Cultural, Spiritual, Nutritional, & Mental Health Disorders
For this Discussion, you will take on the role of a clinician who is building a health history
Case 1
Chief Complaint " came for my annual physical , but do not want to be a burden to my daughter."
History of Present Illness(HPI) At-risk 86-year-old Asian male - who is physically and financially dependent on his daughter, a single mother who has little time or money for her father's health needs.
Past medical History
Hypertension (HTN), gastroesophageal reflux disease(GERD), b12 deficiency and chronic prostatitis
PSHS/P cholecystectomy
Drug HxCurrent Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and Cipro 100mg daily.
Allergies: none
Family Hx
Review of Systems (ROS)
General
+ weight loss of 25 lbs over the past year; no recent fatigue, fever, or chills.
Head, Eyes, Ears, Nose & Throat(HEENT)
No changes in vision or hearing, no difficulty chewing or swallowing. Neck
No pain or injury Respiratory
CV
GI
GU
no urinary hesitancy or change in urine stream Integument
multiple bruises on his upper arms and back.
MS/Neuro
+ falls x 2 within the last 6 months; no syncopal episodes or dizziness
PE
B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt110; BMI 17.8
General
HEENT
Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.
Lungs
CTA AP&L Card
S152 without rub or gallop
Abd
benign, normoactive bowel sounds x 4 GU
Ext
no cyanosis, clubbing or edema Integument
multiple bruises in different stages of healing - on his upper arms and back. MS
Neuro
No obvious deformities,
CN grossly intact II-XII
answer the following questions:
Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
Utilizing the five assessment domains, which ones would you utilize on your patients in conducting a comprehensive nutritional assessment.
Discuss the functional anatomy and physiology of a psychiatric mental health patient. Which key concepts must a nurse know in order to assess specific functions?
Sample Solution
Socioeconomic Factors:
- Financial Dependency: The patient's dependence on his daughter for financial support limits his access to healthcare resources and may contribute to neglect or delayed care.
- Social Isolation: Living alone and having limited social support can impact the patient's overall well-being and adherence to treatment.
Full Answer Section
Spiritual Factors:- Cultural Beliefs: Understanding the patient's cultural beliefs about health, illness, and the role of healthcare providers can help tailor care to meet his needs and preferences.
- Nutrition: The patient's weight loss and BMI suggest inadequate nutrition, which may be related to limited resources or difficulty preparing meals.
- Physical Activity: The patient's level of physical activity is unknown, but it could be influenced by his age, health conditions, and limited resources.
- Substance Use: The patient's medication history does not indicate any current or past substance use, but this should be assessed to identify potential risk factors.
- Cultural Beliefs About Illness: Understanding the patient's cultural beliefs about illness and treatment can help to ensure culturally sensitive care.
- Language Barriers: If there are language barriers, appropriate interpreters should be used to facilitate communication and ensure effective care.
- Diet History: Assess the patient's typical dietary intake, including frequency, portion sizes, and types of foods consumed.
- Medical and Social History: Review the patient's medical history, social history, and any factors that may affect their nutrition, such as chronic diseases, medications, or living situation.
- Anthropometric Measurements: Measure the patient's height, weight, BMI, and body composition to assess nutritional status.
- Biochemical Data: Review laboratory tests, such as complete blood count, albumin, prealbumin, and electrolytes, to assess nutritional status.
- Clinical Evaluation: Assess for signs and symptoms of malnutrition, such as weight loss, muscle wasting, fatigue, and poor skin condition.
- Neurotransmitters: Chemical messengers that transmit signals between neurons in the brain. Imbalances in neurotransmitters are often implicated in psychiatric disorders.
- Brain Structures: Different brain regions are involved in various cognitive, emotional, and behavioral functions. Understanding the anatomy of the brain can help to identify the underlying causes of psychiatric symptoms.
- Psychopathology: The study of the nature, causes, and development of mental disorders. Knowledge of psychopathology is essential for accurately diagnosing and treating psychiatric conditions.
- Cognition: Memory, attention, problem-solving, and executive functioning.
- Mood: Affect, mood regulation, and emotional expression.
- Behavior: Thought processes, communication, and social interaction.
- Perception: Sensory perception and interpretation.
- Psychomotor Functioning: Movement, coordination, and speech.