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In this assignment, a response to a colleague’s post is needed to a case study they were assigned. Based on their response, I am to:
- Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
- Suggest additional health-related risks that might be considered.
- Validate an idea with your own experience and additional research
THIS IS WHAT THE INITIAL ASSIGNMENT CONSIST OF AND A FILE IS ATTACHED WITH TWO (2) COLLEAGUES RESPONSE IN WHICH I AM TO ADDRESS THE BULLETS ABOVE.
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.
In this assignment, a response to a colleague’s post is needed to a case study they were assigned. Based on their response, I am to: Share additional interview and communication techniques that could
POST A Patient: 80-year-old white male with angina lives on a farm 80 miles away from a healthcare center Summary of the Interview The clinical interview is an important process in gaining information while using effective communication skills to build a trusting relationship with the patient (Ball et al., 2019, p 2). When a clinician first meets a new patient, it is important to build a positive relationship with the patient, this plays a role in their health outcomes (Ball et al., 2019, p 2). When a patient is ill, they are in a vulnerable position (Ball et al., 2019, p 2). It is essential to remain professional and personal. When entering the room, knock on the door and then come in and introduce yourself (Ball et al., 2019, p 3). Address the patient at first by their first and last name, then ask what they go by, first name only, nickname, and so on (Ball et al., 2019, p 3). It is important that a patient feels comfortable enough to speak openly to clinician. Clinicians should be understanding and have some emotional control as to not offend patient (Ball et al., 2019, p 2). Clinicians need to get a health history, family history, health practices, medications, a physical examination, and review vitals (Ball et al., 2019, p 6). The longer we live the more likely we are to have comorbidities or to be on multiple medications (Weiss & Lee, 2012). Reviewing if patient is on any medications that are contraindicative or have side effect of angina, is necessary to rule out if that is the cause. The more medications a patient takes, the higher the risk for adverse effects (Weiss & Lee, 2012). Another important factor is to determine what life stressors this patient has. It can be relevant to patient’s symptoms. This specific patient is an elderly patient who lives on a farm far away from medical care. It is important to see if they brought themselves to the facility, if they live alone, and how well they can get around (Ball et al., 2019, p 21). The older we get the harder it is for us to get around, the more health problems we may have. Since the patient lives 80 miles away, it is important to know whether he has access to any facilities that can run tests or if he has access to obtain ordered treatment or therapy. These are things clinicians need to keep in mind when ordering tests or medications for this specific patient. Furthermore, it is necessary for this information to be documented by the clinician; this information can be used to look back during follow up visits (Sullivan, 2018, p 2). Also, it helps make sure appropriate treatment is provided for patient (Sullivan, 2018, p 2). Description of Communication techniques While there are communication techniques that can be used for patients of all ages. It is important to use techniques that are specific to this patient. Asking open-ended questions allows most patients to speak openly and say things that are important for clinicians to know (Ball et al., 2019, p 4). Listen as the patient speaks and respond by nodding or using eye contact (Ball et al. 2019, p 4). It’s important not to show negative facial expressions, as this could make the patient apprehensive to share vital information (Ball et al., 2019, p 4). With an elderly patient, it is necessary to have patience (Ball et al., 2019, p 4). Elderly patients may be hard of hearing, facing them when you speak and speaking clearly and slowly; without raising your voice helps them understand better without offending them (Ball et al, 2019, p 4). Elderly patients may experience death of loved ones, spouses, and friends. They may or may not be retired or have financial issues (Ball et al., 2019, p 20). They may not be used to asking for help. They may have life stressors or coping with depression (Ball et al., 2019, p 20). These are things clinicians need to take into consideration when taking care of an elderly patient. While this may not be true for all elderly patients as each person ages at different rates (Ball et al., 2019, p 20). The elderly can have lower ability to cope with stress and it can cause negative health outcomes (Ball et al., 2019, p 20). It is important to ask patient about life stressors to determine if that is a factor in the angina he is experiencing (Ball et al., 2019, p 20). Another communication technique that can used for this patient that lives very far away is possibly communicating via facetime or by phone for follow up appointments. According to Clark (2018), following up with patients more frequently via telehealth can assist in “health maintenance” by ensuring they are taking medications and following up with care. For a patient that lives 80 miles away, following up with him via telehealth more often can help clinicians know if he is following up with therapy or treatment. Clark (2018) found that most of the elderly had responded well to telehealth and were able to access it. This is a possible communication method that can be discussed with this specific patient. Risk assessment instrument The risk assessment tool I would use for this patient is a functional assessment screening. Functional assessment screening is a tool used to determine the ability for a patient to do basic activities of living (Ball et al., 2019, p 21). Age and illness can diminish these abilities (Ball et al., 2019, p 21). It assesses the ability of a patient to get around their home, carry things, do chores, groom themselves, manage their medications, cook, shop, etc. (Ball et al., 2019, p 21). The reason I would use this risk assessment tool is because it relevant to an elderly patient who lives very far from medical facilities. This tool can help clinicians determine whether this patient requires assistance and what type of assistance he may need. POST B NURS 6512-Week 1 discussion-Building a health history 22 yo LGBTQIA female Hispanic immigrant living in a middle class suburb Health providers need to conduct a comprehensive health assessment of a patient and build the necessary history to help make the right diagnosis. While building a health history, a provider must be aware of the factors that influence a patient’s health or illness, such as ethnicity, age, race, gender orientation, and environment. For this discussion, we will build a history on a 22-year-old LGBTQIA female Hispanic immigrant who lives in a middle-class suburb. Therefore, communication is essential when building a health history of a patient. For this case scenario, as an APRN, I must establish a rapport with the client and inquire how she would like to be addressed without discrimination or judgment. The communication should aim at asking the patient the right questions respectfully. According to Medina-Martinez et al. (2021), important topics APRNs should discuss with this patient during assessment should include their sexual orientation, gender identity, sexual relationships, HIV and sexually transmitted infection risk, mental health concerns, and relationships with the family (. Assessment of LGBTQIA patients needs lots of professionalism, respect for client autonomy, and proper therapeutic communication techniques like active listening, paraphrasing, seeking clarification, and open-ended questions (Cox & Furphy, 2018). The patient should be taught about her rights and infomed that she has a choice to answer and not to answer any of the questions when they feel uncomfortable. Some of the questions that should be asked include the following: How would you identify your sexual orientation and gender identity? Currently, are you in any active sexual relationship? Have you and your partner(s) been tested for HIV and assessed for sexually transmitted infections, and when? How has your sexual orientation affected your relationship with your family, close relatives, friends, and the community at large? Does the environment your live in or work affect you negatively based on your sexual orientation/gender identity? How has your sexual orientation affected your mental health? Have you at any point felt depressed, anxious, or thought of committing suicide? What are some of the discriminations that you have faced based on you sexual orientation/gender identity? How did they affect you health-wise and mentally?