NURS 6512 – Advance Health Assessment and Diagnostic Reasoning

 

 

Clinical Assessment

Student’s Name:

Institutional Affiliation:

Clinical Assessment

A 55 Year Old Asian Female Living in a High-Density Public Housing Complex

The patient in this scenario is a 55-year-old Asian female living in a high-density poverty housing complex. The first thing I will do is to find out if she understands English. In case she doesn’t, I will make arrangements to have a translator. While interviewing, I need to be competent in the cultural aspect to avoid any actions or words that would be inflicted on her culture. I will be able to do this by maintaining a high level of sensitivity to her heritage, sexual orientation, and social-economic conditions (Aranda, Davies & Jackevicius, 2019). I would also pay attention to her ethnicity and general cultural background.

Communication Techniques

At 55 years is the end of middle-aged adults and the beginning of older adults. That age is a vulnerable time in a person’s healthy life. Considering her place of dwelling, which is a high-density public complex, she may be going through severe social, economic challenges. Such difficulties would make her not easy to open up in most of the conversation (Deckx et al., 2015). Extracting information from a person undergoing such challenges can be quite difficult. At equal measure, it is also essential to provide such information with privacy. Therefore, as a clinician, I will be seeking to get the chief concern for her seeking health care services. If I find, she is not able to open up in the presence of family members, I would request them to step out of the clinic room for further engagement with the patient. I will start my conversation with the patient’s day to day activities.

I will always remember to respect her and gain her trust (Quinn & Gordon, 2015). When faced with silence, I have to recognize that too. However, I will try to figure out if her silence is out of anger, her economic situation, or if she is just unwilling to share. My objective will try to seek out in detail her concerns, by presenting genuine interest and curiosity towards addressing her concerns (Rosenberger & Lachin, 2015). I will use simple and understandable language and avoid any form of confrontation. I will listen keenly to what the patient says. Once I determine the principal concern, I will go on to discuss other sensitive health issues based on the information I gather from her.

Risk Assessment Instrument/Tool

Knowing that older adults have many health risks, and because assessment must be individualized multiple assessment tools will be necessary. I would use self- report information and the clinician-rated scales. The clinician-rated scale will help to conduct a clinically first diagnostic test. The clinical examination will be useful in narrowing down the patient’s conditions and results in proper medication. Besides, patient medical history will help in determining the most appropriate diagnosis (Wright, Tobias & Hickman, 2017). Even though HEEADSSS is for assessing adolescents, I would use it to determine her home environment, employment, eating pattern, and her other daily activities. This assessment tool will play a fundamental role in undertaking the most appropriate diagnosis.

Questions that I would ask

  • How are things at the place of residence?  In terms of pollution from area residence or industries around?
  • How old are you?
  • What type of occupation do you do?
  • What do you expect from this medical visit?
  • Have you taken any medication in the recent past? And if yes what was it?
  • Do you involve yourself in physical exercise?

Such open-ended questions will enable my patient to open up and talk more about areas that are troubling her.

 

References.

Aranda, J. P., Davies, M. L., & Jackevicius, C. A. (2019). Student pharmacists’ performance and perceptions on an evidence-based medicine objective structured clinical examination. Currents in Pharmacy Teaching and Learning11(3), 302-308.

Deckx, L., van den Akker, M., Daniels, L., De Jonge, E. T., Bulens, P., Tjan-Heijnen, V. C. G., Buntinx, F. (2015). Geriatric screening tools are of limited value to predict decline in functional status and quality of life: Results of a cohort study. BMC Family Practice, 16, 1–12. https://doi-org.ezp.waldenulibrary.org/10.1186/s12875-015-0241-x

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