NR 509 Week 4 Discussion; Client Challenges - Adolescent client reluctant to answer
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Analyze techniques to enhance communication with the client and address the client’s behavior. An older adolescent client may not be profound to consultation, especially if difficult subjects such as recreational drug use which mentioned in front of the parents. They might not speak up due to fear of possible punishment. The nurse practitioner (NP) must be aware that the client may not want to talk about the "problem" until he is ready. Therefore, the NP must make every effort to gain the confidence and trust of the adolescent client. Older adolescents are in the stage of development where disapproval of others is extremely important, so they do not talk about their issues to protect their self-images (Srinath et al., 2019). It would be useful to ask the parents to leave the room and talk to the client alone. The NP can ease into collecting generalinformation from the client to build some common ground, such as what their interests are, who their favorite celebrities are, or what songs they have been listening to lately. This may take some time, but it would facilitate a relationship between NP and client (Srinath et al., 2019). The NP must remember to have much patience when it comes to children and adolescents and to take it slow. Over time, the client should eventually start to open up about their issues, and helpcan be guided from there. Create sample documentation for the encounter. The providers documentation should include all subjective information like medical history,allergies, and chief complaint,the objective information like vital signs, physical assessment, pertinent labs, or diagnostic findings, assessment is the NP's assessment like diagnoses and differential diagnoses,the plan which isthe suggestion of the client needs(Bickley, 2021). Subjective: 17-year-old adolescent male coming into clinic due to referral from school. The school states that he has recent behavioral changes consisting ofmany skipped classes and possible recreational drug use. Client only reports that he has been seenby others before without success. Per the mom, the client has no prior medical or psychiatrichistory. They also deny any family psychiatric history. Unable to obtain a review of systems dueto client reluctance to answer any questions or even wanting to do it. Objective: BP:128/61, HR:89, RR:21, O2:99% on RA, temp:98.9 F, Urine tox screen: positive formarijuana, alcohol screen: negative Assessment: Possible differential diagnoses are acute anxiety, drug abuse, and depression. Physical: The client is uncooperative and reluctant to speak. He appears to be in mild distress when his momargues in the exam room. Hehas dressed appropriately for his age. He has minimal eyecontact, and flat affect, cognition is intact, and he has a short attention span. The examination is limited due toclient reluctance. Plan: My suggestion for the future care of the client will be monthly visits until the client feels comfortable talking about his issues. Behavioral assessments must be done once the client opens up. Education willalso be given regarding marijuana use and cessation program. It also appears that parent might be a part of the problem, so I
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