week 4 group discussion
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School
Chamberlain College of Nursing *
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Course
509
Subject
Health Science
Date
Dec 6, 2023
Type
docx
Pages
2
Uploaded by KidBookBarracuda23
1.
ApplicationofCourseKnowledge:
Answer all questions/criteria with explanations and
detail
.
a.
Create a scenario depicting an interaction between an NP and a client. Describe
the setting and type of encounter.
b.
Describe the client’s challenging behaviors related to the topic assigned.
c.
Examine the potential impact of the client’s behavior on the client-provider
relationship.
d.
Analyze techniques to enhance communication with the client and address the
client’s behavior.
e.
Create sample documentation for the encounter.
A.D. a 40-year-old patient presents to the clinic for undiagnosed hypertension. He was
referred to the clinic for a failed physical exam for work clearance due to elevated blood
pressure. He has no past medical history other than smoking and drinking on the
weekends. Reports headaches but denies visual changes or chest pain. Vitals are 179/101
p 89. The patient is upset he won’t be able to start work and now must pay more money
to get physically cleared to work.
The patient is upset, demanding, increasingly impatient with time, and is rushing to be
seen. The receptionist informed the patient he is considered new and would require a
longer visit to establish care. The patient then proceeds to kick a chair out of frustration.
The potential impact of the client’s behavior on the client-provider relationship
jeopardizes the provider's ability to see the patient due to being unsafe. This would hinder
the provider from properly assessing, diagnosing, setting goals, and educating the patient
if he is not willing to take the time to process his new diagnosis and the seriousness of
this disease. This often leads to nonadherence to medications, follow-ups, and other
potential complications like stroke and heart attacks.
Patients place their anger on clinicians as a reflection of their frustration or pain. In many
cases, patients are angry because they are ill, have suffered a loss, have lost control of
their health, or feel overwhelmed by the healthcare system. This anger may be directed at
you (Bickley et al., 2021).
First and foremost, the provider and staff need to feel safe and
protected from violent patients. This could be done by alerting security and remaining
non-confrontational and nonthreatening. Techniques to enhance communication and
address the client's behavior are to actively listen and show empathy for the patient and
his situation. This must be a financial strain on him not being able to work and the
thought of having to deal with a new diagnosis and medications. When the patient has
calmed down, the provider can now establish rapport, which helps the patient move on
from feeling angry and address the reason for the visit. Next is to set boundaries and
expectations such as “this behavior is not tolerated at our clinic”.
Sample documentation: SOAP format
S- Headaches, expresses frustration due to inability to work
O- BP 179/101 pulse 89
A-
A.D. A 40-year-old male with no past medical history. Social history of smoking and
drinking presents to the clinic with elevated blood pressure. The patient was referred
to the clinic after a failed physical exam for a new job. He reports having headaches
but denies visual changes chest pain or shortness of breath. His blood pressure in the
office is 179 / 101 pulse 89. The patient is obviously frustrated had a violent outburst
in the waiting area by kicking a chair and is rushing to be seen and treated.
P- A.D. will be started on Norvasc 5mg daily and have him follow up in the clinic in one
month. He can follow-up sooner if he's experiencing worsening headaches or new
symptoms. I will also recommend that he keep a log of daily blood pressure. I will also
offer patient education on smoking cessation and refrain from drinking alcohol.
Reference
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021).
Bates' guide to
physical examination and history taking
(13th ed.). Wolters Kluwer.
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