Lecture 5: Interview Basics III and IV

Question 1

Past Medical History

Answer 1

• screen for hospital stays or ER visits

- illnesses the patient has had/has now (may be ongoing)

Question 2

Past Surgical History

Answer 2

• any time the patient has had an operation

- does not include: most dental surgeries, sutures for minor injuries

Question 3

Current Medications and what to record

Answer 3

• prescriptions, over-the-counter, supplements

- record: dose, timing, positive/negative

Question 4

Allergies and what to record

Answer 4

• ask about medications, environmental, food

- record: reaction, positive/negative

Question 5

Family History

Answer 5

• first degree relatives (kids, spouse, siblings, parents)

- things that run in the family (cancers, mental health issues, cardiac)

Question 6

FEDTACOS (Social History)

Answer 6

F - food (nutrition/diet)

E - exercise (daily activity and exercise)

D - drugs (recreational)

T - tobacco (smoking/smokeless)

A - alcohol

C - caffeine

O - occupation

S - spirituality and sexual history

Question 7

How much activity does the CDC recommend for adults and adolescents 6 years and older?

Answer 7

Adults - 150 min/week of moderate activity and strength training twice/week

Children - 1 hour+ daily activity

Question 8

Drugs and what to record

Answer 8

• recreational drug use

- record: quantity, frequency, and route of administration

Question 9

Tobacco and what to record

Answer 9

• smoking/smokeless, vaping/eCigs

- record: quantity, duration, pack years

Question 10

What is a pack year?

Answer 10

packs per day x years

Question 11

Alcohol and what to record

Answer 11

record: quantity and frequency

Question 12

AUDIT (alcohol use)

Answer 12

Alcohol Use Disorders Identification Test

• more sensitive than CAGE
• more questions to ask and difficult to score

Question 13

CAGE questionnaire (alcohol use)

Answer 13

• screen patients who drink more than one drink daily or a lot on the weekends
• open door conversation about getting help
• LOTS of false positives

Question 14

CAGE Questions

Answer 14

1. Has anyone suggested CUTTING BACK?
2. Are you ANNOYED when people talk about it?
3. Do you feel GUILTY about it?
4. Do you need a drink to steady nerves? (EYE OPENER)

Question 15

Safe Drinking Limits (women, men, those over 65 yo)

Answer 15

1. women/over 65 yo - 3 drinks or less a day, no more than 7 drinks a week
2. men - 4 drinks on a single day, no more than 14 drinks a week

Question 16

What is a drink? (Beer, Wine, Liquor amounts)

Answer 16

Beer = 12 ounces

Wine = 5 ounces

Liquor = 1 ounce

Question 17

Caffeine and what to record

Answer 17

• record: how much, how often, what form

Question 18

Occupation and considerations

Answer 18

• what do you do for a living?
• what kind of work do you do?

consider: stress, exposure, work policies

DO YOU THINK ANYTHING AT WORK OR HOME IS AFFECTING YOUR SYMPTOMS NOW?

Question 19

Spirituality/Religion and FICA

Answer 19

• do you feel supported in your community?, is spirituality important to you?

F - faith and belief
I - importance
C - community
A - Address in Care or Assessment and plan

Question 20

Safety

Answer 20

• seatbelt/helmet use, care seats, fences around pool, life jackets on boat
• medication storage around kids and immunizations

Question 21

SAFE and Domestic Violence

Answer 21

• ask about guns/weapons in the home

S - stress/safety
A - afraid/abused
F - friends/family
E - emergency plan

Question 22

Special Patient Populations and ROS (3)

Answer 22

1. unconscious, demented, severe intellectual disability
2. language issues (use language translator)
3. pediatrics (ask parent)