the patient’s degree of hopelessness.

References

Auriemma, C. L., Harhay, M. O., Haines, K. J., Barg, F. K., Halpern, S. D., & Lyon, S. M. (2021). What matters to patients and their families during and after critical illness: a qualitative study. American Journal of Critical Care, 30(1), 11-20. https://doi.org/10.4037/ajcc2021398

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2021). Seidel’s Guide to Physical Examination-E-Book: An Interprofessional Approach. Elsevier Health Sciences.

Balsamo, M., Carlucci, L., Innamorati, M., Lester, D., & Pompili, M. (2020). Further insights into the beck hopelessness scale (BHS): Unidimensionality among psychiatric inpatients. Frontiers in psychiatry, 11, 727. https://doi.org/10.3389/fpsyt.2020.00727

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A Sample Answer For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

SAMPLE 4

Our book refers to “building” a health history as opposed to “taking” one as the advanced practice registered nurse (APRN) and the patient are partners in a joint effort, who are building the history together (Ball et al., 2019). This encourages patient-centered care and heavily involves the patient to gain rapport and gather the most accurate information. This ensures that the APRN has a whole understanding of the patient and their past while at the same time, the patient feels heard, understood, and like they are just as equally involved in their care. The purpose of this discussion post is to provide a patient profile and specific interview techniques, to identify a risk assessment based on the patient’s needs, and to develop targeted questions to ask the patient.

Patient Profile and Interview

Communication and interview techniques should differ with each patient depending on the different factors that influence a patient history as well as social determinants. Diamond-Fox writes that we must consider a patient’s understanding of health literacy, culture, and language (2021). Some other patient factors to consider include a patient’s age and gender as well as social determinants such as a patient’s race, ethnicity, and living condition (Hacker et al., 2022). Case E involves an adolescent Hispanic/Latino boy living in a middle-class suburb.

This case has many factors that will determine the best way to communicate with the patient. An adolescent requires a different approach than an adult would. Adolescents need to feel like they can trust a provider, especially when discussing uncomfortable or sensitive topics that they might now be willing to share with their parents. The APRN needs to build rapport with the adolescent before any deep questions are asked. This can be done by first asking the patient’s parents to leave the exam room for privacy.

The patient will be more inclined to answer honestly when alone with the provider. The APRN also should explain confidentiality laws in a way that the adolescent can understand. The patient needs to be assured that the provider will not share any information discussed unless it poses a threat to the patient. This patient being of Hispanic/Latino background may prove some cultural or language differences depending on the provider. The APRN should be aware of this and modify the interview accordingly such as resources in Spanish and acknowledgments of cultural differences regarding Western medicine.

Risk Assessment

Adolescents will have their own set of concerns that might differ compared to the adult patient. Some common concerns for an adolescent boy include height concerns, concerns with penis size, worry about sexual preference, sex, STDs, substance and alcohol use, parents, friends, bullying, school, and mental health concerns such as self-harm and suicide (Ball et al., 2019). Taking these into consideration, the APRN can choose risk assessment tools to aid in the assessment of these adolescent patients.

A couple of popular assessments are HEEADSSS and PACES. HEEADSSS includes the topics of home, education, eating, activities, drugs, sexuality, suicide/ depression, and safety (Ball et al., 2019). PACES include the topics of parents/ peers, accidents/ alcohol/ drugs, cigarettes, emotional issues, and school/ sexuality (Ball et al., 2019).

Between these two assessment instruments, most of the common topics and concerns are addressed. As mentioned previously, it is important for the APRN to establish trust with the patient as these topics are sensitive for the adolescent. Either tool would be beneficial in building a health history with the adolescent boy.

Targeted Questions

Along with focusing on building trust with the adolescent patient, it is also extremely important for the APRN to make sure that the patient is safe. HEEADSSS and PACES both include talking points regarding safety. The APRN should ask the patient if they have ever had thoughts of hurting or killing themself. This is an extremely sensitive question and may make the patient uncomfortable, but it is important to know. Another question to ask is if they have ever felt pressure to try something that they did not want to try. This could be more specific to substances or sexual encounters, depending on the patient.

A third question that can be asked is if they have any concerns about their body. This can be phrased as things that they like as well as things that they do not like. Body image concerns are very prevalent among adolescents and should be addressed. Another question to ask is regarding a patient’s hobbies and interests. This might help identify any social issues or concerns for the patient.

A fifth question that can be asked is if the patient has anything they want to ask an adult, the APRN, that they might not want to ask their parents. This is a more open-ended question but can be beneficial to adolescents who do not have a great relationship with their parents. These are just a few questions that can be asked to form a solid health history of the adolescent.

Conclusion

In conclusion, building a health history is an important foundation for having a relationship with a patient. Every patient will have different needs, as well as different factors that determine the style of communication from the APRN, needed to be effective in the interview. Assessment tools are a great way to address concerns when still building a history with the patient. Overall, the APRN needs to be aware of differences that will occur and conduct patient interviews accordingly.

References

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.). Elsevier Mosby.

Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level. British Journal of Nursing, 30(4), 238–243.

Hacker, K., Auerbach, J., Ikeda, R., Philip, C., & Houry, D. (2022) CDC’s approach to social determinants of health. JPHMP Direct. Retrieved May 29, 2023. https://jphmpdirect.com/2022/10/07/cdcs-approach-to-social-determinants-of-health/

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A Sample Answer 2 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample EssayTitle: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Communication and Interview Techniques

Target Questions Based on Social Determinants of Health

Selected Risk Assessment Instrument

Summary of the Interview

References

A Sample Answer For 3 the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample EssayTitle: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Building rapport with the patient

Crucial factors of consideration

Assessment

Specific targeted questions

Conclusion

References

A Sample Answer 4 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Title: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Brief summary of interview

Communication technique

Risk assessment instrument

Target questions to be addressed to the patient includes:

References

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Discussion: Building a Health History

Communication Techniques

Target Interview Questions

Conclusion

References

A Sample Answer 6 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample EssayTitle: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

WK 1 Discussion: Building a Health History

Communication and Interview Techniques

Considerations of Social Determinants of Health

Questions Posed to Assess Health Risks

Potential Health Risks Based on Patient’s Age, Gender, and Ethnicity

Risk Assessment Tool

Targeted Risk Assessment Questions

Conclusion

References

A Sample Answer 7 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample EssayTitle: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

RE: WK 1 Discussion: Building a Health History

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A Sample Answer 8 For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample EssayTitle: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay

Interview Summary:

Interview Technique:

HRAs:

Questions:

References:

Case Study: Adolescent Hispanic/Latino boy living in a middle-class suburb.

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.

Risk assessment tools

Targeted questions

References

Discussion week 1 main post

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By Day 3 of Week 1

References

Main Discussion Post

Description of Communication technique

Risk Assessment Instrument

References

Five targeted questions asked of this patient to assess his health risks and build a health history are as follows:

References

According to Sacks & Westwood (2003), some target questions that a Provider should ask:

References

References

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A Sample Answer For the Assignment: NURS 6512 Week 1 Discussion: Building a Health History Sample Essay
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