NU 610 – DISCUSSION REPLIES UNIT 2: HEALTH HISTORY
10590Discussion Peer/Participation Prompt Due Sunday by 11:59 pm
Instructions:
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least two of these prompts:
Do you agree with your peers’ assessment?
Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
Share your thoughts on how you support their opinion and explain why.
Present new references that support your opinions.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
RESPONSE 1:
Steve Kline
MondaySep 12 at 9:27pm
Consider performing a health history on someone that may not be able to provide you with answers, such as an infant, child, an elderly person, a developmentally disabled individual, or patients who speak a language you do not know.
What strategies would you employ to obtain a complete health history?
I have to incorporate many strategies when performing assessments on my patients in their home for home health. Each patient will need to be interviewed differently as they will most likely have different objectives and concerns that will need to be addressed. It doesn’t matter who or where a practitioner conducts an interview, if a patient does not feel like they are being heard or if the interviewer seems like they lack confidence or knowledge, they will not open up and disclose all that is needed for a proper assessment to be completed. “Research confirms interviewing is an effective system of gathering essential information regarding the personality and character of another person. In the medical profession, interviews are a key element for gathering information on a one-on-one basis, starting with applying to professional school to daily interviews with patients in a variety of settings”.(Slade, S & Sergent, S., 2022) When I am conducting an assessment on an elderly patient in their home, I have to use strategies that ensure that the patient is able to hear what is being asked and give them time to answer certain questions as they are not always able. Some can get confused and need to be reoriented. When conducting an assessment or health interview on a geriatric patient, I make sure that I ask if they can hear me and at different intervals, I ask if they need to take a break before continuing. Home health admissions can be lengthy depending on what complaints and what orders the physician has sent. A practitioner must get to know a patient that is older and understand their limitations.
Provide a rationale for why you think these strategies would be effective.
I have used these strategies when performing admissions in the home for geriatric patients. Most are extremely easy to talk with and will answer most all assessment questions that are proposed. There are times when I get a patient that is suffering from early dementia or is delirious. When performing an assessment on this type of patient, I ask for the assistance of family members in order to make the patient feel more comfortable and relaxed.
Reference
Slade S, Sergent S. Interview Techniques. [Updated 2022 Apr 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
https://www.ncbi.nlm.nih.gov/books/NBK526083/
RESPONSE2:
Melisa Stacey
MondaySep 12 at 2:02pm
According to “Bate’s Guide to Physical Examination and History Taking”, a surprisingly amount of information can be gathered about the patient just through survielance. This can include how the patient interacts with others and their surroundings, tone of voice, tone of muscles through movement, and many more (Bickley, 2021). This is especially pertinent on newborn, children, and special needs patients, and most of these patients are accompanied by parents or caregivers. Seeing children react to familiar faces, how they sit on their parents lap, and how they respond to stimulation can tell providers about hearing, neurological, and muscular deficits. Caregivers and parents are also some of the first to recognize an abnormality with these patients as well since they spend so much time together (Bickley, 2021). Reports from these caregivers can help guide providers on focus assessments to determine the root cause or contributing factors.
When working with geriatric patients it is important to remember that many of these patients have developed chronic health conditions through their life and are more susceptible to illness and disease. According to the National Institute of Aging – there are five pointers that are suggested when completing a health history interview:
try to gather preliminary information before the visit such as medical records from hospitals or other offices
sit eye level to patient and talk slowly and loudly to accommodate for hearing or vision loss
Have the patient voice their concerns and stories only once to prevent fatigue or missing parts from telling too many people
ask open-ended questions to try to gather as much information as possible (National Institute of Aging, 2017).
Another part of gathering health history from special populations includes being able to be flexible. Many times many providers get in the groove of routine health histories. Being able to adjust our assessment skills per the patient needs to obtain the most accurate information for safe treatment is the top priority.
References
Bickley, L.S. (2021). Overview: Physical examination and history taking. Bates’ guide to physical examination and history-taking, 13th ed. New York: Lippincott, Williams, & Wilkins. ISN-13:9781496398178
National Institute of Aging. (2017, May 17). Obtaining an older patient’s medical history. National Institute on Aging. Retrieved September 12, 2022, from https://www.nia.nih.gov/health/obtaining-older-patients-medical-history
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