NURS 6512 Discussion: Diversity and Health Assessments example

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks. NURS 6512 Discussion: Diversity and Health Assessments example

ORDER  HERE A PLAGIARISM-FREE PAPER HERE

The Nurse practitioner should take the socioeconomic, spiritual, and cultural factors into consideration when building the patient’s health history. Also, the healthcare provider should be aware that people have different cultural and religious practices that influence their daily life, health, and wellbeing. Hence when interacting with patients to obtain information that will help to build up patient’s health history, the healthcare provider should be careful of sensitive comments that could be considered offensive and cause the patient to withhold vital healthcare information (Ball, Dains, Flynn, Solomon, & Stewart, 2015). NURS 6512 Discussion: Diversity and Health Assessments example

The assigned case study for this discussion is the case of the 54-year-old Caucasian male referred to the nurse practitioner’s clinic to get treatment from a recent hospitalization due to seizure he suffered from alcohol withdrawal. The patient is hypertensive and has a history of alcohol abuse, including cocaine. Also, the patient is homeless and presently lives in a local homeless shelter.

The healthcare practitioner should use the cultural assessment guideline in obtaining accurate and vital information about the patient’s beliefs and spiritual practices, including healthcare practices and daily rituals (Ball et al., 2015). The NIDA-Modified ASSIST screening tool will be used to get more information about patient drug use and alcohol abuse. This tool helps clinicians go through different kinds of questions in identifying harmful substances that can affect a person’s health when consumed (Ball et al., 2015). When interacting with the patient to gain information about the patient health and wellbeing, the nurse practitioner will be careful with her choice of words so that the patient does not feel bad about his present socioeconomic situation or living condition. Also, the nurse practitioner will be careful when asking the patient culturally sensitive questions and will communicate in the way manner that will make the patient provide all the necessary information needed for building patient health history. The five targeted questions to ask the patients include (Vermeir et al. 2015). NURS 6512 Discussion: Diversity and Health Assessments example

• How will you describe your physical condition and wellbeing, and what does spirituality mean to you?
• How do you carry out your spiritual beliefs?
• How will you describe your cultural practices?
• Please tell me how you ended up doing drugs?
• Please tell me the things you’ve done to try to stop doing drugs?
• Please tell me how you support yourself and your current lifestyle?
• Do you feel sad and depressed sometimes, if so, how often  and what do you do to overcome sadness and depression?

References

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to

            physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., … Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice, 69(11), 1257–1267. doi:10.1111/ijcp.12686

By Day 6 of Week 2

Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why. NURS 6512 Discussion: Diversity and Health Assessments example

response

You are correct on getting a health history of the patient and building rapport. I also believe that this patient should have a psych social done because most patient’s with alcohol abuse have some type of underlying psych issue that they need to deal with. You indicate that besides alcohol, this patient has polysubstance abuse including cocaine. Since the patient is homeless, he might have some type of underlying psych illness that he is self-medicating with the substances. Some psych medications can be costly, and the patient does not have insurance or stable income to be compliant with scheduled meds. Plus, some psych meds need to be monitored with routine lab draw that are done once or twice a week. The patient would not have the means to travel to the clinic for routine lab draws. So, being non-compliant with medication regimen would be something that the practitioner should include in the patient’s plan of care. A few assistance programs are available through states, nonprofits, and drug companies. (Wegmann, 2020). Assisting the patient in finding resources that they can utilize is a great way for them to stay compliant with meds. Some patient thinks that since they do not have money to buy the meds, then why should they continue taking the medication. But they do not know that there are programs out there that can help them, and it is free of charge. There are nonprofit organization or county clinic that offer routine check and dispenses meds free of charge to patient’s that meet the low-income criteria. The only thing that is required is an ID and for the patient to arrive during normal business hours. NURS 6512 Discussion: Diversity and Health Assessments example

Sometimes, the patient may not know or understand what type of illness they have or does not comprehend what they practitioner is teaching them. The miscommunication leads them to be non-compliant with teaching and follow up care. For example, the practitioner asks the patient to collect a urine specimen because they believe the patient has a urinary tract infection. For the practitioner to prescribe the correct antibiotic that the patient is not sensitive to, a UA and culture and sensitivity needs to be collected. The patient never collected a specimen, so the practitioner never prescribes the antibiotic. The patient’s illness exacerbate leading to a kidney infection and the patient ends up in the emergency room. This was all caused due to poor health teaching and miscommunication. Health literacy was affected by the variables of literacy, cognitive ability, culture and society, and individual characteristics. (Wannasirikul, Termsirikulchai, Sujirarat, Benjakul & Tanasugarn, 2016). At the end of all teachings, the practitioner should ask the patient if they understood the teaching and if they had any questions that needs to be clarified.

All the questions you presented are justifiable. If the patient has been abusing alcohol for a long period of time, there might some exacerbations related illness that needs to be discovered by the practitioner. Liver disease is a big one, so labs needs to be obtained especially the liver panel. Delirium tremens is a bad side effect of alcohol withdrawals. It is characterized by the rapid onset of severe confusion and changes in the way your brain regulates blood circulation and breathing. (American Addition Centers, n.d.). This could be a fatal symptom, but most of the time it would not be recognized because they think it is normal behavior of a person who is under the influence of alcohol and other substances. The treatment is that these symptoms needs to be recognized early to counteract the symptoms. IV benzos, antihypertensives, cooing measures, rehydration are just some of the treatment options. If recognized early patient will be saved and might not have any residual side effects from the disease. NURS 6512 Discussion: Diversity and Health Assessments example

References

American Addition Centers. (n.d.). What is delirium tremens. Retrieved on June 10, 2020 from https://americanaddictioncenters.org/alcoholism-treatment/delirium-tremens-symptoms-and-treatment

Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., & Tanasugarn, C. (2016). HEALTH LITERACY, MEDICATION ADHERENCE, AND BLOOD PRESSURE LEVEL AMONG HYPERTENSIVE OLDER ADULTS TREATED AT PRIMARY HEALTH CARE CENTERS. Southeast Asian Journal of Tropical Medicine and Public Health, 47(1), 109-120. Retrieved from https://search-proquest-com.ezp.waldenulibrary.org/docview/1799913077?accountid=14872

Wegmann, J. (2020). 5 reasons for medication noncompliance and how healthcare professionals can help. Retrieved on June 11, 2020 from https://pharmatherapist.com/5-reasons-for-medication-non-compliance-and-how-healthcare-professionals-can-help’ NURS 6512 Discussion: Diversity and Health Assessments example

response 2

Great post!! It is interesting to read through this post as it contains thoughtful arguments which are very informative. I must agree with you that the nurse practitioner should take the socioeconomic, spiritual, and cultural factors into consideration when building the patient’s health history (Brown, 2018). The challenge for health professionals is in understanding that patients often turn to their religious and spiritual beliefs when making medical decisions. Religion and spirituality can impact decisions regarding diet, medicines based on animal products, modesty, and the preferred gender of their health providers. The influence of culture on health is vast (Finset, 2018). It affects perceptions of health, illness and death, beliefs about causes of disease, approaches to health promotion, how illness and pain are experienced and expressed, where patients seek help, and the types of treatment patients prefer. The influence of culture on health is vast. It affects perceptions of health, illness and death, beliefs about causes of disease, approaches to health promotion, how illness and pain are experienced and expressed, where patients seek help, and the types of treatment patients prefer (Le Cam & Bolz-Johnson, 2019). NURS 6512 Discussion: Diversity and Health Assessments example

References

Brown, H. (2018). Fuelling patient engagement in health: Perceptions and utilisation of patient self-monitoring. https://doi.org/10.26226/morressier.5b719e485aff74008ae4cc5d

Finset, A. (2018). Family involvement, patient engagement and benefits of patient education interventions. Patient Education and Counseling, 101(6), 969. https://doi.org/10.1016/j.pec.2018.04.008

Le Cam, Y., & Bolz-Johnson, M. (2019). Expert by experience: Valuing patient engagement in healthcare. Patient Engagement, 233-267. https://doi.org/10.1007/978-3-030-14101-1_9 NURS 6512 Discussion: Diversity and Health Assessments example