taking a Health History: Building a Health History: Asking Difficult Questions
Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.
Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations.
More importantly in today’s society, the possible Social Determinants of Health for each of our patient’s also needs to be taken into consideration
For this Assignment, you will develop a make-believe script to be used when you first encounter a patient for a well woman appointment.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To prepare:
· Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.
· Review the media programs related to a vaginal exam, pap test, and breast exam.
· Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a complete health history. (
Note: You will also find the Health History Form in Chapter 7)
· Provide all the components of a complete gynecologic health history. Include considerations for special populations such as LGBTQ+ individuals.
· What health maintenance guidelines should be included for initial and follow up might be needed for follow-up assessments? (i.e., bone density test, Gardasil vaccine, pap smear, Mammorgram, etc.)?
· Using the 5 areas of the Social Determinants of Health:
(Examples of SDOH include but not limited to)
·
· Safe housing, transportation, and neighborhoods
· Racism, discrimination, and violence
· Education, job opportunities, and income
· Access to nutritious foods and physical activity opportunities
· Polluted air and water
· Language and literacy skills
· SDOH also contribute to wide health disparities and inequities.
· What questions would you consider in your patient’s complete health history?
· Develop your own script for building a complete health history and as you create your script, consider the difficult questions you want to include in your script. There is no sample template to provide to you. (Utilize chapter 7 of your Schuiling textbook to provide guidance). You are the one to develop the script. Think of it as you are writing a movie and you need to write the script for the movie. What lines would you provide for the actor to utilize when sitting down with a patient to perform a COMPLETE Medical History which also entails those DIFFICULT GYN questions. You do not need to provide the answers to the questions however, if you find that beneficial, you may do so.
Assignment: (1- to 2-page reflection)
· In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:
· A brief summary of your experiences in developing and implementing your script during your health history.
· Explanations of what you might find difficult when asking these questions. What you found insightful and what would you say or do differently.
· As a NP, what could you implement in your community to provide resources/assistance of the Social Determinants of Health.
ReminderLinks to an external site.
: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at papers submitted must use this formatting.
By Day 7 of Week 2
Submit your Module 1 Assignment by
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Rubric
NRNP_6552_Module1_Assignment_Rubric
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NRNP_6552_Module1_Assignment_Rubric |
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Criteria |
Ratings |
Pts |
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This criterion is linked to a Learning OutcomeSeparate from the actual script, what are the considerations for special populations such as young women, new mothers, older women, women with disabilities, and LGBTQ+ individuals? Provide health maintenance guidelines that should be included during the initial and follow up assessments. (i.e., bone density test, pap smear, Gardasil (HPV) vaccine, shingles, etc.)? |
30 to >26.7 ptsExcellentThe response provides clear, complete, and all appropriate special considerations. Health maintenance guidelines are clear and complete. 26.7 to >23.7 ptsGoodThe response provides clear, complete, and most of the special considerations. Most health maintenance guidelines are included and appropriate. 23.7 to >20.7 ptsFairThe response provides special considerations but are incomplete, vague or inaccurate. Health maintenance guidelines are somewhat complete or inappropriate applied. 20.7 to >0 ptsPoorThe response provides unclear, incomplete, or inappropriate components . The special considerations and the maintenance guidelines are missing, incorrect, or inappropriate applied. |
30 pts |
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This criterion is linked to a Learning OutcomeBuilding a Health History: Asking Difficult Questions. Create your own script for building a health history. Consider the type of language you would use to help your patient be more comfortable). Ensure you include the difficult questions required to complete a thorough health history. |
25 to >22.3 ptsExcellentThe script contains a complete set of questions, including difficult questions, necessary to build a health history. Questions are phrased in a manner that supports the patients comfort. 22.3 to >19.75 ptsGoodThe script contains a mostly complete set of questions, including difficult questions, necessary to build a health history. Most questions are phrased in a manner that supports the patients comfort. 19.75 to >17.25 ptsFairThe script containing some relevant questions, including a few difficult questions. Information collected provides a cursory health history. Questions are not phrased in a supportive tone. 17.25 to >0 ptsPoorThe script contains few or no relevant questions, including few or no difficult questions. Information collected is not sufficient to provide an adequate health history. Questions are not phrased in a supportive tone. |
25 pts |
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This criterion is linked to a Learning OutcomeIn addition to your script for building a health history for this assignment, include a separate section called “Reflection.” Provide a brief overview of the 5 areas of SDOH for this patient and the questions you would consider. Briefly reflect and provide a summary of your experiences in developing your script during your health history. |
30 to >26.7 ptsExcellentThe response provides information on the SDOH and an accurate, clear, and complete summary of experiences in developing the script during the health history. 26.7 to >23.7 ptsGoodThe response provides information on the SDOH and an accurate summary of experiences in developing the script during the health history. 23.7 to >20.7 ptsFairThe response provides vague information on the SDOH and a vague, inaccurate, or incomplete summary of the experiences in developing the script during the health history. 20.7 to >0 ptsPoorThe response provides a vague, inaccurate, or incomplete SDOH and summary of the experiences in developing the script during the health history, or the summary is missing. |
30 pts |
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This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. |
5 to >4.45 ptsExcellentParagraphs and sentences follow writing standards for flow, continuity, and clarity… A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. 4.45 to >3.95 ptsGoodParagraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time… Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive. 3.95 to >3.45 ptsFairParagraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time… Purpose, introduction, and conclusion of the assignment is vague or off topic. 3.45 to >0 ptsPoorParagraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time… No purpose statement, introduction, or conclusion was provided. |
5 pts |
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This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
5 to >4.45 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 4.45 to >3.95 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 3.95 to >3.45 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 3.45 to >0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
5 pts |
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This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. |
5 to >4.45 ptsExcellentUses correct APA format with no errors. 4.45 to >3.95 ptsGoodContains a few (1 or 2) APA format errors. 3.95 to >3.45 ptsFairContains several (3 or 4) APA format errors. 3.45 to >0 ptsPoorContains many (≥ 5) APA format errors. |
5 pts |
