Week 2 Discussion: Assessment for Health Promotion (graded)

Sample Answer for Week 2 Discussion: Assessment for Health Promotion (graded) Included After Question

Discussion

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 5 hours of sleep per night, but that is okay with her. She drinks coffee all morning to “keep her going.” She lives 1 hour from campus and commutes each day, and often drinks diet cola to “stay awake.” When asked what she does to relax and de-stress, Maria states she “doesn’t even have time to think about that.”

Maria’s vitals today are as follows; T 98.6, R 20, HR 88, BP 148/90

Using the lesson and text as your guide, answer the following questions.

1. What additional assessment data (subjective and/or objective) would you like to gather from Maria?
2. What actual health concerns and risk factors have you identified?
3. What are some opportunities to promote health and wellness for Maria?
4. Write one nursing diagnosis for Maria (actual, wellness or risk), based on one of the health concerns or opportunities you have identified. (Please use one of the formulas outlined in the text and lesson!)

Remember to use and credit the textbook or lesson, as well as an outside scholarly source, for full credit.

1. Additional subjective and objective data for Maria:
   1. Ask for an example of a 24 diet or food diary for her.  What exactly is eaten to get a better idea of the amount of daily calories and intake?
   1. How much coffee and diet cola is being ingested daily?  How much water intake?
   1. Any pertinent PMH I need to be aware of–medical diagnoses?
   1. Medications list including OTC meds.
   1. Details of mental health: what type of work does her spouse do?  How available is he to assist with family and home? Why exactly does everything seem to fall on her to be completed at home?  Religious beliefs?
   1. Sleep-Do you have difficulty falling asleep, staying asleep?
   1. Any routine for exercise?  Any recreational/leisure activities you enjoy?  Do you participate in any activities (physical) with your children?
   1. What do you do to cope with stress/anger?  What support system do you have in place?
   1. Obtain objective data by doing a complete head to toe assessment outside of the already provided vital signs.

Collecting subjective and objective data is a vital piece of the puzzle to be able to complete a nursing assessment. (Weber, Kelley, 2018)  Being able to obtain a complete health history means you are collecting as much subjective data about the patient as possible.  Obtaining the objective data requires a lot of practice on the nurses part to become proficient and accurate. (Weber, Kelley, 2018)

2) Actual risk factors and health concerns identified:

1. Fatigue r/t only obtaining 5 hours of sleep every night and using caffeinated beverages throughout the day
   1. Stress/anxiety r/t multiple responsibilities of home/school
   1. Excessive caloric intake vs sedentary lifestyle r/t diet and inability to find time for exercise

3) Opportunities to promote health and wellness to Maria:

1. Ask Maria to keep a food diary or use an app like myfitnesspal to track her intake daily to see if there is a pattern where things could be changed within her diet
   1. Give Maria information to be able to speak to a counselor pertaining to her stress levels to give her an outlet.  This can also possibly allow counseling to include her spouse so he understands she needs him as a support system and how to manage that.
   1. Try to encourage Maria to make a calendar for time management.  This will give her the opportunity to place everything in her life into a schedule, see where she could possibly make changes or make better use of all of her time to complete things efficiently for her and her family.  This could also give her the opportunity to have recreational/leisure time to then have an outlet for her stress/anxiety.
   1. Encourage Maria to find time to not only have quality time with her children, but possibly incorporate physical activity to give all of them energy, keep them moving and have that mental/emotional release.

Opportunities to promote health wellness can be difficult with minority groups such as Maria.  Research has shown that utilization by Mexican women for preventative services is huge.  (Mendias et al., 2001)  So due to her ethnic background she may be hesitant to recognize the need for holistic health services or even where to get the help she sounds like she truly needs.

4) Nursing diagnosis for Maria:

Imbalanced nutrition: more than body requirements r/t excessive intake in relation to metabolic need as evidenced by the patient stating she has had a 14 pound weight gain 

References:

Weber, J., Kelley, J., (2018).  Health Assessment in Nursing 6th ed., 2-3.

Mendias, E., Clark, M., Guevara, E., (2001).  Women’s self-perception and self-care practice: implications for health care delivery. Health Care for Women International. 22(3). 299-312.  Retrieved from:  https://eds-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=10&sid=1e3683e7-5e66-4a5d-806c-3a37e6d47c7d%40sessionmgr4006Links to an external site.

A Sample Answer for the Assignment: Week 2 Discussion: Assessment for Health Promotion (graded)

Title: Week 2 Discussion: Assessment for Health Promotion (graded)

5. Grading Rubric

Discussion Criteria	A (100%) Outstanding or highest level of performance	B (87%) Very good or high level of performance	C (76%) Competent or satisfactory level of performance	F (0) Poor or failing or unsatisfactory level of performance
Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week. 16 points	Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.16 points	Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.14 points	Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.12 points	Minimally addresses the initial discussion question(s) or does not address the initial question(s).0 points
Integrates evidence to support discussion. Sources are credited.* ( APA format not required) 12 points	Integrates evidence to support your discussion from:assigned readings** OR online lessons, ANDat least one outside scholarly source.***Sources are credited.*12 points	Integrates evidence to support discussion from:assigned readings OR online lesson.Sources are credited.*10 points	Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.Sources are credited.*9 points	Does not integrate any evidence.0 points
Engages in meaningful dialogue with classmates or instructor before the end of the week. 14 points	Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.14 points	Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.12 points	Responds to a classmate and/or instructor but does not further the discussion.10 points	No response post to another student or instructor.0 points
Communicates in a professional manner. 8 points	Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).8 points	Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).7 points	Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).6 points	Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).0 points
PARTICIPATION: Response to initial question: Responds to initial discussion question(s) by Wednesday, 11:59 p.m. M.T.	0 points lostStudent posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.		-5 pointsStudent does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.
PARTICIPATION Total posts: Participates in the discussion thread at least three times on at least two different days.	0 points lostPosts in the discussion at least three times AND on two different days.		-5 pointsPosts fewer than three times OR does not participate on at least two different days.