Adolescent client who is reluctant to answer questions

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Instructions:
a. Create a scenario depicting an interaction between an NP and a client. Describe the setting and type of encounter.
b. Describe the client’s challenging behaviors related to the topic assigned.
c. Examine the potential impact of the client’s behavior on the client-provider relationship.
d. Analyze techniques to enhance communication with the client and address the client’s behavior.
e. Create sample documentation for the encounter.
f. Cite a scholarly source in the initial post.
Accurately analyze, synthesize, and/or apply principles from evidence
Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations
1. Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.
2. Reference Citation: Use current APA format to format citations and references and is free of errors.

Sample Solution

Scenario: NP and Client Interaction

a. Setting and Encounter

Setting: A busy urban primary care clinic.Encounter: A 30-minute follow-up appointment for a 45-year-old male client, Mr. Johnson, with a history of type 2 diabetes.

b. Client’s Challenging Behaviors

Mr. Johnson presents to the clinic visibly frustrated and agitated. He expresses disbelief in his diagnosis of type 2 diabetes, claiming that it is a conspiracy by the medical community. He refuses to adhere to the recommended diet and exercise plan, insisting that his lifestyle is healthy. He frequently interrupts the NP, dismissing her expertise and questioning her credentials.

c. Impact on Client-Provider Relationship

Mr. Johnson’s challenging behaviors can significantly erode the trust and rapport essential for effective healthcare delivery. His denial of the diagnosis and refusal to engage in self-management strategies can lead to complications and poor health outcomes. Additionally, his dismissive and confrontational attitude can create a hostile environment, making it difficult for the NP to provide quality care.

d. Techniques to Enhance Communication and Address Behavior

To improve communication and address Mr. Johnson’s behavior, the NP can employ the following techniques:

  • Active listening: Demonstrating genuine empathy and understanding can help to de-escalate the situation.
  • Empathy: Validating Mr. Johnson’s feelings without agreeing with his beliefs can foster a sense of connection.
  • Motivational interviewing: Exploring Mr. Johnson’s reasons for resistance to treatment can help identify potential barriers and develop a collaborative plan.
  • Setting limits: Establishing clear boundaries and expectations can help maintain control of the interaction.
  • Involving support systems: Encouraging Mr. Johnson to involve family or friends in his care can provide additional support and accountability.

e. Sample Documentation

  • Subjective: Patient presents for follow-up visit regarding type 2 diabetes. Appears agitated and defensive. Denies diagnosis, blames medical community for conspiracy. Refuses recommended diet and exercise plan. Expresses disbelief in NP’s credentials.
  • Objective: Patient’s blood sugar levels elevated. Patient demonstrates poor understanding of diabetes management.
  • Assessment: Patient exhibits denial and resistance to treatment for type 2 diabetes. Risk for complications due to non-adherence to treatment plan.
  • Plan: Educated patient about the importance of diabetes management and complications. Provided patient with written materials. Encouraged patient to consider involving family in care. Scheduled follow-up visit in one month.

f. Scholarly Source

Murray, R. M., Finlayson, M., & Treacy, P. (2011). Challenging patient behaviour: A review of the literature. Journal of Advanced Nursing, 67(9), 2007-2020. doi: 10.1111/j.1365-2648.2011.05764.x

This article provides a comprehensive overview of challenging patient behaviors and strategies for managing them. It offers valuable insights into effective communication techniques and the importance of building therapeutic relationships.

 

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