Intro Flashcards
Infants
Additional concerns for Health Hx
Growth hx,
growth trajectory,
development milestones (Past and present),
diet (breast/formula fed, solid foods),
sleep,
injury prevent
Children
Additional concerns for Health Hx
major neonatal problems until school age,
growth and development,
behavior,
school performance,
ROS: eczema, seborrhea, otitis media, snoring, mouth breathing, allergies, dental care, bed wetting
Adolescents
Additional concerns for Health Hx
peer group,
school performance,
extracurricular activities,
risky behaviors (may need privacy, don’t force conversation, maintain confidentiality when safe)
Preggos
Additional concerns for Health Hx
Gravidity/Parity,
menstrual/gynecologic/obstetric hx,
adjustment to pregnancy
Geriatrics
Additional concerns for Health Hx
Community and family support,
functional assessment
Communication Techniques
Facilitate—encourage your patient to say more, either with your words or with a silence that the patient may break when given the opportunity for reflection.
Reflect—repeat what you have heard to encourage more detail.
Clarify—ask, “What do you mean?”
Empathize—show your understanding and acceptance. Do not hesitate to say “I understand,” or “I’m sorry” if the moment calls for it.
Confront—do not hesitate to discuss a patient’s disturbing behavior. This might be done by simply acknowledging the emotion and asking the client to explain. Remain calm and listen.
Interpret—repeat what you have heard to confirm the patient’s meaning
RESPECT Model
bridge the cultural divide between patients and healthcare providers
R Respect- Understand how respect is shown within given cultural groups. Counselors demonstrate this attitude through verbal and nonverbal communications
E Explanatory Model- Devote time in treatment to understanding how clients perceive their presenting problems. What are their views about their own substance abuse or mental symptoms? How do they explain the origin of current problems? How similar or different is the counselor’s perspective?
S Sociocultural Context- Recognize how class, race, ethnicity, gender, education, socioeconomic status, sexual and gender orientation, immigrant status, community, family, gender roles, and so forth affect care.
P Power- Acknowledge the power differential between clients and counselors.
E Empathy- Express, verbally and nonverbally, the significance of each client’s concerns so that he or she feels understood by the counselor.
C Concerns and Fears- Elicit clients’ concerns and apprehensions regarding help-seeking behavior and initiation of treatment.
T Therapeutic Alliance, Trust- Commit to behaviors that enhance the therapeutic relationship; recognize that trust is not inherent but must be earned by counselors. Recognize that self-disclosure may be difficult for some patients; consciously work to establish trust.
CAGE
Screen for alcoholism
C Cutting down
A Annoyance by criticism
G Guilty Feelings
E Eye-openers
Score of 0 or 1 on each item. Score of 2 or higher is considered clinically significant
Partner Violence Screen (PVS)
Positive answer on any question indicates a positive screen
Positive answers require accurate documentation, using words, drawings, and, if possible, photographs and the preservation of any tangible evidence.
- Have you been hit, kicked, punched, or otherwise hurt by someone within the past year? If so, by whom?
- Do you feel safe in your current relationship?
- Is there a partner from a previous relationship who is making you feel unsafe now?
HITS
How often does your partner physically hurt you?
How often does your partner insult you or talk down to you?
How often does your partner threaten you with harm?
How often does your partner scream or curse at you?
Each item is answered on a 5-point Likert scale:
1=never
2=rarely
3=sometimes
4=fairly often
5=frequently
Score range: 4–20
Cutoff for IPV: ≥10
FICA
F: What is your faith or belief?
Do you consider yourself spiritual or religious?
What things do you believe in that give meaning to your life?
I: Is it important in your life?
What influence does it have on how you take care of yourself?
How have your beliefs influenced your behavior during this illness?
What role do your beliefs play in regaining your health?
C: Are you part of a spiritual or religious community?
Is this of support to you and how?
Is there a person or group of people you really love or who are really important to
you?
A: How would you like me, your healthcare provider, to address these issues in your healthcare?
5 Ps of Sexual Health Hx
Partners
Practices
Protections from STIs
Past Hx of STIs
Pregnancy Intentions
Use this surface whenever discriminatory touch is needed for determining position, texture, size, consistency, masses, fluid, and crepitus
Palmer surface of fingers and finger pads
most sensitive area for distinguishing vibration
Ulnar surface of the hand
best for estimating temperature
Dorsal surface of the hand
Tymphany
Percussion
loud, high, drum-like
Gastric bubble
Ressonance
Percussion
loud, low, hollow
Healthy lung tissue
Hyperressonance
Percussion
very loud, low, booming
Emphysematous lung tissue
Dullness
Percussion
soft, moderate, thud-like
Liver
Flat
Percussion
soft, high, dull
Muscle
4 Competency areas of IPEC
Values and Ethics: Work with team members to maintain a climate of shared values, ethical conduct, and mutual respect.
Patient interest at center
Respect patient dignity
Embrace diversity
Cooperate
Develop trust
Roles and Responsibilities: Use the knowledge of one’s own role and team members’ expertise to address individual and population health outcomes.
Understand roles
Engage in order to complement
Use the full scope
Communication: Communicate in a responsive, responsible, respectful, and compassionate manner with team members.
Effective communication tools
Active listening and encourage ideas
Teams and Teamwork: Apply values and principles of the science of teamwork to adapt one’s own role in a variety of team settings
Absorption
drug’s movement from its site of administration into the blood or systemic circulation
Distribution
drug’s movement from the blood to the interstitial space of tissues and from there into cells and to the site of drug action
Metabolism (biotransformation)
enzymatically mediated alteration of drug structure
