Describe the importance of pertinent positive and pertinent negative findings in gathering a patient history.
- Describe the importance of pertinent positive and pertinent negative findings in gathering a patient history.
- Then, using the information from the Mental Health assignment in Shadow Health, describe two areas in the history where you elicited a pertinent positive finding. Describe what the positive findings were and why these may be significant.
Note ( incorporate this into your paper ) based on the interview
On the shadow health revealed that Ms Jones
Pertinent Positive Findings from the Shadow Health Interview with Ms. Jones. Negatives: It took a lot of questions before ms jones revealed to me she was involved in an accident about a month ago.
1. Difficulty Sleeping Related to StressOne pertinent positive finding was Ms. Jones’ report of difficulty sleeping, which she stated began about one month ago. She explained that this occurs mainly at night when she overanalyzes upcoming exams, finds a job, and manages life responsibilities.
This is significant because chronic sleep disturbance can be a symptom of anxiety or depressive disorders and can also exacerbate other mental health symptoms, such as poor concentration and fatigue. Her sleep difficulties, linked directly to stress and worry, suggest that anxiety may be a contributing factor and warrant further assessment and intervention.
2. Ineffective Coping MechanismsAnother pertinent positive finding was Ms. Jones’ description of her coping strategies, which include making to-do lists, talking with friends, and attending church. However, she acknowledged that these methods have not been effective lately in relieving her stress or improving her sleep.
This is significant because it indicates a lack of effective coping strategies and suggests that her current support systems may be insufficient. Identifying this allows for a targeted plan that might include cognitive behavioral therapy (CBT), stress management techniques, or counseling referrals to build healthier coping mechanisms and reduce psychological distress.
3.was involved in a minor fender bender, but states everything was fine