Question

NUR 210 Health Assessment: Denzel Kinsale

Case Study

Denzel, age 12, has been experiencing shortness of breath playing soccer.   He is being seen today for evaluation of his symptoms. As part of a complete health history, the following was revealed.

• His father, Larry Kinsale, age 43, is lactose intolerant, has smoked 2 packs a day for 20 years, and is hypertensive.
• His mother, Janelle Kinsale, age 41, is obese with a body mass index of 35.
• His sister, Lorel Kinsale, age 16 has no prior medical problems.  
• His brother, Greg Kinsale, age 13, is struggling with issues surrounding his sexual orientation.
• The maternal grandmother, Mrs. Rose Franklin, age 81, has diabetes and the maternal grandfather, Mr. Leo Franklin, age 83, is forgetful.
• The paternal grandmother, Mrs. Luanne Kinsale, age 71, is in good health.
• The paternal grandfather, Mr. Carl Kinsale, age 70, was recently diagnosed with lung cancer.
• The paternal uncle, David Kinsale, age 38, has a long history of alcohol and drug abuse.
• The paternal uncle, Robert Kinsale, age 40, is in good health.

Discussion:

1. You are performing a health assessment on Denzel. What would your approach be to learn more about his shortness of breath? Identify at least 3 strategies that would provide additional information regarding Denzel’s condition.

2. Identify at least 3 specific person-centered communication techniques that would foster disclosure. Include verbal and nonverbal behaviors. (Use the person-centered communication that was used when completing the Health History in Lab 1).

3. Identify at least 3 specific techniques that would interfere with disclosure.

Answer 1

First of all initial assessment of the patient should be done who came with the complaint of shortness of breath:

• Assess breathing pattern and listen to the lungs
• measure vital signs
• Obtain any history of cardio pulmonary disease.
• Ecg should be monitored.

I will approach the patient gently and politely, to know more about the disease history, make him comfortable:

• Reassess the patient's airways, mental condition, breathing condition.
• History of medicine use,fever, chest pain.
• Listen to the breath sounds

3 PERSON CENTERED COMMUNICATION TECHNIQUES THAT WOULD FOSTER DISCLOSURE;

Verbal method :

• Progress- Don't interrupt the patient when he talks, just support him and say hmm i am listening.
• Open-ended questions: Ask more interesting facts about the patient.
• Approve; Whatever the patient says give a good approval, which encourage him to disclose more.

Non verbal method:

• Attention- First of all make a good eye contact.
• Way of responding; is the patient anxious?
• Active listening: is the patient nodding head?

3 TECHNIQUES THAT WOULD AFFECT DISCLOSURE:

• If we interrupt or disurb the patient in between when he talks.
• When a patient answers to our question and if we are not listening actively to what he /she says.
• If we make fun of the situation or the blunder mistakes which the patient has done.