Week 1 Discussion & Responses - Advanced Health Assessment & Diagnostic Reasoning PDF

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7 6 ye a r ol dBl a c k/Af r i c a nAme r i c a nma l ewi t hdi s a bi l i t i e sl i vi ngi na nur ba ns e t t i ng To prepare: With the information presented in Chapter 1 in mind, consider the following:        

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 age, gender, ethnicity, or environment? What risk assessment instruments would be appropriate to use with each patient? What questions would you ask each patient to assess his or her health risks? Select one patient from the list above on which to focus for this Discussion. 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 26 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 Post a description of the interview and communication techniques you would use with your selected 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. We e k1Di s c us s i onPos t Thepur pos eoft hi spos t i ngi st opr o vi deade s c r i pt i onofi nt e r vi e w and c ommuni c a t i ont e c hni que st obee mpl oye dwhe na s s e s s i nga7 6 ye a r ol dBl a c k/Af r i c a nAme r i c a nma l ewi t hdi s abi l i t i e sr e s i di ngi na nur banar e a .Fort hi spos t , ourpa t i e ntwi l l bena me dMi ke . Addi t i ona l l y , ar i s ka s s e s s me nti ns t r ume ntwi l lber e c omme nde da l ong wi t hfivet ar ge t e dpa t i e ntque s t i ons . I nt e r vi e wa ndCommuni c a t i onTe c hni que s The r ea r es e ve r a lt e c hni que st ha tc a nbebe ne fic i a li ni nt e r vi e wi ngMi ke .T o a c c ommoda t ef orMi ke ’ sdi s a bi l i t i e s , i ti si mpor t antf ort her oom t obef r e ef r om c l ut t e r . I ti si mpor t a ntf ort hephys i c i a nt onotha vef ur ni t ur ebe t we e nt he ms e l ve sa ndt he pa t i e nt .I fi ti sne c e s s a r yf ort hepa t i e ntt ot r ans f e rt oa ne xa mt a bl e ,ma kes ur et oa s k t hepa t i e ntho wt he ydot hi sa st he ya r et hee xpe r t si nt hi ss i t ua t i on( Ba l l , Fl ynn, Sol omon,&S t e wa r t , 2 0 1 9) . Toac c ommoda t ef orMi ke ’ si nc r e as e da ge , i ti si mpor t antt oa l l ow mor et i mef or phys i c a lmove me ntoft hepa t i e nt .I ti si mpor t a ntno tt or us ha ne l de r l ypa t i e nt , or

s ome onewi t hmobi l i t yi s s ue s , a l l o wt i mef ort hepa t i e ntt or e pos i t i on( Ba l l , Fl ynn, Sol omon,&S t e wa r t , 2 0 1 9) . Ri s kAs s e s s ment The r ea r es e ve r a lr i s ka s s e s s me nt st ha twoul dbehe l pf ulf ort hi spa t i e nt .The s e i nc l udebuta r enotl i mi t e dt oas ui c i de , de pr e s s i on, f a l l s , a nde l de ra bus e .Ac c or di ngt o as ys t e ma t i cr e vi e w ofl i t e r a t ur ee l de ra bus er i s kf a c t or si nc l udec ogni t i vei mpa i r me nt , be ha vi orpr obl e ms , ps y c hi a t r i ci l l ne s s e s , f unc t i onalde pe nde nc e , l o wi nc omes t a t us , t r aumaorpa s ta bus e , e t hni c i t y ,l ow s oc i a ls uppor t , a ndf a mi l yc onfli c t( Wa ng, Br i s bi n, Loo , &St r a us , 2 01 5 ) . TheEl de rAbus eSus pi c i onI nde xi saye sorno , s i xque s t i on que s t i onna i r e sf ore l de rabus es c r e e ni ng( Wa nge tal . , 20 1 5 ) . Fi veQue s t i ons 1 .Ho w doyouge tar ound/t r a ns f e r ? a .Ra t i o na l e : As ki ngt hepa t i e ntt hi sque s t i ona s s i s t si nt hea s s e s s me ntoft he pa t i e nt , a swe l la sc ont r i but e st opa t i e nts a f e t y .I ti si mpor t a ntt oa l s o unde r s t a ndyourownphys i c a ll i mi t a t i onswhe na s s i s t i ngwi t hat r a ns f e r i nor de rt opr e ve nti nj ur i e sorf a l l s( Ba l l , Fl ynn,Sol omon, &St e wa r d, 2 0 1 5) . 2 . Mi ke , doe syourdi s a bi l i t yma kei tdi ffic ul tt oobt ai nhe a l t hc a r e ? a .Ra t i o na l e D :e pe ndi ngont hedi s a bi l i t y , s omema yc a us emobi l i t ya nd t r a ns por t a t i oni s s ue s( Sme l t z e r& Ma r i ani , 2 0 17 ) .Addi t i ona l l y , t he i de nt i fic a t i onofphys i c a lba r r i e r sc a na s s i s ts t a ffi naddr e s s i ngba r r i e r st o ma ket hehe a l t hc ar ei ns t i t ut i onmor eas s e s s i bl ef orpa t i e nt swi t h di s a bi l i t i e s( Sme l t z e r& Ma r i a ni , 2 0 17 ) . 3 .Ho w doe sy ourdi s a bi l i t yi mpa c ty oura bi l i t yt oc a r ef oryour s e l f ?Wha tt a s ks dur i ngt heda ydoy oune e das s i s t a nc ewi t h? a .Ra t i o na l e T : hi sa l l owst hec l i ni c i a nt oi de nt i f yi ft he r ear ea nymodi fic a t i ons ora c c ommoda t i onst ha tc a nbear r a nge df ort hepa t i e nt ’ shomet obemor e a c c e s s i bl e( Sme l t z e r&Ma r i a ni , 2 0 1 7 ) . 4 .Mi ke , whohe l psyouwi t hyoura s s i s t e dda i l yl i vi ngt as ks ? a .Ra t i o na l e T : hi sque s t i ona l l o wst hephys i c i a nt oi de nt i f ya s pe c t soft he s oc i a lands uppor tne t wor korl a c kt he r e ofoft hepa t i e nt .I ti si mpor t a nt whe ni nt e r vi e wi ngol de ra dul t st oi de nt i f yc ommuni t yandf a mi l ys uppor t s ys t e ms( Ba l l , Da i ns , Fl ynn, Sol omon&S t e wa r t , 2 0 19) . 5 .Doyouha vea nadva nc e ddi r e c t i v e ? a .Ra t i o na l e S : houl dc a t a s t r ophi ce v e nt soc c urandt hepa t i e ntbe c omeuna bl e t oc ommuni c a t eort he i rc ogni t i vei mpa i r me ntde c l i net hea dva nc e d di r e c t i vewoul dpr ovi degui da nc et ot hehe a l t hc a r et e am a st ot hepa t i e nt s de s i r e sf ort r e a t me nt .Thi sque s t i ona l l o wst hec l i ni c i ant oi de nt i f yt he pr e s e nc eoft hi sdoc ume nt , aswe l lt hei ndi vi dua lt ha twi l lbema ki ngt he he al t hc a r ede c i s i onsf ort hepa t i e nt( Ba l l , Da i ns ,Fl ynn, Sol omon, & S t e wa r t , 2 0 1 9 ) . Re f e r e nc e s Bal l , J . W. , Da i ns , J . E. , Fl ynn, J . A. , S ol omon, B.S. , &St e wa r t , R. W. ( 20 1 9 ) .Se i d e l ' sg ui de t op h y s i c a le xa mi na t i o n( 9 t he d. ) . S t .Loui s , MO:El s e vi e rMos b y .

Sme l t ze r , S. C. ,Ma r i a ni , B. ( 2 0 1 7 ) . As s e s s me ntoft hepa t i e ntwi t hadi s a bi l i t y .Na t i o na l Le a guef o rNur s i ng .Re t r i e ve df r om ht t p: / /www. nl n. or g/pr of e s s i ona l de ve l opme nt pr ogr a ms / t e a c hi ngr e s our c e s /a c e d/addi t i ona l r e s our c e s /a s s e s s me nt of a pe r s onwi t hdi s a bi l i t y Wa ng, X. M. , Br i s bi n,S. , Loo ,T. , &S t r a us ,S. ( 2 015 ) .El de rabus e : anappr oa c ht o i de nt i fic a t i on, a s s e s s me nta ndi nt e r v e nt i on.CMAJ:Ca na d i a nMe d i c a l As s o c i a t i o nj o ur na l =j o ur na ld el ' As s o c i a t i o nme d i c a l ec a na d i e nne , 1 8 7 ( 8 ) , 5 7 5 – 58 1 . doi : 1 0 . 1 5 0 3 /c ma j . 1 4 13 2 9

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! Read a selection of your colleagues’ responses. By Day 6 Respond to at least two of your colleagues on two different days who selected a different patient than you, using one or more of the following approaches:   

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.

Re s pons eOne Br i ,Ie nj oye dr e a di ngyourpos t , a ndt heque s t i onst ha tyouc hos ewe r ee x c e l l e ntope ne nde dque s t i onst ha twoul dpr omot ec ommuni c a t i on.I na ddi t i on, It hi nki ti s i mpor t a ntt oa s kaque s t i onort wor e l a t e dt ot heps y c hol ogi c a ls t r e s st ha tt hepa t i e nti s unde r goi ngande va l ua t ef ors oc i a ls uppor t .Te e na gemot he r sha vehi ghdi s t r e s sr a t e s whi c hi sa t t r i but a bl et oc hr oni cs t r e s s , poors oc i oe c onomi cs t a t us , a ndl i mi t e ds uppor t ( Smi t hBa t t l e& Fr e e d,2 0 1 6 ) . Addi t i ona l l yIt hi nki twoul dbebe ne fic i a lt oe va l ua t et hepr e par e dne s soft heyoung mot he r .I tmi ghtbene c e s s a r yt oi nvol v es oc i a lwor kt oa s s i s ti nge t t i ngi nf a nte s s e nt i al s s uc ha sac a rs e a t , ors a f es l e e pi ngar r a nge me ntf ort hei nf a nt .Adol e s c e ntpr e gna nc y a ndpa r e nt i nga r eapubl i che a l t hc onc e r n.Ea r l yi nt e r ve nt i onf ori nc r e a s e ds oc i a l s uppor tofa dol e s c e ntmot he r ss howe dar e duc t i oni npr e ma t ur ebi r t hsl ow bi r t hwe i ght ( Koni a k Gr i ffin, Ande r s on,Ve r ze mni e ks , & Br e c ht , 2 0 0 0 ) . Re f e r e nc e s

Smi t hBa t t l e , L. , &Fr e e d, P .( 2 01 6 ) . Te e nmot he r s ’me nt a lhe al t h.MCN,TheAme r i c a n J o ur na lo fMa t e r na l / Ch i l dNur s i ng , 4 1( 1 ) ,3 1 3 6 . Koni a k Gr i ffin, D. , Ande r s onN. L. , Ve r z e mni e ks , I . ,Br e c ht , M. L.( 2 00 0 ) .Nur s eRe s4 9 ( 3 ) 1 3 0 1 3 8 .

Re s pons eT wo Ai me et ha nkyouf ori de nt i f yi ngt hei mpor t a nc eofl a ngua geba r r i e r s . Mi s s c ommuni c a t i oni nhe a l t hc a r ec anha ves e r i ousc ons e que nc e s .Iha veut i l i ze daf e w di ffe r e ntt r a ns l a t i ons e r vi c e s , a ndt hevi de ot r ans l a t i ons e r vi c e sa r emyf a vor i t e . Cur r e nt l ya tmyor ga ni z a t i onweus ea nI pa dt ha ti sonar ol l i ngt a l ls t a ndt ha tha sa pr ogr a mc a l l e dMARTTI .Ha vi ngal i mi t e dEngl i s hl angua geunde r s t a ndi ngc ont r i but e s t ohe a l t hdi s pa r i t i e sa ndpoorhe a l t hout c ome s( Nj e r u, St .Sa uve r , J a c obs on, Ebbe r t , Taka ha s hi ,Fa n, &Wi e l a nd,2 0 15 ) .Fur t he r mor e , al i mi t e dEngl i s hunde r s t a ndi ngwhi l e obt a i ni nghe al t hc a r ewi t hi nt heUni t e dS t a t e ss howspoorut i l i z a t i onofpr e ve nt a t i ve he a l t hc a r es e r vi c e s , a ndl i mi t e da c c e s st ohe a l t hc ar e( Nj e r ue ta l . , 2 0 15 ) .Whe nut i l i z i ng a ni nt e r pr e t e ri ti si mpor t antt odoc ume ntt heut i l i z a t i onofa ni nt e r pr e t e r , a swe l la st he i nt e r pr e t e r si nf or ma t i onwi t hi nt heme di c a lr e c or d( Sul l i van, 2 0 1 9) .

Re f e r e nc e s Nj e r u, J . W. ,S t . Sa uve r , J . L. , J a c obs on, D. J . , Ebbe r t , J . OTa ka ha s hi , P . Y. , Fa n, C. , & Wi e l a nd,M. L. ( 2 0 1 5) . Eme r ge nc yde par t me nta ndi npa t i e nthe a l t hc a r eut i l i z a t i on a mongpa t i e nt swhor e qui r ei nt e r pr e t e rs e r vi c e s .BMCHe a l t hSe r vi c e sRe s e a r c h ,1 5 ( 2 1 4 ) , 1 9. Re t r i e ve df r om ht t ps : / /bmc he a l t hs e r vr e s . bi ome dc e nt r al . c om/a r t i c l e s /1 0. 1 1 86 /s 1 2 9 1 3 0 1 50 87 4 4 Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis....