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Scenario: At the insistence of his mother, 13-year old Michael is seeing his pediatrician to check a painful wrist injury that is making it difficult for him to complete schoolwork and participate in other activities. Michael is a Hispanic teenager who lives in a low socioeconomic and urban neighborhood. Michael had seen this doctor three months earlier to treat a sinus infection. Since then, he has lost a significant amount of weight. He also appears decidedly more disheveled and sloppily dressed compared to his earlier appointment. As you update his health history, he appears to be sullen and even hostile when replying to your questions. Michael is dismissive of his wrist pain, and complains that his mother is making a big deal out of nothing. You also notice that Michael’s mother has extensive bruising on her lower arms. While Michael’s wrist problem brought him into the office, you are aware that biopsychosocial factors may be impacting his health and well-being—and that a biopsychosocial history is as important as a physical exam.
Respond to the questions below from your perspective as the nurse providing care for this patient. Support your thoughts and ideas with appropriate citations from scholarly references.
1- Explain how the Home environment, Education and employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide/depression, and Safety (HEEADSSS) method of interviewing may help to identify biopsychosocial factors to help explain Michael’s health and well-being. Support your responses with appropriate resources. (1-2 paragraphs)
2– Using biopsychosocial factors, write two (2) questions that you would ask an adolescent patient suspected of drug or alcohol abuse. Provide a rationale for each question. (1-2 paragraphs)
3- Describe one screening instrument that you might use to help identify adolescent alcohol abuse. Justify the use of this screening instrument in this situation. Support your response with appropriate resources. (1-2 paragraphs)
4- Using biopsychosocial factors, create two questions for an adolescent patient suspected of experiencing domestic violence. Provide a rationale for each question. Support your response with appropriate resources. (1-2 paragraphs)
5- Explain how a biopsychosocial history helps to support a physical exam for a patient’s health. Support your response with appropriate resources. (1-2 paragraphs)
6- Explain the relationship between biopsychosocial factors and the social determinants of health. Support your response with appropriate resources. (1-2 paragraphs)
7- Describe two social determinants of health that are associated with the neighborhood and the built environment and relate to Michael’s health history and physical exam. Explain one way that this determinant of health might impact the ability to access, promote, or maintain health and well-being for each. Support your response with a reference to Healthy People 2020. (1-2 paragraphs)