Effective commuication in history taking

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The following paper is a presentation of a difficult medical situation which needs to be addressed with understanding and in portraying emotional intelligence. The aim of the case is to influence the possible outcome in the context of a threatening situation. Some of the points which will be addressed in the paper include the effective communication, the role of the nursing in handling the case, aspect of history taking from the patient and the importance of pharmacokinetic and physiology and allergic reactions.

Effective communication in history taking

In most cases, family nursing find themselves in situations that are challenging in their clinical operations. These conditions in most cases leave the nursing with feelings of frustrations, and the patient may also not be satisfied due to the service delivery of a nursing which may be affected by the poor working condition that has been presented. The patient may have their needs unmet, with medical issues that have not been resolved or have their expectations being unfulfilled. The common physical factors include bias against a particular medical condition, communication skills that are poor. It also includes the tendency of a patient refusing to adhere to the prescriptions of a nursing and symptoms that are multiple and poorly defined stressing situations such as interference of the third parties in the process of treatment (Sheldon, Barrett & Ellington 2016.). The situational factors which can occur in the process of treatment include the social issues which are complex, the pleasure of time during visits and conflicts between the patient and the staff. In the management of a complex clinical accountancy, the nursing has to factor out all the causative factors and starting with the individual personality characteristics. The nursing should incorporate the skills of sympathetic communication to achieve the plan that has been mutually agreed. The duration and timing of visits and also the expected conduct that is required in the process of negotiation (Arnold & Boggs 2015). The nursing should possess the skills of caring, and evaluation to determine the challenges that the patient is experiencing. The assessment and understanding of the factors which are contributing to the difficulties of the patient should be considered to achieve a more effective experience with is satisfactory to the patient.

Nursing Factors in Handling the Case

The experience of a nurse should be brought to the encountance with the patient. At a scenario where the ability to improve the conditions of the patient is endangered, like the father who raises his voice and demands the immediate treatment of his daughter in the case provided, the identity and ability of the nurse are also undermined. In this case, the nurse is impaired and the service delivery is also compromised because the nurse develops a feeling that his ability and knowledge are being challenged and therefore can respond defensively (Kourkouta & Papathanasiou 2014). Besides, when a patient is presented with symptoms that are recurrent like in the allergic case that is presented in the study case, the nurse can question their ability to influence the behavior of the patient. In the case where the self-image or competence of a nurse is challenged as in the situation where the father to the sick girl raises his voice to the nurse, the nurse becomes vulnerable to his professionalism. In pursuit of sustaining the quality of patients care, the nurse has to be consistent in achieving and promoting their self-care. The self-awareness of a nurse is the initial step in facilitating the success of a difficult encountance.

The Approach to a Difficult Situation

Each challenging clinical experience has aspects which are peculiar, and the skill of recognizing the components of the experience is useful in the management of these situations. The nurse’s awareness of the internal feelings can result in fewer chances of the patient being categorized as challenging. This may also lead to a negative feeling towards the patient which includes the feelings of anger and frustrations. These can damage the relationship between the nurse and the patient. Some strategies can help the nurse in identifying the personal factors which contribute to the difficult encountance with the patient (Bramhall 2014). These factors include recognition of bias, self-reflection and holding a discussion with an experienced colleague. The factors can also include aspects such as seeking help from a psychotherapist and other focus groups within the medical environment. In the case provided, the nurse should handle the father of that patient in a calm manner and resist from showing any forms of anger and refrain from showing any kind of negative attitude both to the ailing girl and also to the parents. This strategy will help in allowing the father to compose himself and give the nurse the required time in treating the girl. Despite the unfavorable environment, the nurse can give a positive tone and give an explanation of the situation to the parents. In the situation, the nurse can give his recognition of the fact that the patient needs more time for assessment and address the situation within the shortest time possible.

The form of interview that the nurse can use in this context is the patient-centered approach which is meant to appreciate the allergic condition of the girl. The motivation interview can also be used where the nurse explores the desires of the patient and her needs. The identification of the expectations of the girl and that of the parents can allow the nurse to have an insight and develop more appropriate forms of treatment mechanisms (Cios & Moore 2012). The parents can be involved by asking them the cause of the problem and other potential solutions. This strategy can increase the collaboration between the nurse and the parents of the girl. A mutually agreed plan can be achieved as a preventive measure of possible subsequent cases of illness.

History Taking in the Patient

The presented patient is identified as having an allergy induced asthma and therefore, successful treatment depends on a completed understanding of the particular condition of the girl. This applies because the treatment focuses on the individual reaction of a patient to the allergy. As a nurse the physiologic changes in the body of the patient must be identified (Roth & Wil 2012). The environment of the patient also has to be understood especially if the patient shows signs of particular reactions such as fever, eczema, and asthma which is prevalent in the girl.

Since allergic reactions induce the symptoms of the patient, then different characteristics have to be identified with particular conditions of the pathogens. The patient has to be assessed for allergic conditions which are an addition to the symptoms which have been identified initially. These can include positive response to allergy in the family members and the presence of eosinophilia in the blood of the patient. Besides, any disease that is caused by allergic reactions may coexist with other complicated forms of diseases, and therefore, special care should be taken before the commencement of the treatment (Skidmore-Roth 2013). Even in cases where the patient may not have asthma, it is still important to ensure that the patient is not suffering from organic diseases of the lungs, heart and even obstruction of the trachea since it presents asthmatic symptoms. The most effective means for treating allergic reactions are the identification of the causative agent and eliminating it in the environment of the patient. In the case presented, the patient is allergic to cats. Although there are no cats in her home, the movement of the patient should be controlled by her parent until the time when she can make judgments on herself and avoid environments with cats.

The diagnosis of the current condition of the patient mostly involves three pillars which include the skin test, physical examination of the patient and the history of the patient. In conducting the skin test, care has to be taken because positive skin tests at times can occur in the absence of symptoms (Potter, Perry, Stockert, Hall, & Peterson 2012). This condition is evident in many patients such as a patient who experiences fever in winter but is experiencing problems in summer and has a positive skin test to the pollens. Therefore, skin tests are no reliable means of concluding the conditions of a patient.

The conditions which are present in the patient are common in many people and many cases, the patient experiences more reactions than the other. The most common symptoms to observe in the patient includes having a runny nose, coughing, and watery eyes. This condition can be as a result of the patient inheriting the condition from either of her parents (Vogel 2013). In the treatment of the disease, the patient can be prescribed for montelukast. This drug will help the patient in both in her allergic and asthmatic conditions. The medication will be administered as a single pill to assist the patient in developing and boosting her immune system against reactions. Allergy shots can be administered to the girl to help her body in building up for the immune tolerance. This medication introduces small quantities of allergen into the body of the patient. The approach is also considered as immunotherapy and requires a series of administration over several years (Wylie 2012). Though the number of years has not been determined and includes the reactions of a patient, the number is an average of three years. Another form of treatment that can be administered to the girl is the use of anti-immunoglobulin immunotherapy, which involves targeting a particular chemical which triggers the reaction first in the body. However, this form of treatment is recommended to people who experience severe to a moderate persistence of asthmatic conditions and who have experienced a failure in the standard therapy.

Importance of pharmacokinetic in Allergic Reactions

Pharmacokinetics is a presentation of the relationship between the dosage of a drug and the time profile of concentration. These relationships are governed by three principles which are the clearance, distribution volume and half-life elimination (Khan 2014). The aspect of clearance represents the volume of the fluid which is entirely cleared from the drug per unit of time. Distribution volume is the content in which a drug has been distributed to develop the concentration which has been measured. The elimination of half-life is the time which is required in the clearing of the half of the drug from the body.

When treating a patient with allergic reactions, it is important to have the knowledge of the volume of the medicine that is required in the body of a patient and the expected concentration of that drug. It is also important in determining the clearance of the drug in the body of the patient. This is the time which the drug is expected to have effects on the body of the patient and become assimilated in the system of the patient. It indicates the exact time which is required to achieve a steady state in the system of the patient and can be used in the determination of the maximum levels of dose between intervals which can produce the expected results (Pharmacokinetics 2017. These aspects of pharmacokinetic are important in the treatment of allergic reactions which induces asthma to a patient. The failure to observe the correct clearance and distribution of the dosage of a drug may lead to more reactions to the patient instead of acting to reduce the reaction.

Most of the factors of pharmacokinetic influence the agents of antiarrhythmic and the route of administration at the time of treatment are varied depending on the conditions of the patient. As a result of differences in metabolism, different results are obtained depending on if the drug was administered through intravenous or oral methods. The achievement of a state of the levels in the blood does not guarantee the achievement of enough myocardial drugs levels (Roth & Wild 2012.). It also does not show that a steady state of effect has been attained. There are various important delays in the accumulation of the pharmacokinetic in the body and until the metabolism, and the properties of the drugs are identified, most of the subsequent testing will be designed with specific antiarrhythmic factors to achieve the expected results.

In most drugs, pharmacokinetic is useful in the determination of the regimen dosage, and it is helpful in comparing the bioavailability of other related drugs which can be used to reduce the reactions of an allergic condition. It is also important in the analysis of the organ which is based on functional activities. An example is the clearance of hepatic rate which might give a peek in the liver of a patient.

Importance of Physiology in Allergic Reaction

Physiology is the study of human beings and other animals and their functions and interrelations and their functions from the level of a cell, organ, tissue, system and even the whole body. The main intention for physiology is to explain the important mechanism which functions in a living organism and their interaction with each other (Sieck 2017). This study is not only important is establishing the duties between the human and animals, but also important in the field of medicine in understanding diseases and the ability to treat and control the diseases in a more effective manner. People develop a different relationship with different animals. The girl who has asthma has contacted her allergic reactions from her relationship with a cat. The effective treatment and control of her disease are through the elimination of environment where she can contact with a cat to avoid the reaction of her body to the presence of the animal (Lin et.al 2014). The study is also important in helping to determine the importance of psychological and mental points of view and helping people to understand the nervous systems in which the subjective experience can be gained and the behavior control. Physiology is essential in the determination of the reactions of the human body cells to specific foreign agents which cause reaction in the cell and the body of an individual. The physiologists can study a particular enzyme which affects the functions of a specific sub cellular organelle in the body of an organism (Catlett, & Holditch-Davis 2013). From the results obtained, a control mechanism can be established, which involves the development of medicine to control the reactions.

Physiology is an important aspect of life because it is the foundation where the meaning of life is developed and therefore the sources of medicine which are used in treatment and control of body reactions. This field of science studies the normal biological functions and offers the understanding of functions that are not usually as seen in animals and translate the results into the management of human diseases. Such reactions include allergic conditions which are experienced in different categories of people depending on their environment. The reactions are then translated to research with the aim of developing solutions to the abnormal reactions that have been identified.


The above is a discussion of a difficult medical situation which needs to be addressed with understanding and in portraying emotional intelligence. Some of the points which will be addressed in the paper include the effective communication, the role of the nurse in handling the case, aspect of history taking from the patient and the importance of pharmacokinetic and physiology and allergic reactions.