Podcast
Questions and Answers
Which action exemplifies the initial step in the pre-interaction phase of a patient interview?
Which action exemplifies the initial step in the pre-interaction phase of a patient interview?
- Asking the patient about their preferred name.
- Introducing yourself to the patient by name.
- Reviewing the patient's current medication list. (correct)
- Stating the purpose of the interview to the patient.
What is the MOST important aspect of ensuring patient privacy during the beginning phase of an interview?
What is the MOST important aspect of ensuring patient privacy during the beginning phase of an interview?
- Closing doors or pulling drapes in the healthcare setting. (correct)
- Explaining the limitations of confidentiality to the patient.
- Postponing sensitive discussions until the patient feels more comfortable.
- Inquiring about the patient's preferred topics of discussion.
What is the primary goal when a nurse employs open-ended questions during the working phase of a patient interview?
What is the primary goal when a nurse employs open-ended questions during the working phase of a patient interview?
- To keep the interview brief and focused on critical issues.
- To obtain specific 'yes' or 'no' answers efficiently.
- To allow the patient to express health practices in their own words. (correct)
- To guide the patient toward predetermined diagnostic conclusions.
What is the key action a nurse should take during the closing phase of a patient interview?
What is the key action a nurse should take during the closing phase of a patient interview?
Which element is NOT a component of a suitable interview environment?
Which element is NOT a component of a suitable interview environment?
What role does 'therapeutic communication' play during patient interviews?
What role does 'therapeutic communication' play during patient interviews?
How does 'active listening' primarily benefit the therapeutic communication process?
How does 'active listening' primarily benefit the therapeutic communication process?
What is the essential element of empathy in therapeutic communication?
What is the essential element of empathy in therapeutic communication?
Which guideline applies to asking questions during a patient interview?
Which guideline applies to asking questions during a patient interview?
What should the nurse avoid when formulating questions for a patient interview?
What should the nurse avoid when formulating questions for a patient interview?
Why is it important for a nurse to 'take their time' during a patient interview?
Why is it important for a nurse to 'take their time' during a patient interview?
What is the MOST effective nonverbal technique a nurse can use to show approval and encourage a patient to continue speaking during an interview?
What is the MOST effective nonverbal technique a nurse can use to show approval and encourage a patient to continue speaking during an interview?
Which action best demonstrates a nurse's use of empathy when a patient expresses feeling sad about their diagnosis?
Which action best demonstrates a nurse's use of empathy when a patient expresses feeling sad about their diagnosis?
In the context of health history, what is considered the primary data source?
In the context of health history, what is considered the primary data source?
What information is required when collecting demographic data during a health history interview?
What information is required when collecting demographic data during a health history interview?
When documenting the 'reason for seeking care', what approach should the nurse use?
When documenting the 'reason for seeking care', what approach should the nurse use?
When gathering information about a patient's current medications, what should the nurse ensure to document?
When gathering information about a patient's current medications, what should the nurse ensure to document?
What is the primary purpose of reviewing a patient's family history during a health assessment?
What is the primary purpose of reviewing a patient's family history during a health assessment?
In the context of functional health assessment, what does 'health perception/health management' primarily explore?
In the context of functional health assessment, what does 'health perception/health management' primarily explore?
When conducting a review of systems, what approach should the nurse follow to ensure comprehensive data collection?
When conducting a review of systems, what approach should the nurse follow to ensure comprehensive data collection?
During a Review of Systems questioning, the nurse asks the patient, 'Have you had any pain or pressure sensations in your chest, neck, or arm?' What condition is the nurse trying to gather more information about?
During a Review of Systems questioning, the nurse asks the patient, 'Have you had any pain or pressure sensations in your chest, neck, or arm?' What condition is the nurse trying to gather more information about?
A patient is describing their symptoms related to pain. Which of the following details would fall under the 'intensity' category of the History of Present Illness?
A patient is describing their symptoms related to pain. Which of the following details would fall under the 'intensity' category of the History of Present Illness?
A patient-centered approach acknowledges which of the following as the primary source of information?
A patient-centered approach acknowledges which of the following as the primary source of information?
During a health interview, a patient mentions, 'I feel like my heart is racing sometimes for no reason.' Which follow-up question would best explore the 'alleviating factors' related to this symptom?
During a health interview, a patient mentions, 'I feel like my heart is racing sometimes for no reason.' Which follow-up question would best explore the 'alleviating factors' related to this symptom?
Which of the following is the MOST effective way to handle confusion in the sequence of events during a patient's health story?
Which of the following is the MOST effective way to handle confusion in the sequence of events during a patient's health story?
According to the provided information, what percentage of communication is attributed to facial expressions and tone of voice?
According to the provided information, what percentage of communication is attributed to facial expressions and tone of voice?
What should the nurse do if there is any confusion about a medication the patient states they are taking?
What should the nurse do if there is any confusion about a medication the patient states they are taking?
Which of the following questions is MOST appropriate for initiating a discussion about a patient's 'Reason for Seeking Care'?
Which of the following questions is MOST appropriate for initiating a discussion about a patient's 'Reason for Seeking Care'?
During a patient interview, the nurse asks, 'Have you had any sudden blackouts without any complaints?' Which body system is the nurse assessing with this question?
During a patient interview, the nurse asks, 'Have you had any sudden blackouts without any complaints?' Which body system is the nurse assessing with this question?
Which of the following best describes 'Functional Health Assessment'?
Which of the following best describes 'Functional Health Assessment'?
When gathering a patient's past health history, what information is MOST essential for the nurse to obtain?
When gathering a patient's past health history, what information is MOST essential for the nurse to obtain?
Which approach demonstrates the nurse’s understanding of nonverbal communication during an interview?
Which approach demonstrates the nurse’s understanding of nonverbal communication during an interview?
To effectively show that you are listening to the details of a patient's complex medical history, what strategy demonstrates 'active listening'?
To effectively show that you are listening to the details of a patient's complex medical history, what strategy demonstrates 'active listening'?
Which of the following actions demonstrates facilitation to encourage elaboration?
Which of the following actions demonstrates facilitation to encourage elaboration?
Which of the following exemplifies a violation of proper question-asking techniques during a patient interview?
Which of the following exemplifies a violation of proper question-asking techniques during a patient interview?
What communication technique involves a nurse in being able to see and feel a situation from the patient's perspective?
What communication technique involves a nurse in being able to see and feel a situation from the patient's perspective?
After the interview, what should you do with the documentation if possible?
After the interview, what should you do with the documentation if possible?
If the patient feelings are sad what should the nurse do?
If the patient feelings are sad what should the nurse do?
Which best describes how a nurse should ask the patient questions?
Which best describes how a nurse should ask the patient questions?
What might irregularities or stuttering in a heartbeat indicate?
What might irregularities or stuttering in a heartbeat indicate?
If a patient stops talking during an interview, what kind of question can be asked to keep them talking?
If a patient stops talking during an interview, what kind of question can be asked to keep them talking?
During an Interview, what posture should the interviewer maintain?
During an Interview, what posture should the interviewer maintain?
During which phase of the interview process does the nurse collect data from the medical record and review the patient's history?
During which phase of the interview process does the nurse collect data from the medical record and review the patient's history?
A nurse discusses neutral topics with a patient during the health interview. Which phase of the interview is this MOST likely to occur?
A nurse discusses neutral topics with a patient during the health interview. Which phase of the interview is this MOST likely to occur?
During which phase of the interview process is summarizing MOST appropriate?
During which phase of the interview process is summarizing MOST appropriate?
When asking questions during a patient interview, what is MOST important for the nurse to ensure?
When asking questions during a patient interview, what is MOST important for the nurse to ensure?
Which component of the health history involves collecting the patient's name, age, gender, and marital status?
Which component of the health history involves collecting the patient's name, age, gender, and marital status?
When documenting the patient's 'Reason for Seeking Care,' which approach is MOST suitable?
When documenting the patient's 'Reason for Seeking Care,' which approach is MOST suitable?
During the 'History of Present Illness,' what is the purpose of asking open-ended questions?
During the 'History of Present Illness,' what is the purpose of asking open-ended questions?
When exploring the 'History of Present Illness' related to pain, assessing the alleviating factors helps to understand what?
When exploring the 'History of Present Illness' related to pain, assessing the alleviating factors helps to understand what?
In the context of collecting data about a patient's current medications, what is the MOST important action for the nurse?
In the context of collecting data about a patient's current medications, what is the MOST important action for the nurse?
During a 'Review of Systems,' what is the appropriate method for a nurse to approach questioning?
During a 'Review of Systems,' what is the appropriate method for a nurse to approach questioning?
Flashcards
Pre-interaction phase
Pre-interaction phase
The phase where the nurse collects data and reviews the patient's history before meeting them.
Beginning phase
Beginning phase
Phase where the nurse introduces herself, states the interview purpose, and asks the patient's preferred name.
Working phase
Working phase
Phase where nurse asks specific questions to meet to elicit appropriate responses.
Closing phase
Closing phase
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Closed-ended questions
Closed-ended questions
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Open-ended questions
Open-ended questions
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Summarizing
Summarizing
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Active listening
Active listening
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Empathy
Empathy
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Focusing
Focusing
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Primary data source
Primary data source
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Secondary data source
Secondary data source
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Demographical data
Demographical data
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Reason for seeking care
Reason for seeking care
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History of past illness
History of past illness
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Past health history.
Past health history.
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Medications for indications
Medications for indications
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Family history
Family history
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Functional health assessment
Functional health assessment
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System's review.
System's review.
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Study Notes
- Istinye University was established in 2015 by the 21st Century Anadolu Foundation.
- MLPCare Group's 25 years of knowledge and experience led to the university's founding.
- Istinye University aims to be among the distinguished universities in Turkey and worldwide.
- The vision is based around being a science and research centre.
- The curriculum provides a broad-based education.
- The curriculum covers technology and art.
- The curriculum provides an environment of learning and progress.
Health Story Collection
- Health story collection is a first step for patient assessment.
Interview Process Phases
- Pre-interaction
- Beginning
- Working
- Closing
Pre-interaction Phase
- The nurse collects data from the medical record before meeting the patient.
- This includes reviewing the medical history, surgeries, current medications, and problem lists.
Beginning Phase
- The nurse introduces themselves by name in the beginning phase.
- The purpose of the interview is stated.
- The patient is asked for their preferred name.
Beginning Phase Continued
- The beginning phase may continue with neutral discussion if the patient seems anxious.
- Ensuring privacy by pulling drapes or closing doors is essential.
- Following confidentiality guidelines is also essential.
Working Phase
- During the working phase the nurse asks specific questions.
- Each question elicits appropriate responses.
- Closed-ended questions have "yes" or "no" answers.
- An example closed-ended question is, "Do you have a family history of heart disease?"
- Open-ended questions are broad and provide responses in the patient’s own words. Examples of open-ended questions include:
- "What is the reason to continue using cigarette?"
- "What do you think about your problems?"
Closing Phase
- The nurse ends the interview by summarizing what's been said.
- They also state the two or three most important patterns of problems.
- Patients will asked if they would like to mention anything else.
- The nurse thanks patients and family for their time.
Summary: Interview Process
- Managing time appropriately.
- Interview environment should be suitable, including privacy, seating, lightning, and temperature.
- The nurse introduces themselves.
- The nurse should explain the interview's purpose.
- Good communication
- Should accurately record sufficient amount of patient history
- Keep records after the interview
Health Story Collection Continued
- Trust between the nurse and the patients needs to be established while taking history.
- Through therapeutic communication, the patient and nurse work together to resolve problems through solutions
- Developing interviewing capabilities will make conversation more comfortable with smooth transitions between questions.
- Establishing trust is most important.
Therapeutic Communication Techniques
- Therapeutic communication makes it easier for the individual to talk about their feelings and thoughts.
- Therapeutic communication techniques keeps communication open.
- Active listening involves focusing on patients and their perspectives.
- Encouraging elaboration assists patients to more completely describe problems and shows the nurse is interested.
- Empathy is the ability to perceive understanding of another person’s feelings without criticism.
- Nurses should see and feel the situation from the patient’s perspective, not their own.
Examples of therapeutic communication
- 12-year-old child: "I am not given any say in the family, no one listens to me."
- Therapeutic response: "It makes you sad that they don't give you a say in the family, you want them to value you and listen to you."
Therapeutic Communication Examples
- Facilitation-Support.
- Using silence.
- Confirm.
- Clarification.
- Explanation.
Question Types
- Open-ended questions
- Closed-ended questions
Asking Questions Considerations
- Be understandable
- Clarify the situation
- Questions extract the details
- It should not satisfy curiosity
- Do not ask more than one question at a time
- The answer to the question should not be there
General Principles of Story Taking 1
- Start with open-ended questions
- Ask specific and narrow questions for a differential diagnosis
- Take your time when interviewing
- If the interviewee stops talking, ask questions that will keep them talking.
- You can ask, "what else do you have."
- Maintain eye contact to appear open, show your openness with body posture
General Principles of Story Taking 2
- Show that you approve with your head gesture (at the appropriate time)
- Give patient the opportunity to express herself/himself by staying silent
- Briefly summarize what he/she is saying when the patient takes a break.
- Continue to listen actively and ensure the accuracy of what is said.
- Generate a list by extracting complaints.
- In case of confusion, clarify the sequence of events by talking about the same thing again
General Principles of Story Taking 3
- If the patient's feelings are obvious, say "you look sad, I understand that, it's annoying," and indicate that you understand
- If they have complaints, ask them about them
- Address all the patient's problems and support them
Nonverbal Communication
- "It’s not what you say but how you say it."
- Nonverbal behaviors can send messages
Nonverbal Communication examples
- The tone of voice
- Facial expressions
- Hand gestures
- How a person paces speech.
- Eye contact
- Body posture
- Physical appearance
Communication Process
- Facial expressions and tone of voice account for 93% of communication.
- Words account for 7% of the communication process.
Overview: Health History
- Take health histories and collect subjective data.
- Assess health status and provide therapeutic communication.
The Elements of a Comprehensive Health History
- Sources
- Components
Sources
- The individual patient is the primary data source.
- Charts and family members are secondary data sources.
Health History Components
- Demographical Data
- Reason for Seeking Care
- History of Present Illness
- Past Health History
- Current Medications and Indications
- Family History
- Functional Health Assessment Review of Systems
Demographical Data
- Name, age, and gender
- Educational status, marital status (whom they live with)
- Address, employment, income, and insurance details
Reason for Seeking Care
- This is a brief statement in the patient’s own words
- It should establish why he or she is making the visit (coming to the hospital)
- Example questions:
- "Tell me why you came to the clinic today”
- "What happened that brought you to the hospital?"
History of Present Illness
- The nurse begins with open-ended questions that are meant for the patient to explain symptoms
- A complete description is essential
- Questions about symptoms (subjective sensations or feelings of patients) in six to eight categories assist patients to be more specific and complete
Considerations for Presenting Illness
- Location
- Intensity Duration
- Description
- Aggravating factors
- Alleviating factors
- Functional impairment
- Pain goal during description
Past Health History (Background)
- Includes the patient’s history of medical and surgical problems
- Includes treatments and outcomes
- Some problems are acute, others resolve, and others are chronic
Current Medications and Indications
- The nurse asks about current medication
- Should determine their purposes, names, doses and routes
Current Medications and Indications Continued
- If any medicication is unclear, ask family or family members to bring pill bottles
- Those patients that are admitted to hospital, must reconcile their medications to see if there is a regular intake and use of the coreect drugs
- The nurse must verify if there if the patient has allergies
- Legal records and the nurse should confirm allergic reactions, side effects and adverse reactions to medications.
Family History
- Questions should be asked about the health of parents, grandparents, siblings, and children
- These questions help identify diseases for which patients are at risk so the appropriate nursing can occur
- Questions help nurses give appropriate teaching
- Important familial conditions:
- High blood pressure
- Coronary artery disease, high cholesterol
- Stroke
- Cancer
- Diabetes
- Obesity
- Alcohol or drug addiction
- Mental illness
- Genetic conditions.
Functional Health Assessment
- Functional health patterns are important to nursing
- Functional health patterns focus on the effects of health or illness on quality of life
- The nurse can assess strengths and areas needing improvement
Functional Health Pattern: Description
-
- Health perception/health management
-
- Nutrition/metabolic
-
- Elimination
-
- Activity/exercise
-
- Cognition/perception
-
- Sleep/rest
-
- Self perception/self-concept
-
- Role/relationship
-
- Sexuality/reproductive
-
- Coping/stress tolerance
-
- Values/beliefs
Functional Health Assessment: Examples of Questions
- Health perception/health management:
- "What things do you do to stay healthy?"
- "How does your current nutritional status influence your health?"
- Elimination: "Do your patterns of bowel or bladder habits affect the types of activities that you do?" -Activity/exercise: "Do you have sufficient energy to complete the desired/required activities?"
- Cognition/perception: “How would you describe yourself?” “Are there any changes in the way that you feel about yourself/your body?” -Sleep/rest: Sleep, rest, and relaxation” -7. Self perception/self-concept: Self-concept, body comfort, body image, and feeling state . Are there any family problems that you have difficulty handling?”
- “How was your illness affected your family?” -Sexuality/reproductive: 9. Sexuality/reproductive: Satisfaction and dissatisfaction with sexuality and reproductive patterns -10. Coping/stress tolerance: General coping pattern and effectiveness in terms of handling stress -Values/beliefs: “ “What are the most important things to you in life? “ “"What gives you hope when times are troubled?"
Review of Systems
- The review of systems is a series of body systems
- The questions help reveal concerns or problems
- The patient's symptoms
- Questions relate to body system.
- This approach must be done before the physical asessment
- Intergating is crucial while assessing each region
Examples of Body Systems
- General Health State
- Thorax and Lungs
- Skin, Hair, and Nails
- Cardiovascular system
- Head and Neck
- Vessels.
Review of Systems Conclusion
- Sequence and format vary with setting
- The sequence and format also depends urgency of the problem
- It also depends of the style of the nurse
Cardiovascular System questions
- Have you ever had any pain or pressure sensations in your chest,neck or arm? -(myocardial ischemia)
- Do you have shortness of breath during exercise??
- Have you ever woken up at night with shortness of breath? ,,(heart failure)
- Can you lie flat without shortness of breath?? Do you have swelling in your ankles??
- Have you ever felt irregularities or stuttering in your heartbeat?
More Cardiovascular Example Questions
- Have you had a sudden blackout without any complaints?
- Have you felt tired in your legs during exercise?
- Have you had coldness and blueness in your hands or feet?
- Have you had a rheumatic fever or heart attack?
- Do you have high blood pressure (hypertension)?
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