Socioeconomic, spiritual, lifestyle, and other cultural factors related to the health
History of present illness HPI-23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle.
Past medical history PHH- none
PSH- none
Drug history – denies
Allergies -none
Family history-He has a family history of diabetes, hypertension, and alcoholism.
Review of symptoms
General-No recent weight gains of losses, fatigue, fever, or chills.
Head, ears, eyes, nose, throat- none
Neck-none
Respiratoru-none
Cardiovascular-no chest discomfort or palpitations
Gi-none
GU-none
Integument-history of eczema – not active
MS/neuro-no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements
Objective data
Vital signs-B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6
General-23-year-old male appears well developed and well-nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress
HEENT-Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, nasopharynx clear, poor dentition – multiple carries.
Lungs-CTA AP&L
Cariac-S1S2, +II/VI holosystolic murmur; without rub or gallop
Abdominal-benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.
GU-none
Extremities-no cyanosis, clubbing or edema
Integument-intact without lesions masses or rashes
MS-none
Neuero-No obvious deficits and CN grossly intact II-XII
1.
Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
2. Utilizing the five assessment domains, which ones would you utilize on your patients in conducting a comprehensive nutritional assessment.
3. 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:
- Income and Education: The patient's socioeconomic status may influence access to healthcare, nutrition, and healthy living resources.
- Housing: The quality of housing can impact exposure to environmental hazards and access to healthy food options.
Spiritual Factors:
- Religious beliefs: The patient's religious beliefs may influence his views on health, illness, and treatment.
- Spiritual practices: Engaging in spiritual practices can provide emotional support and coping mechanisms.
Full Answer Section
Lifestyle Factors:- Substance use: The patient's use of marijuana and alcohol may have negative health consequences, including increased risk of addiction, mental health problems, and chronic diseases.
- Diet: The patient's diet may be influenced by cultural factors and socioeconomic status. A diet high in processed foods and unhealthy fats can contribute to obesity and other health problems.
- Physical activity: Regular physical activity can improve overall health and well-being. However, the patient's anxiety and substance use may interfere with his ability to exercise.
- Native American heritage: The patient's cultural background may influence his views on health, illness, and treatment. It may also impact his access to healthcare services and the quality of care he receives.
- Stigma: The stigma associated with mental health conditions and substance use may discourage the patient from seeking help or disclosing his symptoms.
- Five Assessment Domains for Nutritional Assessment
- Diet History: This includes information about the patient's typical dietary intake, eating habits, and any dietary restrictions or preferences.
- Anthropometric Measurements: This involves measuring the patient's height, weight, body mass index (BMI), and other physical characteristics to assess nutritional status.
- Biochemical Data: This includes laboratory tests to evaluate nutrient levels, such as hemoglobin, hematocrit, albumin, and prealbumin.
- Clinical Examination: This involves a physical examination to assess for signs of malnutrition, such as muscle wasting, edema, and skin changes.
- Functional Assessment: This assesses the patient's ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that require energy and nutrition.
- Functional Anatomy and Physiology of a Psychiatric Mental Health Patient
- Neurotransmitters: Understanding the role of neurotransmitters, such as serotonin, dopamine, and norepinephrine, in mental health conditions is essential for assessing and treating psychiatric patients.
- Brain Structures: Knowledge of the anatomy of the brain, including the frontal lobe, limbic system, and hippocampus, is important for understanding the underlying mechanisms of mental health disorders.
- Psychopathology: Understanding the various types of psychopathology, such as mood disorders, anxiety disorders, and psychotic disorders, is necessary for accurate diagnosis and treatment planning.
- Medication Effects: Nurses should be familiar with the mechanisms of action, side effects, and potential interactions of psychiatric medications.
- Therapeutic Relationships: Building therapeutic relationships with patients is crucial for effective psychiatric care. Nurses should understand the principles of therapeutic communication and counseling.