I’m working on a nursing question and need a sample draft to help me learn.

A 56-year-old patient with newly diagnosed stage 1 hypertension has been referred to you for counseling regarding lifestyle modifications. He is married, with four children — two in high school, two in college. His job as a senior vice-president for a major retail chain requires that he work long hours and frequently eat at restaurants. He smokes two packs of cigarettes a day, has a body mass index (BMI) of 29 kg/m2, and a waist-hip ratio of 1.6. He usually drinks one to two dry martinis to relax after he gets home from work.

1. How would you develop a realistic plan to help this patient reduce his blood pressure and prevent complications?
2. Which risk factors would be among your top two or three priorities for this patient, and what interventions or recommendations would you provide for modifying these?

CAN YOU ALSO RESPOND TO THESE DISCUSSION POSTS  

1 Please make separate document for this response 

1. How would you evaluate a patient’s ability to understand your instruction and their current knowledge base about their problem? What characteristics of the patient would be helpful?

To decrease gaps in health status, health practice enhancements that address inadequate health literacy are required. As inadequate health literacy is prevalent and can be difficult to identify, experts recommend that practices assume all patients and caregivers may have trouble interpreting health information and engage in communication in a way that anybody can comprehend. Examples include simplifying communication, validating comprehension for all patients to reduce the possibility of miscommunication, making the health care system more comprehensible, and supporting patients’ attempts to improve their health. As patient discussion continues, characteristics such as eagerness to learn more or curiosity will help move the conversation forward (DPHS, 2020).

1. How would you be certain that the patient understands your medication instruction?

Asking the patient to repeat back to the provider the entire medication regimen discussed at the visit is the first way to assess comprehension. As the provider listens carefully for any misunderstandings and can then further supply educational handouts and other resources to help understand the care plan (Woo & Robinson, 2020).

1. What methods of therapeutic communication would be useful in advanced practice?

Open communication and closed-loop communication can be helpful during patient interviews and in assessing understanding. Follow-up evaluation via any media comfortable and accessible to the patient to help with questions or concerns while following the effects and outcomes of the patient’s perceptions of the care being conducted at home with medication regimens and side effects (Woo & Robinson, 2020).  

References

Office of Disease Prevention and Health Promotion [DPHP]. (2020). Health literacy | healthy people 2020. Healthypeople.gov. https://www.healthypeople.gov/2020/topics-objectiv…

Woo, T. M., & Robinson, M. V. (2020). Pharmacotherapeutics for advanced practice nurse prescribers (5th ed.). F.A. Davis Company

2 (make separate document for this response) 

How would you evaluate a patient’s ability to understand your instruction and their current knowledge base about their problem? What characteristics of the patient would be helpful?

There are several methods that can be used to evaluate a patient’s ability to understand instructions and important healthcare information regarding their condition/problem. A patient’s ability to comprehend is dependent upon their educational level, language spoken, intellectual abilities, emotional state, and age. These are characteristics to take into consideration when attempting to communicate with a patient. One method in particular that has proven to be effective in providing instruction is the teach-back method. The provider has the patient explain the healthcare instructions in their own words. The teach-back method allows health care providers to assess a patient’s understanding and reteach or modify teaching if necessary (Yen & Leasure, 2019).

How would you be certain that the patient understands your medication instruction?

In terms of medication instruction, it is important for the patient to have a general understanding of each medication they are prescribed and why they are being prescribed the medication. I would make sure the patient understands the name of the medication, reason they are taking it, dosage, and any side effects they may experience. The teach-back method could also be useful when giving instructions for medications too. If a patient has poor knowledge about their own medications this could result in misuse and poor compliance impacting medication safety and health outcomes (Manchanayake et al., 2018).

What methods of therapeutic communication would be useful in advanced practice?

Communication between the advanced practice provider and the patient should be caring, plain language, and provided in a setting that is a blame-free environment (Yen & Leasure, 2019). Often times it is the responsibility of the advanced practice provider to hold critical conversations with patients/families regarding medical care, results, and prognosis (Stein et al., 2022). Some methods of therapeutic communication that are useful in advanced practice include active listening, being empathetic, and clarifying information for patients to make sure they have an understanding.  

References

Manchanayake, M.G.C.A., Bandara, G.R.W.S.K., & Samaranayake, N. R. (2018). Patients’ ability to read and understand dosing instructions of their own medicines – a cross sectional study in a hospital and community pharmacy setting. BMC Health Services Research, 18(425). https://doi.org/10.1186/s12913-018-3252-1

Stein, D., Cannity, K., Weiner, R., Hichenberg, S., Leon-Nastasi, A., Banerjee, S., & Parker, P. (2022). General and unique communication skills challenges for advanced practice providers: A mixed-methods study. Journal of the Advanced Pratitioner in Oncology, 13(1), 32–43. https://doi.org/10.6004/jadpro.2022.13.1.3

Yen, P. H., & Leasure, A. R. (2019). Use and effectiveness of the teach-back method in patient education and health outcomes. Federal Practitioner, 36(6), 284–289.