11 Nov Case Study The nurse conducts a health history int
Case Study The nurse conducts a health history interview with Mrs. Martha Washburn, a 67-year-old African American. The following are excerpts from the health history: “Mrs. Washburn, I am going to ask you a lot of questions before the physical assessment. I need to have correct responses and I have to tell you, there will be a lot of them if we are to get to the root of your problem. I will use the information to develop a plan of care. “What are you here for? Did someone come with you? I see on your chart that you have some problems with urination; are you incontinent? How long have you had the problem? You really should use the adult diapers when you go out.” The nurse includes the following questions: “What is your economic status? Do you go to church? What do you do when you are ill?” “We need information about your family, so let’s start out with your parents. Are they alive? Do you have siblings?” During the interview, Mrs. Washburn seems very anxious. She becomes quite upset when the nurse asks her about her incontinence. She tries to deny it at first and then admits it when the nurse makes reference to her medical record documentation of the problem. The nurse completes a review of symptoms and prepares the patient for the physical examination by showing her a room and telling her to get undressed. Critical Thinking Questions 1. Critique the nurse’s actions in the initial interview phase of the case study. 2. Identify the types of information sought in the questions in the case study. 3. Create alternative approaches to the interview and questioning techniques in the case study. 4. Describe how your cultural norms and biases could influence your approach to the patient. Explain how you would prepare for an interview of Mrs. Washburn in regards to her age and culture. 5. If Mrs. Washburn did not speak English, explain how you would modify the health history exam.
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