NR 305 Week 1 Discussion
Healthy People Initiative (graded)
The topic this week asks you to apply what you have learned to the following case
... [Show More] study.
As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic who is in her second year of nursing school. She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. After conducting her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. She is married with two school-age children. She attends class a total of 15 hours per week, plus she must be present for 12 hours of labs and clinical. She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children. She states that she is lucky to get 6 hours of sleep per night, but that is okay with her. She lives 1 hour from campus and commutes each day. Using Healthy People 2020 and your text as a guide, answer the following questions.
What additional information would you like to gather from Maria?
What are Maria's real and potential health risks?
Why is Maria's culture important when obtaining the health assessment?
Pick one of Maria's health risks. What would be one reasonable short-term goal for this risk?
What nursing interventions would you incorporate into Maria's plan of care to assist her with meeting your chosen goal? Please provide rationale for your selections..
Respond
Topic responses
Discussion
Questions
WEEK 1
1. Things I would like to know about Maria: more about her reasons for seeking care, the perception she has of her health and why she wants to do something about her weight. I would also like to know any past medical history, as well as any family history. I would like to know if she is on any medications, if she has any allergies, and a functional assessment. Lastly I would like to have more objective information regarding her systems. I would also like to find out how she cooks her meals (ingredients, spices, etc) and how often and how much she is eating.
Jarvis (1993), states that “the following health history provides a complete picture of the person’s past and present health. It describes the individual as a whole and how the person interacts with the environment:
a) Biographic data
b) Reason for seeking care
c) Present health or history of present illness
d) Past history
e) Medication reconciliation
f) Family history
g) Review of systems
h) Functional assessments”.
2. Given that we don’t really know whether Maria is at a healthy weight or not, a potential risk would be obesity and unhealthy weight status. According to Healthy People 2020, individuals who are at a healthy weight are less likely to:
• Develop chronic disease risk factors, such as high blood pressure and dyslipidemia.
• Develop chronic diseases, such as type 2 diabetes, heart disease, osteoarthritis, and some cancers.
• Experience complications during pregnancy.
• Die at an earlier age.
Due to her Hispanic heritage, Maria is at higher risk for cardiovascular diseases and type 2 diabetes.
3. Culture plays a big part of how people perceive and treat illness. It can also affect the way we eat, dress, socialize, etc. Having all that in mind can help us make better decisions regarding our patient’s health because we can customize our care plans so that our interventions fit their way of life, which increases the likelihood of their compliance. Also, according to our lesson, "illness is a stressful time when patients rely on traditions and cultural beliefs", so in order for us to help them achieve an optimal outcome, we must respect and integrate their culture in their care.
4. A goal that I would choose is to maintain Maria’s A1C under 5.7. Given that Maria is concerned and seems like she wants to do something about her weight, my first intervention would be education. I would teach her about DM, her risks and how to prevent it. I would then develop a plan for her regarding her diet and how to make healthy versions of her favorite dishes. I would also try to help her develop an exercise regimen. She is a busy mom, but she needs to take care of herself to be able to take care of her family. “Lifestyle change has been proven effective in preventing or delaying the onset of type 2 diabetes in high-risk individuals. Based on this, new public health approaches are emerging that may deserve monitoring at the national level. For example, the Diabetes Prevention Program research trial demonstrated that lifestyle intervention had its greatest impact in older adults and was effective in all racial and ethnic groups.” (www.healthypeople.gov). I would also help her select a PCP or a clinic where she could go for follow up appointments and monitoring.
Reference
Jarvis, C. (7th Ed.). (1993). Physical Examination and Health Assessment. Retrieved from www.bookshelf.vitalsource.com [Show Less]