response to discussion
RESPOND To#1: Adolescent Hispanic/Latino boy living in a middle-class suburb.
The adolescent patient in this scenario is a Hispanic adolescent. I will first find out if he understands English. If he does not, I will arrange for an interpreter. It is very important to introduce myself to my patient and family, explaining to them what I will be doing. This allows me to develop rapport and a therapeutic relationship with my patient (Price, 2017). I need to be culturally competent. I can do this by being sensitive to his heritage, sexual orientation, socioeconomic situation, ethnicity, and cultural background (Cuellar et al., 2008).
Communication techniques is important when assessing adolescent for this is the time of life from puberty to maturity. This is the most vulnerable time of a person’s life. Keeping communication clear and formal, and avoiding medical jargon. Most teenagers do not usually open to conversation. Getting information from teenagers can be quite challenging. Privacy is very important when it comes to teenagers. I will get the chief concern from the parent/guardian if present and ask them to step out of the examination room for further investigation from the teenager patient. Providing conducive and comfortable environment will prevent distractions. I will begin the conversation with day-to-day activities in the teenager’s life. This will be done with respect to gain his trust. I must respect his silence as well, I will assess if the silence is due to anger, shame, or just the unwillingness to talk. My primary focus will be to find out the details about his concerns and show good interest and curiosity. I will use language that is understandable by the teenager. I will avoid confrontation. I will listen to what the patient is saying. Once I figure out the chief concern, I can discuss other sensitive issues such as sex, drug, or alcohol use (Ball et al., 2015). Risk Assessment Tool Knowing the fact that adolescents go for risky behaviors, it will be important to assess him for the same. I would use the Home, Education, Eating, Activities, Drugs and Alcohol, Suicide and Depression, Sexuality and Safety Assessment (HEEADSSS) screening tool for adolescent issues for this will help find out more about his home environment, education, employment, eating pattern, his activities, ambitions. I will find out about any drug use, his sexuality, or if he is having any suicidal thoughts and if he is safe from injury and violence (Ball et al., 2015).
I would ask the patient the following questions- how are things at home, how is school going, tell me about your friends, what types of computer and electronic games do you play, and what are you good at doing? This kind of open-ended questions will allow my patient to talk about areas that are troubling him.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel's guide to physical examination (8th ed.) (pp. 1-29). St. Louis, MO: Elsevier Mosby.
Cuellar, N. G., Brennan, A. M., Vito, K., & Siantz, M. L. (2008). Cultural Competence in the Undergraduate Nursing Curriculum. Journal of Professional Nursing, 24(3), 143-149. doi:10.1016/j.profnurs.2008.01.004
Price, B. (2017). Developing patient rapport, trust and therapeutic relationships. Nursing Standard, (50), 52. Retrieved from
https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edsgea&AN=edsgcl.501218919&site=eds-live&scope=site
Wu, R. R., & Orlando, L. A. (2015). Implementation of health risk assessments with family health history: Barriers and benefits. Postgraduate Medical Journal, (1079), 508513
RESPOND To#2: Adolescent Hispanic/Latino health history
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Introduction
Examine communication techniques used to obtain patient's health histories based upon social determinant of health for adolescent Hispanic /Latino boy living in a middle class suburb.
Therapeutic communication is essential tools to assess information from a patient especially adolescent group. Nurse practitioner must receive adolescent with warm reception to the examine room, provide a private communication and assessment in the room alone without the parent if accompanied by parent the privacy will alone adolescent to express his mind and communicate well with nurse practitioner. check patient vital signs, , height and weight to assess the patient health condition and past health history .
Social determinants related to Hispanic /Latino boy living in a middle class -suburb. According to the American Academy of family physicians define social determinants as the conditions under which people are born , grown , live , work and age, risk factors include socioeconomic status, racism and discrimination, poverty and income inequality (M.Marmot ,2018) Numerous studies suggest that social determinant of health account for between 30- 55% of health outcomes (M. Marmot , 2018) there is up to 20 years of gap in life expectancy between the counties with the lowest and highest life expectancy in the US.(M.Marmot 2018)
Reference to the social determinant scale the Hispanic boy fall under middle age which means the health condition will be assess in relation to middle class, I will use open ended question strategies and Yes or no question techniques. I will ask question on the health history , medical history, family history, education, sport in the school, smoking, drugs, sex, immunization. and if any concern in the community that can be share and provide resources available in the community .
I will use electronic health records to document interviews , assessment and vitals signs of the patient and escort the patient out of the examine room.
References
M.Marmot (2018) Addressing social determinant of health in primary care: Determine the method of communication to be used during the patient encounter.
http//: www.aafp.org
American Academy of family physicians (2018) Social determinant of health policy
https://aafp.org/aboutpolicies/all/social-determinants.html
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