Posted: June 14th, 2023

Select one of the challenging patient situations and behaviors

Discussion 1
Select one of the challenging patient situations and behaviors referenced in Chapter 2 of this week’s assigned reading. Discuss best practices in managing this scenario in the context of the focused history and physical examination encounter. Support your response with a minimum of two APRN-approved scholarly resources.
https://bibliu.com/app/#/view/books/9781975109950/epub/OEBPS/toc.html#page_21
Bickley, L. (2021). Bates’ guide to physical examination and history taking (13th ed.). Wolters Kluwer. ISBN-13: 9781496398178
Discussion 2
Refer to “The Medical H and P” and “How to Create a Differential Diagnosis” videos, located in the topic Resources. Discuss your observations. What questions did the videos raise for further exploration? Explain what else you would add to the examination and patient interaction activities. Support your response with a minimum of two APRN-approved scholarly resources.
https://batesvisualguide.com/index.aspx
Bickley, L. (2019). Bates’ visual guide: 12-month access card to BatesVisualGuide.com with OSCE clinical skills videos. Wolters Kluwer. ISBN-13: 9781469863856

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Discussion 1:

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One of the challenging patient behaviors discussed in Chapter 2 of Bates' guide to physical examination and history taking is noncompliance with medical treatment. Noncompliance is a complex issue that can result in poor health outcomes, increased healthcare costs, and a strain on the patient-provider relationship.

The best practices for managing noncompliance in the context of the focused history and physical examination encounter include understanding the reasons behind the patient's noncompliance, educating the patient on the importance of treatment adherence, and involving the patient in the treatment decision-making process.

To better understand the reasons for noncompliance, the APRN should ask open-ended questions and use active listening skills to identify any barriers that the patient may be facing. These barriers can include financial constraints, lack of social support, fear of side effects, or forgetfulness. Once the APRN has identified the barriers, he or she can work with the patient to find solutions to overcome them.

Educating the patient on the importance of treatment adherence is also crucial. The APRN should explain the risks of noncompliance, such as disease progression or complications, and the benefits of treatment adherence, such as improved quality of life and reduced healthcare costs. The APRN should also provide clear instructions on how to take medications, including any potential side effects, and ensure that the patient understands them.

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Finally, involving the patient in the treatment decision-making process can improve treatment adherence. The APRN should ask the patient about his or her treatment goals and preferences and work with the patient to develop a treatment plan that is tailored to his or her needs and preferences.

Two APRN-approved scholarly resources that support the best practices for managing noncompliance are:

Grant, R. W., & Wald, J. S. (2017). Strategies for Improving Patient Adherence to Therapy and Long-Term Health Outcomes. American Journal of Medicine, 130(2), 221–224. https://doi.org/10.1016/j.amjmed.2016.09.016
This article provides an overview of the factors that contribute to noncompliance and strategies for improving patient adherence to therapy. The authors emphasize the importance of understanding the patient's perspective and developing a collaborative treatment plan.

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Sabaté, E. (2003). Adherence to Long-Term Therapies: Evidence for Action. World Health Organization. https://www.who.int/chp/knowledge/publications/adherence_report/en/
This report from the World Health Organization provides a comprehensive overview of the factors that contribute to noncompliance and strategies for improving patient adherence to long-term therapies. The report emphasizes the importance of patient education, communication, and involvement in the treatment decision-making process.

Discussion 2:

The Medical H and P and How to Create a Differential Diagnosis videos provide a comprehensive overview of the key components of a thorough medical history and physical examination and the process of generating a differential diagnosis.

One observation from the videos is the importance of obtaining a thorough medical history. The APRN should ask open-ended questions and use active listening skills to obtain a detailed account of the patient's symptoms, medical history, and social history. This information can provide valuable clues for generating a differential diagnosis and developing an effective treatment plan.

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Another observation is the importance of conducting a focused physical examination. The APRN should use a systematic approach and focus on the areas that are relevant to the patient's chief complaint. The physical examination can provide additional clues for generating a differential diagnosis and identifying any potential complications.

One question that the videos raised for further exploration is the role of diagnostic tests in generating a differential diagnosis. While the videos briefly mention the use of laboratory tests and imaging studies, it would be beneficial to explore in more detail how these tests can be used to support the differential

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