Health03

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©2024 Walden University 1

Health Assessment XH3003: Health History Across the Lifespan

Competency Assessment: When Taking a Health History Is a Challenge

Student Name: Date:

Use this template to record your response to each avatar scenario at Neighborhood Clinic, the fictional community health center, as you address communication challenges and identifying priority information. Base your responses on the Mursion interactive media, Learning Resources, and other resources you identify. Your completed document should be 4–5 pages plus a reference page.

Scenario 1: Health History for a Young Child

Archie, age 7, and his father, Gabriel Moore

· Analyze this scenario for the specific challenges presented in gathering a patient health history of a young child.

· What communication skills does a nurse need in this situation with a parent and young child? Include specific examples based on emotional intelligence.

· Explain your specific goals with this parent and child in terms of obtaining a health history.

· What information would be a priority to obtain, and why?

· Thinking about the situation in the examining room at the end of the scenario, what would be your next steps to get the information you need to make a health assessment of this child? Explain your reasoning.

Scenario 2: Health History for an Adolescent

Jasmine Walker, age 14

· Analyze this scenario for the specific challenges presented in gathering a patient health history of an adolescent.

· What communication skills does a nurse need in this situation with an adolescent? Include specific examples based on emotional intelligence.

· Explain your specific goals with this patient in terms of obtaining a health history.

· What information would be a priority to obtain, and why?

· Thinking about the situation in the examining room at the end of the scenario, what would be your next steps to get the information you need to make a health assessment of this adolescent? Explain your reasoning.

Scenario 3: Health History for an Older Adult

Colleen Hart, age 76

· Analyze this scenario for the specific challenges presented in gathering a patient health history of an older adult.

· What communication skills does a nurse need in this situation with an older adult? Include specific examples based on emotional intelligence.

· Explain your specific goals with this patient in terms of obtaining a health history.

· What information would be a priority to obtain, and why?

· What information would be a priority to obtain from the adult stepson if he joined the appointment, and why?

· Thinking about the situation in the examining room at the end of this scenario, what would be your next steps to get the information you need to make a health assessment of this older adult? Explain your reasoning.

References

All references must be in APA style.

© 2024 Walden University, LLC Page 3 of 3

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Assessment:

When Taking a Health History Is a Challenge

Recall some of your most challenging patients for gathering a health history. If you include a crying young child with a distracted parent, a moody adolescent, or an older adult with perhaps something to hide—or maybe all three—get ready to revisit those patients for this Assessment. The setting is Neighborhood Clinic, a fictional community health center. The avatar clinic director, Asha Gill, will introduce and conclude each scenario. You will engage with the following avatar patients:

· Archie, age 7, and Gabriel Moore, his father, who are making a first visit to the clinic because a very miserable Archie is sick

· Jasmine Walker, age 14, at the clinic for a high school physical but without her mother, who has previously accompanied her to appointments

· Colleen Hart, age 76, whose stepson may join the appointment, much to her resistance 

Each scenario presents a distinct situation for the professional nurse and involves applying emotional intelligence and knowledge of health history information to gather for each patient. 

To prepare:

· Access the Health History Challenges template document and review the requirements of this Assessment.

· View the video of each scenario as many times as you need. You are encouraged to take notes for details to support your analysis of each scenario. Keep these questions in mind as you view and analyze each scenario:

· What health history information is needed?

· What questions would you ask to obtain it?

· How would you demonstrate emotional intelligence to win trust?

· What may be presenting as a specific problem or need?

· Compete the Assessment based on the interactive media, other Learning Resources, and any additional resources you identify.

To complete the Competency Assessment:

Use the Health History Challenges template document to record your responses for each scenario. Your submitted document should be 4–5 pages plus a reference page. You should address the following:

Click each of the items below for more information on this Assessment.

Scenario 1: Health History for a Young Child

Archie, age 7, and his father, Gabriel Moore

· Analyze Scenario 1 for the specific challenges presented in gathering a patient health history of a young child.

· What communication skills does a nurse need in this situation with a parent and young child? Include specific examples based on emotional intelligence.

· Explain your specific goals with this parent and child in terms of obtaining a health history.

· What information would be a priority to obtain for a health history of this child, and why?

· Thinking about the situation in the examining room at the end of Scenario 1, what would be your next steps to get the information you need to make a health assessment of this child? Explain your reasoning.

Scenario 2: Health History for an Adolescent 

Jasmine Walker, age 14

· Analyze Scenario 2 for the specific challenges presented in gathering a patient health history.

· What communication skills does a nurse need in this situation with an adolescent? Include specific examples based on emotional intelligence.

· Explain your specific goals with this adolescent in terms of obtaining a health history.

· What information would be a priority to obtain, and why?

· Thinking about the situation in the examining room at the end of Scenario 2, what would be your next steps to get the information you need to make a health assessment of this adolescent? Explain your reasoning.

Scenario 3: Health History for an Older Adult 

Colleen Hart, age 76

· Analyze Scenario 3 for the specific challenges presented in gathering a patient health history.

· What communication skills does a nurse need in this situation with an older adult? Include specific examples based on emotional intelligence.

· Explain your specific goals with this older adult in terms of obtaining a health history.

· What information would be a priority to obtain, and why?

· What information would be a priority to obtain from the adult stepson if he joined the appointment, and why?

· Thinking about the situation in the examining room at the end of Scenario 3, what would be your next steps to get the information you need to make a health assessment of this older adult? Explain your reasoning.

Pre-Assessment

Belkis Pacheco Santiago

Walden University

Health History Across the Lifespan

Dr Sara Cano

10/01/2024

Scenario 1: Young Child

Challenges in Gathering a Health History of a Young Child

The big issue in Scenario 1 is the communication between the child and the parent. Children like Archie may be scared and anxious or unable to identify their feelings. Children might not be clear about what they are trying to be asked or explain how they are feeling, which can be challenging when trying to take a health history(Brennan & McElvaney, 2020). Additionally, they may be rebellious about the nurse's mode of questioning and even show dispositions against talking, as Archie insists that he wants to go home. This puts tension on the parent, who will most likely feel distressed; distress would also make them not provide the necessary information with high levels of clarity and accuracy.

Communication Skills Needed by the Nurse

To communicate well, the nurse needs emotional intelligence, patience, empathic listening, and attachment to a child and parent. Consequently, the nurse may comfort a child by saying, "I know you are not feeling well, but we are here to make you feel better." This would build child trust and lessen anxiety. Supportive arts like active listening and reflecting on parents' concerns create a supportive environment (Levy & Adjapong, 2020). She might add, "I understand it has been stressful for both of you, but we are going to work together to make Archie feel better." Emotional intelligence includes knowing when a youngster is too distraught to respond and when critical information must be delivered directly to the parent.

Goals in Obtaining a Health History

Specific nursing goals for this scenario include getting complete information about the child's symptoms, including how often and how bad the fever and breathing difficulties have been while causing the child the least distress. Making the parent feel understood and cared for is important in getting a correct history. In addition, the nurse must prioritize establishing trust with both the child and the parent for easier interactions later on.

Scenario 2: Adolescent

Challenges in Gathering a Health History of an Adolescent

In adolescents like Jasmine, challenges stem from their stage of life. Teens may find it difficult to divulge information, especially if it involves mental health or private portions of their body. They may feel ashamed, nervous, and unable to describe their anxiety. Finding a balance between privacy and disclosure of vital adolescent health information is difficult for the nurse.

Communication Skills Needed by the Nurse

Communicating with teens requires emotional intelligence. The nurse should show empathy and develop a connection by noting the adolescent's pressures, like when she quotes Jasmine about high school being "pressure." Validation, active listening, and open-ended inquiries help adolescents relax. How about "Can you tell me more about what makes you nervous about high school?" This helps teens open up without judgment. Honest conversation requires confidence and a safe, non-judgmental setting.

Goals in Obtaining a Health History

The nurse's goal is to make the environment comfortable enough for the adolescent to discuss physical and emotional concerns. Trust and confidentiality are important when trying to obtain accurate and complete information. The nurse should be able to evaluate physical health and emotional/psychological stressors that can impact overall well-being.

Scenario 3: Older Adult

Challenges in Gathering a Health History of an Older Adult

Other complications with elderly individuals like Colleen include cognitive impairment, hearing and vision problems, which make communication difficult, and the presence of a caregiver or any family member. The tendency of the elderly to minimize symptoms or not report them is because they are afraid of a diagnosis that may involve serious illness, or they have gotten used to it that they have accepted many health problems as part of life. This may sometimes be dominated by family members who give a history that may not be wholly accurate or complete from the patient's perspective.

Communication Skills Needed by the Nurse

A nurse should be patient, listen intently, and empathize with an older patient. For instance, addressing the patient before the son arrives respects her autonomy. The nurse may say, "I know your son is arriving, but let me begin by asking you to describe how you have been feeling for the last year." The nurse should speak clearly and frequently check for comprehension. Emotional intelligence helps create discomfort and reluctance to recognize when to change the interview direction.

Goals in Obtaining a Health History

The nurse's goals in communicating with the older adult include eliciting as much appropriate information as possible regarding the patient's health while maintaining patient autonomy and ensuring the older adult remains in control of the conversation (Glomsås et al., 2022). Family members or caregivers should be involved to a helpful degree but not dominating the older adult's views.

References

Brennan, E., & McElvaney, R. (2020). What Helps Children Tell? A Qualitative Meta-Analysis of Child Sexual Abuse Disclosure. Child Abuse Review, 29(2). https://doi.org/10.1002/car.2617

Glomsås, H. S., Knutsen, I. R., Fossum, M., Christiansen, K., & Halvorsen, K. (2022). Family caregivers’ involvement in caring for frail older family members using welfare technology: a qualitative study of home care in transition. BMC Geriatrics, 22(1). https://doi.org/10.1186/s12877-022-02890-2

Levy, I. P., & Adjapong, E. S. (2020). Toward Culturally Competent School Counseling Environments: Hip-Hop Studio Construction. Professional Counselor, 10(2), 266–284. https://eric.ed.gov/?id=EJ1259697