Health History and Screening of an Adolescent or Young Adult Client
February 8, 2018
Compare/Contrast · Treaties vs. Executive Agreements
February 9, 2018

Please review the video on the assignments page under the discussion section as it will provide you with an
opportunity to immerse yourself in the role of a nurse addressing tobacco use during routine patient care. In
doing so, reflect on what you have learned about tobacco use and the role that nurses and other interdisciplinary
team members play in helping to assist tobacco users with quitting. While viewing, it is also important to keep in
mind that tobacco users move through stages of change in the process of quitting. They move from precontemplation
to contemplation, contemplation to preparation; preparation to abstinence; abstinence to
maintenance. Every stage requires a different strategy by a nurse.
After watching the video, and reflecting on the information presented, address each of the following questions.
What are the common symptoms associated with an exacerbation of COPD
What assessment techniques will you use to assess Mary
Identify smoking strategies that would be appropriate for each of the encounters that Mary had with the nurse
throughout the video that could have been used to assist Mary in quitting smoking.
Find a resource in your community that could assist Mary. Start by searching the Internet for your local health
department’s website. What services are available to Mary Briefly describe the services that the state quit line
provides. Does it meet the 4 As Is it accessible, acceptable, affordable, or available for Mary
What will you do to follow up on Mary’s smoking cessation process
This is what the video says Case Study
Nurse: My next patient is Mary, She is 53, Caucasian and had a heart attack a year ago. She’s been seen today
for an exacerbation of COPD. She also has controlled type 2 Diabetes. She’s had depression that started when
she lost her job a year ago. She’s still unemployed but receiving government checks. But that’s not enough
income for her to live independently. She had to move in with her daughter and son in law. Today her chief
complaint is a harsh productive cough and increased Shortness of Breath. And she’s still smoking which is
upsetting her daughter who has a young child who is bothered by the secondhand smoke.
Nurse: Hi Mary, how you feeling today
Mary: Overall, I feel pretty healthy, I walk about a half hour every day. And ive been following the diet the
dietician suggested, watching what I proud of the fact that my diabetes has never been better controlled.
Nurse: So far so good. Is there anything that concerns you
Mary: lately, ive been coughing so hard and having difficulty catching my breath, which is causing me to feel
like I might be having some twinges in my chest. and I’m scared to death that I’m going to have another heart
attack. I want to know more I can do to prevent that from happening again.
Nurse: you are still smoking
Mary: yes, cigarretes are my one remaining vice. ive been smoking for over 40yrs. my parents smoked. and they
taught me how to light their cigarettes when I was 12.
nurse: how much are you smoking
Mary: about a pack a day, that’s 20 cigarettes. I light up first thing in the morning. if I don’t, its all I think about.
My boy craves it. Its just so frustrating especially since its upsetting my daughter and son in law so much. I don’t
know where I will go if they kick me out of their home.


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