Health Assessment

XH3003: Health History Across the Lifespan

Competency Assessment:

When Taking a Health History Is a Challenge

Student Name: Date: 27^th April 2025

Scenario 1: Health History for a Young Child: Archie, age 7, and his father, Gabriel Moore

1. Analyze Scenario 1 for the specific challenges presented in gathering a patient's health history of a young child.

The case clearly shows Archie, as a child, experiencing severe pain and discomfort attributed to constant crying, normally confirming pain or discomfort for his age (Walden University, LLC., 2024a). Therefore, a key challenge with gathering information on health history is the limited use and relevance of the interaction between a child and a healthcare provider. At seven years, Archie cannot answer the questions provided for promoting a conclusion about issues related to the presented symptoms (Mariati, Jakri & Djerubu, 2022). It is a serious challenge because he is in serious distress, specifically limiting his ability to provide vital input about how he is feeling. The next challenge relates to the issue of children within this age to define onsets of the symptoms in a way providing an exact and precise timeline, a key element when diagnosing symptoms and history of the issue. Finally, the third challenge relates to the tendency of relying on the information presented by the parent, where most times, is biased by anxiety and stress attributed to their child's suffering and pain.

2. What communication skills does a nurse need in this situation with a parent and young child? Include specific examples based on emotional intelligence.

A nurse should prioritize empathy as a communication skill when engaging a child and a parent like in Archie and his father’s case. For instance, the nurse should use a soft tone (soft skills), showing an understanding and identifying with Archie’s pain. Empathy as a communication skill also implies the nurse using words that encourage the father to believe that he is helping Archie. The second communciaiton skill is comfort, evidence when asking Archie if he may sit on the father's lap. It will be a show that the nurse cares about the patient and planning better care, relief and ensuring their comfort (Khademi et al., 2021).

3. Explain your specific goals with this parent and child in terms of obtaining a health history.

The first specific goal when interacting with Archie and the father, Gabriel, entails determining the presented symptoms, with the health history possibly presenting underlying causes of the issue or challenge affecting Archie (Walden University, LLC., 2024a). The second goal entails promoting an environment that fosters assessing and evaluating the disease timeline as this will inform the duration the issue has persisted as well as how aspects of vital body signs like temperature are manifesting as symptoms. Here, the specific goal is finding answers on the duration that Archie has been wheezing and whether there are other possible occurences. Therefore, these goals will guarantee proper and accurate diagnosis matching Archie’s symptomology (Mariati et al., 2022).

4. What information would be a priority to obtain for a health history of this child, and why?

My priority information when working with Archie is to obtain insight into how long he has been wheezing (Walden University, LLC., 2024a).The information or history is crucial because it will guide me in identifying the degree by which this issue has been present. Another priority is also to obtain information on underlying issues, because in some cases, healthcare problems can be caused by confounding factors not understood by the patient (Consolini, 2023). The importance of this information is to make the diagnosis easier. Furthermore, I need to prioritize temperature levels because this will help in determining the severity of the infection.

5. Thinking about the situation in the examining room at the end of Scenario 1, what would be your next steps to get the information you need to make a health assessment of this child? Explain your reasoning.

My next step in this case would be to follow the recommended approaches and explore or assess Archy’s Electronic Medical records. My reasoning for this step is because Archie’s medical records are updated. Therefore, I will identify whether the current issue is an outcome of cased by past experiences (Consolini, 2023).

Scenario 2: Health History for an Adolescent : Jasmine Walker, age 14

1. Analyze Scenario 2 for the specific challenges presented in gathering a patient's health history.

The main challenge in collecting health information from Jasmine is her stage of life as an adolescent. Mostly, teens are private and less likely to share information, more so when involving mental health or privacy like private body parts (Walden University, LLC., 2024b). Therefore, teens may feel nervous, ashamed, and unable to define or explain their anxiety (Barch et al., 2021). A nurse will find it challenging balancing privacy and disclosure among adolescents for their health information.

2. What communication skills does a nurse need in this situation with an adolescent? Include specific examples based on emotional intelligence.

It requires emotional intelligence as a skill when communicating with Jasmine as a teenager or adolescent. The nurse needs to show empathy and create rapport by acknowledging the pressures affecting Jasmine. For instance, Jasmine quoted and defined high school "as being pressure," information that the nurse should use to show empathy to her (Walden University, LLC., 2024b). Other key communication skills include open-ended inquiries, active listening and validation to help Jasmine relax. An example of communicating with Jasmine would be, "Kindly tell me what is making you nervous about being in high school?" Using this empathetic inquiry supports her to open up without necessarily being judgmental. Effective communication skills also includes honest conversation demands a safe non-judgmental setting and confidence (Barch et al., 2021).

3. Explain your specific goals with this adolescent in terms of obtaining a health history.

My goal in collecting information from Jasmine is to create a comfortable environment as an adolescent, she can disclose and discuss her emotional and physical concerns (Walden University, LLC., 2024b). Furthermore, I will prioritize confidentiality and trust, crucial to obtaining specific, accurate, and complete information (Barch et al., 2021). My final goal will include evaluating Jasmine’s physical health and emotional or psychosocial stressors impacting her well-being.

4. What information would be a priority to obtain, and why?

Priority information should be Jasmine’s mental health status, sexual and reproductive health, physical activity, diet and substance use, and common health risks among contemporary adolescents (Walden University, LLC., 2024b). Menstrual history information may identify reproductive issues or hormonal balances as anxiety or depression screening will explain her mood or withdrawal (Barch et al., 2021). Information should be gathered about bullying, peer relationships, and academic distress to uncover psychosocial stressors affecting her health. The importance of this information is to provide a clear picture of Jasmine’s current health and risk factors, as well as personalized education as needed, including referrals.

5. Thinking about the situation in the examining room at the end of Scenario 2, what would be your next steps to get the information you need to make a health assessment of this adolescent? Explain your reasoning.

Jasmine evidently felt uneasy at the end of the scenario. Therefore, the next step is to invite her to a separate room for an intimate and detailed discussion, especially after the doctor performs a regular check-up for her vitals (Walden University, LLC., 2024b). This step will encourage her to discuss health issues uncomfortable to share openly, which the nurse practice requires to understand and provide a comprehensive health check and assessment (Barch et al., 2021).

Scenario 3: Health History for an Older Adult: Colleen Hart, age 76

1. Analyze Scenario 3 for the specific challenges presented in gathering a patient's health history.

Cognitive impairment, vision, and hearing loss make it difficult to collect information or health history data for older adults like Colleen (Walden University, LLC., 2024c). The presence of a family member or caregiver can also be a hindrance as Colleen feels pressured. Another challenge relates to how Colleen could be prone to minimizing her symptoms or not reporting at all as an older adult because of the fear that diagnosis may unearth serious conditions or illnesses. Sometimes, older may have gotten used to their condition and accepted health problems as normal part of their lives (Stefanacci, 2022). Additionally, family members may dominate the process by giving a health history that is not complete or fully accurate from the perspective of the patient, like the presence of Colleen’s stepson.

2. What communication skills does a nurse need in this situation with an older adult? Include specific examples based on emotional intelligence.

Communicating with older people is challenging, and a nurse will need specific communication skills when engaging with Colleen. These include intentional listening, patience, and empathy, required when dealing with older patients (Stefanacci, 2022). For example, a nurse can engage with Colleen before the son arrives to respect and consider her autonomy. The best statement to use in this case, for instance, would be, "I understand that your son is arriving soon, but let me ask about your feelings in the past year." Furthermore, clear communication skills are needed and frequently used to confirm comprehensive, clear signs of emotional intelligence in communication (Walden University, LLC., 2024c). Therefore, prioritizing emotional intelligence communication skills will promote comfort and easily change the direction of the interview when necessary.

3. Explain your specific goals with this older adult in terms of obtaining a health history.

My specific goal when working with Colleen should be to elicit enough and appropriate information as possible about her health status while concurrently ensuring her autonomy. Engaging or interacting with adults should allow the patient to control the content and direction of the conversation (Walden University, LLC., 2024c). The next goal is to involve the family members to help t o a given extent, not dominating Colleen’s views, especially when the son is involved.

4. What information would be a priority to obtain, and why?

The priority information to be collected from Colleen is to establish whether there is enough social support since the information influences her treatment, recovery journey, and well-being. Understanding Colleen's social support system will ensure that the delivered care aligns with available resources for the case, making it more useful and tailored to her (Walden University, LLC., 2024c). Furthermore, information about her belief and skepticism about the treatment is necessary, especially the need for such interventions for the elderly. Prioritizing such information will address the underlying skepticism that she may have about the process, leading to her active participation in the care process. Prioritizing the information leads to a less subjective and more detailed health evaluation (Stefanacci, 2022).

5. What information would be a priority to obtain from the adult stepson if he joined the appointment, and why?

If the adult stepson joins the appointment, information should be asked about Collen’s current living arrangement and environment, how her behavior changes, or about her health issues (Walden University, LLC., 2024c). Furthermore, it is recommended to prioritize information from the stepson about Colleen’s functional ability at home. The reason for asking these questions is because the stepson is a family member and will provide information that Colleen may be embarrassed to share, like her changing mobility and memory (Walden University, LLC., 2024c).

6. Thinking about the situation in the examining room at the end of Scenario 3, what would be your next steps to get the information you need to make a health assessment of this older adult? Explain your reasoning.

The next step is to implement a progressive management approach to Colleen’s condition. Therefore, I may confide within the stepson’s presence and consider continue the conversation outside the bedroom away from the stepson. Furthermore, I will ensure trust and self-autonomy to encourage Colleen to share important information (Stefanacci, 2022).

References

Consolini, D. M. (2023). Health supervision of the well child. In, Merck manual (Professional version). Merck. https://www.merckmanuals.com/professional/pediatrics/health-supervision-of-the-well-child/health-supervision-of-the-well-child?query=pediatric%20exam

Khademi, E., Abdi, M., Saeidi, M., Piri, S., & Mohammadian, R. (2021). Emotional intelligence and quality of nursing care: A need for continuous professional development. Iranian Journal of Nursing and Midwifery Research, 26(4), 361–367. https://pubmed.ncbi.nlm.nih.gov/34422618/

Mariati, L. H., Jakri, Y., & Djerubu, D. (2022). The effect of emotional intelligence on nurse’s communication skill. Jurnal Ners Dan Kebidanan (Journal of Ners and Midwifery), 9(2), 218–226. https://doi.org/10.26699/jnk.v9i2.ART.p218-226

Stefanacci, R. G. (2022). History-taking in the older adult. In, Merck manual (Professional version). Merck. https://www.merckmanuals.com/professional/geriatrics/approach-to-the-geriatric-patient/history-taking-in-the-older-adult

Walden University, LLC. (2024a). Health history across the life span: Young child and parent: Archie and Gabriel Moore [Interactive media]. Walden University Brightspace. https://mytempo.waldenu.edu

Walden University, LLC. (2024b). Health history across the life span: Adolescent: Jasmine Walker [Interactive media]. Walden University Brightspace. https://mytempo.waldenu.edu

Walden University, LLC. (2024c). Health history across the life span: Older adult: Colleen Hart [Interactive media].  Walden University Brightspace. https://mytempo.waldenu.edu