NURS 6512 Week 2 Discussion Post

When it comes to the advanced practitioner, every patient encounter necessitates a strategic approach to effectively gather pertinent and reliable information. Multiple variables must be considered, including gender, race, religion, socioeconomic status, culture, age, education, understanding level, and others. Let’s consider the scenario: JC, an at-risk 86-year-old Asian male, depends on his daughter both financially and physically. However, his daughter, a single mother, has limited time and resources for her father’s healthcare needs. JC has a medical history of hypertension (HTN), gastroesophageal reflux disease (GERD), B12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. During his annual exam, he mentions, “I came for my annual physical exam, but do not want to be a burden to my daughter.”

Constructing a Comprehensive Health History for the Patient

Building a health history requires the practitioner to conduct an interview, gathering information without causing offense, while simultaneously displaying empathy and competence to earn the patient’s trust. The patient’s history, along with their statement about not wanting to burden their daughter, offers valuable insights that can guide the interview process.

Addressing Communication Challenges with Specific Populations

The Asian American population is growing in the United States, and many older Asian Americans may prioritize their cultural beliefs and heritage over traditional “Western” medicine. Practitioners must consider each patient’s beliefs when conducting interviews, particularly within the Asian American population. Research indicates that as Asian American patients perceive increased cultural sensitivity from their healthcare providers, their trust in providers and adherence to treatment also improve (Kang et al., 2016). Therefore, it is crucial to ensure that older patients understand why they are taking prescribed medications, tailoring education to their individual health literacy levels. NURS 6512 Week 2 Discussion Post

Five Targeted Questions

JC, as an older Asian male with limited resources and multiple medications, requires careful attention to maintain his baseline health status without burdening his daughter. The following five questions focus on the lack of support and JC’s concerns:

1. Can you obtain your medications? This broad question helps identify potential barriers such as transportation, financial constraints, and educational opportunities to discuss the importance of each medication. It opens the door to addressing any obstacles the patient may face in adhering to the prescribed medication schedule. If JC receives injections, the practitioner can ensure he knows the proper technique or assess if he requires assistance. Social work intervention can be considered to assist with reducing prescription costs.
2. You mentioned feeling like a burden to your daughter. What leads you to make that statement? This question explores the emotions underlying JC’s perception of burden. It provides an opportunity to gain insight into his relationship with his daughter, detecting signs of abuse or neglect. The practitioner can also assess JC for symptoms of depression and ensure his safety upon leaving the office, considering the relatively high prevalence of attempted suicide in the elderly with certain mental symptoms (Zhang et al., 2017).
3. Who prepares your meals? This question aims to ensure that JC or his caregiver meets his nutritional requirements for maintaining good health. If JC is unable to cook or prepare meals for himself, appropriate resources and meal supplements can be recommended. NURS 6512 Week 2 Discussion Post
4. Are you taking any herbal supplements? Many patients overlook the fact that herbal remedies are considered medications. This question helps identify potential interactions between herbal supplements and prescribed medications. For example, Asian ginseng (P. ginseng) has been shown to induce CYP3A4, potentially decreasing the effectiveness of certain drugs (Zhang et al., 2017). A comprehensive health interview should cover all therapies used to address the patient’s health.
5. Is there anything else you would like to discuss? This open-ended question allows JC to raise any additional concerns or ask questions that were not previously addressed. Providing the patient with a platform to express themselves fosters effective communication and allows the practitioner to address any remaining issues.

Conclusion

When conducting interviews, practitioners must consider all variables and potential barriers specific to each patient. Interviews should be conducted professionally and tailored to the patient’s health literacy level. It is essential to incorporate evidence-based practice guidelines and make clinical decisions based on high-quality scientific evidence and clinical judgment (Dains et al., 2019). Understanding the cultural and spiritual needs of the patient helps build rapport and establish trust. Although a practitioner may have a well-prepared game plan for the interview, they must be flexible and adapt their approach based on the patient’s individual disposition. NURS 6512 Week 2 Discussion Post

References

Kang, S., Tucker, C. M., Wippold, G. M., Marsiske, M., & Wegener, P. H. (2016). Associations among perceived provider cultural sensitivity, trust in provider, and treatment adherence among predominantly low-income Asian American patients. Asian American Journal of Psychology, 7(4), 295.

Zhang, W., Ding, H., Su, P., Xu, Q., Du, L., Xie, C., … Tian, W. (2017). Prevalence and risk factors for attempted suicide in the elderly: a cross-sectional study in Shanghai, China. International Psychogeriatrics, 29(5), 709–715.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.