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NURS612 Advanced Health Assessment: Exam 1 Study Guide

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NURS612 Advanced Health Assessment: Exam 1 Study Guide What are concepts of developing a relationship with the patient? The first meeting with the patient sets the tone for a successful partnership as you inform the patient that you really want to know all that is needed and that you will be op...

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  • 23 juni 2023
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  • 2022/2023
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NURS612 Advanced Health Assessment: Exam 1 Study Guide What are concepts of developing a relationship with the patient? The first meeting with the patient sets the tone for a successful partnership as you inform the patient that you really want to know all that is needed and that you will be open, flexible, and eager to deal with questions and explanations. A primary objective is to discover the details about a patient’s concern, explore expectations for the encounter, and display genuine interest, curiosity and partnership. Identifying underlying worries, believing them, and trying to address them optimizes your ability to be of help. Personal interactions and physical examination play an integral role in dev eloping meaningful and therapeutic relationships with patients. Because cost containment is also essential, the well performed history and physical examination can justify the appropriate and cost - effective use of technological resources. This underscores the need for judgment and the use of resources in a balance appropriate for the individual patient. What are the effective communication strategies when obtaining a health history? o Seeking connection o Professional Dress and Grooming o Enhancing Patient Responses What is a patient -centered question? Give examples. • Respecting and responding to patients’ wants, needs, and preferences, so that they can make choices in their care that best fit their individual circumstances. • How would you like to be addressed? • How are you feeling today? • What would you like us to do today? • What do you think is causing your symptoms? • What is your understanding of your diagnosis? Its importance? Its need for management? • How do you feel about your illness? Frightened? Threatened? Angry? As a wage earner? As a family member? (Be sure, however, to allow a response without putting words in the patient’s mouth). • Do you believe treatment will help? • How are you coping with your illness? Crying? Drinking more? Tranquilizers? Talking more? Less? Changing lifestyles? • Do you want to know all the details about your diagnosis and its effect on your future? • How important to you is “doing everything possible’? • How important to you is “quality of life’? • Have you prepared advance directives? • Do you have people you can talk with about your illness? Where do you get your strength? • Is there anyone else we should contact about your illness or hospitalization? Family members? Friends? Employer? Religious advisor? Attorney? • Do you want or expect emotional support from the healthcare team? • Are you troubled by financial questions about your medical care? Insurance coverage? Tests or treatment you may not be able to afford. Timi ng of payments required from you. • If you have had previous hospitalizations, does it bother you to be seen by teams of physicians, nurses, and students on rounds? • How private a person are you? • Are you concerned about the confidentiality of your medical records? • Would you prefer to talk to an older/younger, male/female healthcare provider? • Are there medical matters you do not wish to have disclosed to others? What are potential barriers of patient and provider communication? Moments of Tension: Potential Barriers to Communication Curiosity about you. Direct answer. Inform patients that you have similar experience can help alleviate fears, and with further exploration, can help in the identification of the patient’s concerns. It is wise to exercise caution and remain professional in what and how much you disclose. Anxiety. You can help by avoiding an overload of information, pacing the conversation, and presenting a calm demeanor. Silence. Sometimes intimidated by silence, many healthcare providers feel the urge to break it. Be patient and do not force conversation. Silence may also be cultural: for example, some cultural groups take their time, ponder their responses to questions, and answer when they feel ready. Do not push too hard. Be comfortable with silence but give it reasonable bounds. Depression. Being sick or thinking that you are sick can be enough to provoke situational depression. Serious or chronic, unrelenting illness or taking certain medications is often accompanied by depression. A sense of s luggishness in the daily experience; disturbances in sleeping, eating, and social contact; and feelings of loss of self -worth can be clues. In addition to screening for depression at ambulatory visits, pay attention. First ask, when did you start feeling this way? Then ask, “How do you feel about it? Have you stopped enjoying the things you like to do? Do you have trouble sleeping? Have you had thoughts about hurting yourself? Are you depressed? Crying and compassionate moments. Name the emotion; be direct about such a tender circumstance, but gently, not too aggressively or insistently. Do not hesitate to say that you feel for the patient, that you are sorry for something that happened, and that you know it was painful. At times, the touch of a hand or even a hug is in order. Sometimes, a concern - a difficult family relationship, for example - must be confronted. You may have to check an assumption and hope that you have guessed correctly in bringing the patient’s feelings to the surface. If uncertain, ask without presupposing what the response might be. Physical and emotional intimacy. Respect modesty, using covers appropriately without hampering a complete examination. You can keep the necessary from becoming too big an issue by being calm and asking questions with professional poise. Seduction. Delivering the immediate message that the relationship is and will remain professional. Anger. Confront it. It is all right to say, “It seems like you’re angry. Please tell me why. I want to hear. Speak softly and try not to argue the point. Avoiding the full story. Patients may not always tell the whole story or even the truth. Do not push too hard when you think this is happening. Allow the interview to go on and then come

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