NR 305 Week 1 Discussion

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 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 Search Collapse All More Sort By:      Instructor Cork Instructor Cork 10/13/2016 8:32:38 PM RE: Class begins Mon, Oct 24th Modified: 10/19/2016 5:54 PM Class - You may begin posting in this TD on Sunday, October 23th, 2016 for credit. Class officially begins Monday, October 24th. Thank you. Missy ReplyShow Less Lilian Galaviz Lilian Galavizreply to Instructor Cork 10/23/2016 1:53:08 PM RE: Class begins Mon, Oct 24th Hello, I'm really excited to begin this new class. I just wanted to let you know I posted my first answer twice, given that I posted the first one before the 23rd so I wasn't sure if I would get credit or not. Thank you! ReplyShow Less Instructor Cork Instructor Corkreply to Lilian Galaviz 10/24/2016 10:26:24 AM RE: Class begins Mon, Oct 24th Thank you, Lilian. I appreciate that. I will certainly accept the early posts for week one due to my error. :) Missy ReplyShow Less Instructor Cork Instructor Cork 10/13/2016 8:34:29 PM Additional questions for Week 1 As you respond to this scenario on Maria, you may also want to consider the following questions as you develop responses throughout the week: a) Look at the Healthy People 2020 areas of concern. Which of these factors are of greatest concern to your community? b) What is your definition of wellness? Compare it to the WHO definition. How does it compare with other definitions of wellness? c) What are some of the established tools that can be used to assess health risks and lifestyle? Which one do you find most helpful? Thank you! Missy ReplyShow Less Dorothy Cochran Dorothy Cochranreply to Instructor Cork 10/30/2016 8:18:51 PM QuestionRE: Additional questions for Week 1 Hello Professor and Class, I believe that the greatest Healthy People 2020 concern in my community is substance abuse. I personally know a handful of people who have died of overdoses and several more that have been personally affected by such deaths. Recently a task force has been formed in my community with a goal of decreasing distribution of and increasing education on recent batches of heroin that are laced with fentanyl. The number of associated deaths have been devastating. My definition of wellness, which I thought was different than most, is optimal quality of life in the presence of disease. This would include remaining free of or managing symptoms as best as possible for as long as possible. My definition is highly defined by my experience with multiple auto-immune diseases. The WHO definition of health and wellness is much the same. Culture and society also influence how health is perceived. People who live in poverty may well think that illness, disease, and debility are a regular part of life, along with mot having access to health care. There are many tools that are useful is assessing health and life style risks. The BMI scale is useful for measuring obesity. Obesity has a very long list of related health conditions. At work we use the BRADEN scale to assess risk of skin break down, the resulting score determines how we monitor the patients skin and what interventions may be necessary. Personally, I use an app to track my fitness, weight, and nutrition to promote a healthier lifestyle and to hopefully prevent associated obesity risks. Dottie Cochran References Jarvis, C. (2016) Physical examination & health assessment (7th ed.). St. Louis, MO: Elsevier U.S. Department of Health and Human Services (2014). Healthy People 2020. Retrieved from: ReplyShow Less Shiara Kaye Peart Shiara Kaye Peart 10/18/2016 1:39:10 PM Healthy People Initiative Hi Prof and Class, Additional information I would try and gather from Maria would be her eating habits. First, I would want to know how much and when does she eat her meals? This will help me determine what nutritional suggestions I can offer her. Second, what activities/exercises has she tried ever since she noticed she had gained weight? If Maria has not done any type of exercises/diet to help reduce her weight, then this will help me identify an appropriate activity/diet for her. And lastly, with the consideration of her cultural background, gathering information about her support system at home. This will help me determine if Maria will need additional support to help push her to lose and maintain her ideal weight. With Maria’s lifestyle and eating habits the way it is, Maria is definitely at risk for conditions such a heart disease, HTN, and diabetes as stated in Healthy People 2020. Living a healthy lifestyle will help promote and reduce the risk of acquiring many of these conditions. In continuation, in helping Maria reach her goal, her cultural background must also be considered prior to because her culture may think that being 14pounds overweight is completely normal while we think different here in America. With Maria being at a high risk for HTN, a short term I have for would be to demonstrate change in eating pattern within a week of starting the weight loss program. Nursing interventions I would incorporate into her plan of care would include the following: 1. Identify her desire to lose weight- Motivation can affect her weight loss program. She must want to lose weight or otherwise the program will not succeed. 2. Encourage Maria to keep a daily food diary including when, what, and how much she ate- This will help Maria focus on factors that she can control and change. And 3. Instruct and assist Maria in appropriate food selections especially avoiding foods that are high in saturated fat- Avoiding saturated fat will help reduce the risk of developing HTN. Jarvis, C. (2016). Physical examination & health assessment (7th ed.) Philadelphia, PA: Saunders. Nutrition and Weight Status. Healthy People 2020. Retrieved from Jakulj, F., Zernicke, K., Bacon, s., van Wielingen, L., Key, B., West, S., and Campell, T. (2007). A High-Fat Meal Increases Cardiovascular Reactivity to Psychological Stress in Healthy Young Adults. The Journal of Nutrition. 137(4) 935-939. Kaye ReplyShow Less Instructor Cork Instructor Corkreply to Shiara Kaye Peart 10/24/2016 10:29:14 AM RE: Healthy People Initiative Shiara - you shared some very good points as far as Maria's plan of care. Evaluating Maria's desire to make changes will be necessary. She must make the decision and then the decision can be supported and encouraged. Missy ReplyShow Less Cailee Christman Cailee Christmanreply to Shiara Kaye Peart 10/26/2016 9:17:40 PM RE: Healthy People Initiative Shiara, Great post! I could not agree more with your discussion this week in its entirety. You really did a great job pinpointing the barriers within the Hispanic culture as a whole and provided excellent POC examples. I look forward to reading you future posts :) ReplyShow Less Karen Eyler Karen Eylerreply to Shiara Kaye Peart 10/27/2016 9:49:54 AM RE: Healthy People Initiative Dear Kaye, I agree with your suggestions, especially assessing her support system. It sounds as though Maria takes on a lot and doesn't have much help at home. Being able to delegate some of her daily tasks would be helpful in alleviating her responsibilities, if she has someone that can help. It may also be that she is just an over-achiever who feels like she needs to do all of this on her own. In the Hispanic culture the women take on more of the mothering, care taking role and the men are more the provider and financial supporter. In this day in age, with women in the workforce, and Maria wanting to further her education to also become a financial provider, it requires a teamwork approach. Realistically, Maria's weight gain will not improve if she doesn't change her routine. Hopefully her family will be supportive and also change some of their habits. Interesting conversation.... Karen Eyler ReplyShow Less Enrique Gonzalez Enrique Gonzalez 10/18/2016 1:45:58 PM Questions to Maria Hi Professor Cork and fellow classmates, Maria has a very interesting but common story which many students have obstacles to hurdle. When you hear Maria story most of us will think that she is overwhelmed. One of my questions to her would be does the stressors of life stop her from getting assignments done. In the reading were told that in order we must understand our own culture to respect other cultures around us (p13). There is another question I would like to ask Maria, how does her husband help accomplish some of her goals in school. Coming from a Spanish culture traditionally the women stays at home takes care of the kids and does all the cooking and takes care of her husband needs. When I was in school I had a classmate that had very similar issues but did not have any help or support of others that accomplish this great feet over there adversities. I am concern about the running around that she is doing and hope that she is hydrating herself , because as dehydration can lead to syncopal episodes . Javis Carolyn, P. (2016). Physical Examination and Health Assessment.(p.13) Reply EditShow Less Shiara Kaye Peart Shiara Kaye Peartreply to Enrique Gonzalez 10/18/2016 3:34:08 PM RE:Questions to Maria Hi Enrique, you bring up a very good point... it does seem like Maria is overwhelmed... I never thought of it that way... I definitely agree with you about addressing the stressors in her life, however I do want to add to your question and actually addressing the problem she came up with (14lb wt gain). Maybe asking her on what she thinks on what could've caused the weight gain? This will probably give us a little bit more insight on what is really going on.. Kaye ReplyShow Less Jennifer Branham Jennifer Branhamreply to Shiara Kaye Peart 10/25/2016 12:26:37 PM RE:Questions to Maria Hello Enrique and Kaye, I think her emotions are an important priority because like you both stated, she is overwhelmed and if it is not considered appropriate in her family for her to be going to school, then she may be silently reaching for help. She came because of concerns for weight gain, which is unusual to see a physician for a 14 lb gain over 2 years. I believe maybe she may be slightly depressed because of not having any help with school and household duties along with getting little sleep. She may be fine, but this would send a little flag up to me. Am I the only one? ReplyShow Less Shiara Kaye Peart Shiara Kaye Peartreply to Jennifer Branham 10/25/2016 4:35:29 PM RE:Questions to Maria Hi Jennifer, I think you also made a great point. Yes, her life situation does send a little red flag. I do agree that she maybe silently asking for help but we can not really just assume that she is depressed until we actually get a little bit more information. We can probably try and get her a psych consult but I think we need to address the "actual" problem first. Kaye ReplyShow Less Karen Eyler Karen Eylerreply to Jennifer Branham 10/27/2016 9:58:05 AM RE:Questions to Maria Jennifer, You bring up a very good point. She may definitely be seeking help from an abusive situation. But as we know it takes an abused person approximately 7 times of being asked before they may admit to their abuse. The fact that she is reaching out is step one in the process of change. As a provider I would bring Maria back frequently to be able to assess her physical and mental state to see if any signs of abuse were occurring. It may just be that her husband has a demanding job that requires a lot of his time and he doesn't have time for himself, but without knowing for sure, it will be hard to assess with just one visit. Having been in an abusive relationship myself, I am proud of her for wanting to further her education and to become an independent woman and mother, setting an example for her young children. I would also like to assess her support system with friends, to see if she has anyone she could rely on in an emergent situation. Providing her with information on support groups and shelters may be necessary if abuse is highly suspected. Thank you for your thoughts, it puts things into a different perspective. Karen Eyler ReplyShow Less Enrique Gonzalez Enrique Gonzalezreply to Shiara Kaye Peart 10/27/2016 12:01:53 PM RE:Questions to Maria Yea that is not a bad comment and I appreciate your input, thanks. Reply EditShow Less Joan Taylor Joan Taylorreply to Enrique Gonzalez 10/28/2016 11:06:18 PM RE: Questions to Maria Enrique and Class, You are absolutely right when you state that Maria story is very common with many students. Having a support system as a student is so vital and many students don't realize it until the stress level is increased. ReplyShow Less Lilian Galaviz Lilian Galaviz 10/19/2016 11:04:48 AM 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 information 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.