NR 509 Midterm Exam Study Guide

NRI509IMidtermIStudyIGuideIWeekI3 Ch. I1 ● BasicIandIAdvancedIInterviewingITechniques BasicInterviewingITechniques ● ActiveIlistening:IActiveIlisteningImeansIcloselyIattendingItoIwhatIthe IpatientIisIcommunicating,I ...

NRI509IMidtermIStudyIGuideIWeekI3 Ch. I1 ● BasicIandIAdvancedIInterviewingITechniques BasicInterviewingITechniques ● ActiveIlistening:IActiveIlisteningImeansIcloselyIattendingItoIwhatIthe IpatientIisIcommunicating,IconnectingItoItheIpatient'sIemotionalIstate,Iand IusingIverbalIandInonverbalIskillsItoIencourageItheIpatientItoIexpandIon IhisIorIherIfeelingsIandIconcerns. EmpathicIresponses:IEmpathyIhasIbeenIdescribedIasItheIcapacityIto IidentifyIwithItheIpatientIandIfeelItheIpatient'sIpainIasIyourIown,Ithen IrespondIinIaIsupportiveImanner. GuidedIquestioning:IGuidedIquestionsIshowIyourIsustainedIinterestIin ItheIpatient'sIfeelingsIandIdeepestIdisclosuresIandIallowsItheIinterviewer ItoIfacilitateIfullIcommunication,IinItheIpatient'sIownIwords,Iwithout Iinterruption. NonverbalIcommunication:INonverbalIcommunicationIincludesIeye Icontact,IfacialIexpression,Iposture,IheadIpositionIandImovementIsuchIas IshakingIorInodding,IinterpersonalIdistance,IandIplacementIofItheIarmsIor Ilegs—crossed,Ineutral,IorIopen. Validation:IValidationIhelpsItoIaffirmItheIlegitimacyIofItheIpatient'sIemotional Iexperience. Reassurance:IReassuranceIisIanIappropriateIwayItoIhelpItheIpatientIfeelIthat IproblemsIhaveIbeenIfullyIunderstoodIandIareIbeingIaddressed. Partnering:IWhenIbuildingIrapportIwithIpatients,IexpressIyourIcommitment ItoIanIongoingIrelationship. Summarization:IGivingIaIcapsuleIsummaryIofItheIpatient'sIstoryIduring ItheIcourseIofItheIinterviewItoIcommunicateIthatIyouIhaveIbeenIlistening Icarefully. Transitions:IInformIyourIpatientIwhenIyouIareIchangingIdirectionsIduringIthe Iinterview. EmpoweringItheIpatient:IEmpowerIpatientsItoIaskIquestions,IexpressItheir Iconcerns,IandIprobeIyourIrecommendationsIinIorderItoIencourageIthem ItoIadoptIyourIadvice,ImakeIlifestyleIchanges,IorItakeImedicationsIas Iprescribed. AdvancedIInterviewITechniques 2 DetermineIscopeIofIassessment:IFocusedIvs.IComprehensive: Comprehensive:IUsedIpatients IyouIareIseeingIforItheIfirstItime IinIthe Ioffice Ior Ihospital.IIncludesIallItheIelementsIofItheIhealthIhistoryIandIcompleteIphysical Iexamination. IsIappropriateIforInewIpatientsIinItheIofficeIorIhospital ProvidesIfundamentalIandIpersonalizedIknowledgeIaboutItheIpatient IStrengthensItheIclinician–patientIrelationship IIHelpsIidentifyIorIruleIoutIphysicalIcausesIrelatedItoIpatientIconcernsIProvides IaIbaselineIforIfuture Iassessments CreatesIaIplatformIforIhealthIpromotionIthroughIeducationIandIcounseling IDevelopsIproficiencyIinItheIessentialIskillsIofIphysicalIexamination Focused:IForIpatientsIyouIknowIwellIreturningIforIroutineIcare,IorIthoseIwith IspecificI“urgentIcare” IconcernsIlikeIsoreIthroatIorIkneeIpain.IYouIwillIadjust ItheIscopeIofIyourIhistoryIandIphysicalIexaminationItoItheIsituationIatIhand, IkeepingIseveral Ifactors IinImind:Ithe Imagnitude IandIseverity IofItheIpatient’s Iprob-Ilems;ItheIneedIforIthoroughness;ItheIclinicalIsetting—inpatientIor Ioutpatient,IprimaryIorIsubspecialtyIcare;IandItheItimeIavailable. IsIappropriateIforIestablishedIpatients,IespeciallyIduringIroutineIorIurgent Icare Ivisits AddressesIfocusedIconcernsIorIsymptoms Assesses Isymptoms Irestricted Ito Ia Ispecific Ibody Isystem AppliesIexaminationImethodsIrelevantItoIassessingItheIconcernIorIproblemIas Ithoroughly IandIcarefullyIas Ipossible BeingIawareIofIyourIreactionsIhelpsIdevelopIyourIclinicalIskills. YourIsuccessIinIelicitingItheIhistoryIfromIdifferentItypesIofIpatientsIgrowsIwith Iexperience,IbutItakeIintoIaccountIyourIownIstressors,IsuchIasIfatigue,Imood,Iand Ioverwork. Self-careIisIalsoIimportantIinIcaringIforIothers.IEvenIifIaIpatientIisIchallenging, IalwaysIrememberItheIimportanceIofIlisteningItoItheIpatientIandIclarifyingIhisIor IherIconcerns. ComponentsIof ItheIHealthIHistory Initial Iinformation DateIandItimeIof Ihistory-timeIisIespeciallyIimportant IinIemergent Isituations IdentifyingIdata-age, Igender, Imarital Istatus, Ioccupation-identifyIsourceIof IhistoryIie: Ifamily Imember, IfriendIetc. Reliability-usuallyIdocumentedIat IendIof IinterviewIie: I“patient IisIvagueIwhenIdescribing Isymptoms”. Chief IComplaint(s) TryItoIquoteItheIpatientsIwords IPresent IIllness Complete, IclearIandIchronological IdescriptionIof ItheIproblemIpromptingItheIpatient Ivisit IOnset, IsettingIinIwhichIit Ioccurred, ImanifestationsIandIanyItreatments 3 ShouldIincludeI7IattributesIof IaIsymptom: Location IQuality QuantityIorIseverity Timing, Ionset,Iduration, Ifrequency ISettingIinIwhichIit Ioccurs IAggravatingIorIrelievingIfactors IAssociatedImanifestations Differential IdiagnosisIisIderivedIfromItheI“pertinent Ipositives”IandI“pertinent Inegatives” IwhenIdoingIReviewIof ISystemsIthat IareIrelevant ItoItheIchief Icomplaint. Present IillnessIshouldIreveal Ipatient’sIresponsesItoIhisIorIherIsymptomsIandIwhat Ieffect Ithis IhasIonItheirIlife. EachIsymptomIneedsIitsIownIparagraphIandIaIfull Idescription. MedicationIshouldIbeIdocumented, Iname, Idose,Iroute, IandIfrequency. IHomeIremedies,InonIprescriptionsIdrugs, Ivitamins, Imineral IorIherbal Isupplem