Patient Assessment Key Concepts
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Questions and Answers

Lilly's _______ __________ for seeing the physician today is a sore throat.

chief complaint

What is a _____ _________?

final diagnosis

What does 'IBS vs. Gastroenteritis' listed under the impression represent?

differential diagnosis

_________ means pertaining to the operation of the mind by which we become aware of perceiving, thinking, and remembering.

<p>Cognitive</p> Signup and view all the answers

_________ is the relationship of harmony and accord that exists between the patient and the healthcare provider.

<p>Rapport</p> Signup and view all the answers

Identify four important rules to remember when preparing the appropriate environment for patient interaction.

<ol> <li>Ensure privacy 2. Prevent interruptions 3. Prepare comfortable surroundings 4. Take judicious notes</li> </ol> Signup and view all the answers

List and describe the three processes of active listening.

<ol> <li>Restatement 2. Reflection 3. Clarification</li> </ol> Signup and view all the answers

List and describe the six components of the medical history.

<ol> <li>Database 2. Chief complaint 3. Past history 4. Family history 5. Social history 6. Systems review</li> </ol> Signup and view all the answers

List and define the three stages of the patient interview.

<ol> <li>Initiation 2. Body 3. Closing</li> </ol> Signup and view all the answers

What are four examples of therapeutic nonverbal behaviors that enhance communication?

<ol> <li>Leaning toward the patient 2. Facing the patient squarely 3. Maintaining eye contact 4. Avoiding closed postures</li> </ol> Signup and view all the answers

What type of question is 'How have you been feeling?'

<p>Open ended</p> Signup and view all the answers

What type of question is 'Do you have a headache?'

<p>Closed ended</p> Signup and view all the answers

Study Notes

Patient Assessment Key Concepts

  • Chief Complaint: Main reason for patient's visit, e.g., sore throat.
  • Final Diagnosis: Conclusion reached after evaluating findings, tests, and results.
  • Differential Diagnosis: Listing of conditions that might explain a patient's symptoms (e.g., "IBS vs. Gastroenteritis").

Cognitive and Rapport

  • Cognitive: Refers to operations of the mind like perception, thought, and memory.
  • Rapport: The harmonious relationship between the patient and healthcare provider.

Patient Interaction Environment

  • Ensure privacy: Room should be clear for the duration of the interview.
  • Prevent interruptions: Minimize distractions to maintain conversation flow.
  • Comfortable surroundings: Conduct interviews with patient and provider at eye level to ease anxiety.
  • Judicious note-taking: Focus primarily on the patient, minimizing distractions from note-taking.

Active Listening Skills

  • Restatement: Paraphrasing patient’s words to confirm understanding (e.g., "You are saying...").
  • Reflection: Summarizing main ideas while acknowledging patient's feelings, demonstrating empathetic listening.
  • Clarification: Simplifying or summarizing thoughts and feelings to resolve confusion.

Components of Medical History

  • Database: Demographics and initial findings.
  • Chief complaint (CC): Reason for visit.
  • Past Medical History (PH): Summary of previous health issues and treatments.
  • Family History (FH): Health details of immediate family members.
  • Social History (SH): Lifestyle factors including diet, hobbies, and substance use.
  • Systems Review (SR): Comprehensive examination of body systems, progressing from head to toe.

Stages of Patient Interview

  • Initiation: Introduction, verification of identity, and clarification of purpose.
  • Body: Exploration of patient's healthcare needs and concerns using therapeutic communication.
  • Closing: Summary of the visit, confirmation of expectations, and encouraging patient input.

Therapeutic Nonverbal Behaviors

  • Leaning in: Shows interest in patient’s health history.
  • Facing the patient: Maintains comfort and sensitivity.
  • Eye contact: Essential for effective therapeutic communication.
  • Open posture: Avoids crossing arms/legs to demonstrate engagement.

Question Types

  • Open-ended Questions: Encourage detailed patient responses (e.g., "How have you been feeling?").
  • Closed-ended Questions: Elicit specific responses (e.g., "Do you have a headache?").

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Description

This quiz explores key concepts in patient assessment, including chief complaints, final diagnoses, and differential diagnosis. It also covers vital communication skills such as cognitive understanding and building rapport, as well as creating a comfortable environment for patient interactions. Enhance your knowledge of effective patient assessment techniques.

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