Taking a Health History: Building a Health History: Asking Difficult Questions

Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.

Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations.

More importantly in today’s society, the possible Social Determinants of Health for each of our patient’s also needs to be taken into consideration

For this Assignment, you will develop a make-believe script to be used when you first encounter a patient for a well woman appointment.

Resources

· Schuiling, K. D., & Likis, F. E. (2022). G ynecologic health c are (4th ed.). Jones and Bartlett Learning.

· Chapter 6, “Gynecologic Anatomy and Physiology” (pp. 87–98)

· Chapter 7, “Gynecologic History and Physical Examination” (pp. 99–124) (Previously read in Week 1)

· Chapter 9, “Periodic Screening and Health Maintenance” (pp. 149–164)

· Chapter 12, “Sexuality and Sexual Health” (pp. 211–228)

· Chapter 13, “Contraception” (pp. 236–266)

· Chapter 14, “Menopause” (pp. 267–291)

· Chapter 15, “Intimate Partner Violence” (pp. 295–307)

· Chapter 16, “Sexual Assault” (pp. 313–329)

Screening Guidelines

· American Academy of Family Physicians. (2021, August ). Adult preventive health care schedule: recommendations from the USPSTF.Links to an external site. American Family Physician. https://www.aafp.org/dam/AAFP/documents/journals/afp/USPSTFHealthCareSchedule2021.pdf

· American College of Obstetricians and Gynecologists (ACOG). (n.d.). Well-Woman Health CareLinks to an external site. . https://www.acog.org/topics/well-woman-health-care?utm_source=redirect&utm_medium=web&utm_campaign=otn

· Agency for Healthcare Research and Quality (2014). Guide to Clinical Preventive Services, 2014 .Links to an external site. https://www.ahrq.gov/prevention/guidelines/guide/index.html

· U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (n.d.). A guide to taking a sexual history .Links to an external site. https://www.cdc.gov/std/treatment/SexualHistory.pdf

Adult Gerontology Resources

· Shifren, J. L., & Gass, M. L. S. (2014). The North American Menopause Society Recommendations for Clinical Care of Midlife Women.Links to an external site. The Journal of The North American Menopause Society, 21(10), pp. 1-25. http://www.menopause.org/docs/default-source/2014/nams-recomm-for-clinical-care.pdf

Resources for LGBTQ+

· Aisner, A. J., Zappas, M., & Marks, A. (2020). Primary Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ) PatientsLinks to an external site. . The Journal for Nurse Practitioners, 16(4), 281–285. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1016/j.nurpra.2019.12.011

· Office of Disease Prevention and Health Promotion (ODPHP). (2020, April 18). Lesbian, gay, bisexual, and transgender health. Links to an external site. https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health

· Wingo, E., Ingraham, N., & Roberts, S. C. M. (2018). Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: A Qualitative StudyLinks to an external site. . Women’s Health Issues, 28(4), 350–357. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1016/j.whi.2018.03.002

Apps for Common Screenings

The following common screening apps will require a download or install into your personal device for you to access. Note: Should you have any technical issues, you will need to contact the rightsholder of the app itself and not Walden Student Support for any assistance.

· Alvar-Gonzalez, J. (2020). iContraception.Links to an external site. https://play.google.com/store/apps/details?id=com.itiox.icontraception&hl=en_US

Note: This download is available for Android devices only.

· ITIOX Technologica S.L. (2020). iContraception.Links to an external site. https://apps.apple.com/us/app/icontraception/id668520861

Note: This download is available for iOS devices only.

· Agency for Healthcare Research and Quality (AHRQ). (n.d.). ePSS Electronic Preventive Services Selector.Links to an external site. https://epss.ahrq.gov/PDA/index.jsp

· Centers for Disease Control and Prevention (2020). CDC Vaccine Schedules.Links to an external site. https://www.cdc.gov/vaccines/schedules/hcp/schedule-app.html#download

Note: This webpage will provide you with downloads for both iOS and Android Devices.

· Nurse Practitioners in Women’s Health. (n.d.). Well Woman Visit Mobile App Links to an external site. . https://npwh.org/page/mobile-app

Clinical Guideline Resources

· American College of Obstetricians and Gynecologists (ACOG).Links to an external site. (2020). https://www.acog.org/

· American Cancer Society, Inc. (ACS). (2020). Information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin. Links to an external site. https://www.cancer.org/

· Centers for Disease Control and Prevention. (CDC).Links to an external site. (n.d.). https://www.cdc.gov/

· American Nurses Association (ANA).Links to an external site. (n.d.). https://www.nursingworld.org/

· The American Association of Nurse Practitioners (AANP).Links to an external site. (2020). https://www.aanp.org/

· HealthyPeople 2030. (2020). Healthy People 2030 Framework .Links to an external site. https://www.healthypeople.gov/2020/About-Healthy-People/Development-Healthy-People-2030/Framework

Required Media

· Taking a Health History Dr. Marianne Shaughnessy discusses one of the most critical components of the nurse/patient relationship—the health interview with the patient. She further discusses how to conduct a health history interview with demonstration (16 mins).

· Women’s Issues and Tough ConversationsLinks to an external site. In this interactive media program, Dr. Rebecca Lee and Cindy Nypaver describe their experiences related to women’s issues and tough conversations (5 mins).

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To prepare:

· Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.

· Review the media programs related to a vaginal exam, pap test, and breast exam.

· Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a complete health history. ( Note: You will also find the Health History Form in Chapter 7)

· Provide all the components of a complete gynecologic health history. Include considerations for special populations such as LGBTQ+ individuals.

· What health maintenance guidelines should be included for initial and follow up might be needed for follow-up assessments? (i.e., bone density test, Gardasil vaccine, pap smear, Mammorgram, etc.)?

· Using the 5 areas of the Social Determinants of Health: (Examples of SDOH include but not limited to)

·

· Safe housing, transportation, and neighborhoods

· Racism, discrimination, and violence

· Education, job opportunities, and income

· Access to nutritious foods and physical activity opportunities

· Polluted air and water

· Language and literacy skills

· SDOH also contribute to wide health disparities and inequities.

· What questions would you consider in your patient’s complete health history?

· Develop your own script for building a complete health history and as you create your script, consider the difficult questions you want to include in your script. There is no sample template to provide to you. (Utilize chapter 7 of your Schuiling textbook to provide guidance). You are the one to develop the script. Think of it as you are writing a movie and you need to write the script for the movie. What lines would you provide for the actor to utilize when sitting down with a patient to perform a COMPLETE Medical History which also entails those DIFFICULT GYN questions. You do not need to provide the answers to the questions however, if you find that beneficial, you may do so.

Assignment: (1- to 2-page reflection)

· In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:

· A brief summary of your experiences in developing and implementing your script during your health history.

· Explanations of what you might find difficult when asking these questions. What you found insightful and what would you say or do differently.

· As a NP, what could you implement in your community to provide resources/assistance of the Social Determinants of Health.

ReminderLinks to an external site. : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

By Day 7 of Week 2

Submit your Module 1 Assignment by Day 7 of Week 2.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

1. To submit your completed assignment, save your Assignment as M1Assgn_LastName_Firstinitial

2. Then, click on Start Assignment near the top of the page.

3. Next, click on Upload File and select Submit Assignment for review.

Rubric

NRNP_6552_Module1_Assignment_Rubric

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