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Differential Diagnosis > Interviewing as a screening tool > Flashcards

Flashcards in Interviewing as a screening tool Deck (93)
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1

Do's of interviewing

Extend small courtesies

Use a sequence of questions that begins with open-ended questions

Leave close-ended questions for the end of interviewing to clarify

Select a private location for confidentiality

Undivided attention; re-assuring comments; eye contact

Ask one question at a time, allow time for patient to respond

Encourage patient to ask questions

Listen with attention of assessing patient's current level of understanding and knowledge of his/her condition

Eliminate unnecessary info and speak at patient's level of understanding

Correlate signs and symptoms with medical history and objective findings to rule-out systemic disease

Provide several choices/selections to questions that require descriptive response

2

Don'ts of interviewing

Jump to pre-mature conclusions based on answers to one or two questions

Interrupt or take over conversation when client speaking

Destroy helpful open-ended questions with closed-ended follow-up questions before patient has chance to respond

Use professional or medical jargon when it is possible to use common language

Overreact to info presented by the patient (including facial expressions)

Use leading questions
- Where is your pain?
(Do you have pain associated with your injury, if so tell me about it)
- Does it hurt when you first get out of bed?
(When does your back hurt?)
- Does the pain radiate down your leg?
(Do you have this pain anywhere else)
- Do you have pain in your lower back?
(Point to the exact location of your pain)

3

What are different racial or ethnic designations?

American Indian/Alaska Native

Asian

Black/African American

Hispanic or Latino (of any race)

Native Hawaiian/Pacific Islander

White/Caucasian

4

What are important aspects of cultural competency while interviewing?

Wait until patient is finished speaking before interrupting or asking questions

Allow "wait time" for some cultures (English could be 2nd language)

Be aware that eye-contact, body-space boundaries, even handshaking may differ from culture to culture

5

Keys to successful interactions via interpreter

Choose a competent medical interpreter

Interpreter who is older than the patient important in some cultures

Info about client's diagnosis and condition is relayed to head of household in some cultures who makes decisions for members of family (Muslim)

Listen to interpreter, but direct gaze at patient

Watch body language while speaking for cues

Head nodding and smiling does not necessarily mean that the patient understands you

Keep remarks simple and short

Avoid using medical jargon

6

What are the topics of data that can be gleaned from a client history?

General demographics

Medical/Surgical history

Current conditions/Chief complaints

Functional status and activity level

Medications

Other clinical tests

Family history

Social/Health habits (past and current)

General health status (self-report, family report, caregiver report)

Living environment

Growth and development

Employment/work (job/school/play)

Social history

**FIGURE 2.1**

7

What age and sex is related to Guillain Barre syndrome?

Any age (hx of infection/alcoholism)

Men > Women

8

What age and sex is related to Multiple sclerosis?

15-35 y.o.

Women > Men

9

What age and sex is related to Rotator cuff degeneration?

30+ y.o.

No difference between sexes

10

What age and sex is related to spinal stenosis?

60+ y.o.

Men > Women

11

What age and sex is related to Tietze's syndrome?

Before 40 y.o., including children

No differences between sexes

12

What age and sex is related to Costochondritis?

40+ y.o.

Women > Men

13

What age and sex is related to Neurogenic claudication?

40-60 y.o.

No difference between sexes

14

What age and sex is related to AIDS/HIV?

20-49 y.o.

Men > Women

15

What age and sex is related to Ankylosing spondylitis?

15-30 y.o.

Men > Women

16

What age and sex is related to abdominal aortic aneurism?

40-70 y.o.

(Hypertensive) Men > Women

17

What age and sex is related to Buerger's disease?

20-40 y.o. (smokers)

Men > Women

18

What age and sex is related to cancer?

Any age; incidence rises over age of 50 y.o.

Men > Women

19

What age and sex is related to Breast cancer?

45-70 y.o.

Women > Men

20

What age and sex is related to Hodgkin's disease?

20-40, 50-60 y.o

Men > Women

21

What age and sex is related to Osteoid osteoma?

10-20 y.o.

Men > Women

22

What age and sex is related to Pancreatic carcinoma?

50-70 y.o.

Men > Women

23

What age and sex is related to RA?

20-50 y.o.

Women > Men

24

What age and sex is related to skin cancer?

Rarely before puberty; increased incidence with age

Men = women

25

What age and sex is related to Gallstones?

40+ y.o.

Women > Men

26

What age and sex is related to Gout?

40-59 y.o.

Men > Women

27

What age and sex is related to Gynecologic conditions?

20-45 y.o.

Women

28

What age and sex is related to Paget's disease of the bone?

60+ y.o.

Men > Women

29

What age and sex is related to Prostatitis?

40+ y.o.

Men

30

What age and sex is related to Primary biliary cirrhosis?

40-60 y.o.

Women > Men