An 89-year-old female complains of a “stabbing chest pain” and points to the area just below her scapula at the right mid-clavicular line. She states that she had an upper respiratory infection last week that “just seems to hang on.” She has no other complaints.
Course reflection assignment is part of the portfolio that students must complete during last class of the program. This assignment is due on week #15. Course reflection assignment has a value of 100 points. It accounts for 20% of the final grade.
There are similarities and differences in doing a physical assessment between an adult and child. Doing a head-to-toe between an adult and a child is similar in many ways except that the nurse should take into account changes related to puberty and developmental issues related with adolescence (Falkner, A., 2020). The nurse should explain to the patient the normalcy of those physical development. During this time there will also be an influx of hormonal changes, making the patient develop curiosity towards sex as a whole (Curtis, 2015). It will be the duty for the nurse to provide education for this too. The more information they get the more likely they will make an informed decision about their bodies (Falkner, A., 2020). In any assessment wether adult or child, the nurse should always practice standard precautions to protect both the nurse and the patient. The rationale for this is to prevent exchange of blood and bodily fluids and the use of hand hygiene, personal protective equipments and disinfecting potentially contaminated equipment and surface (Nelson, L., 2020). Before any physical assessment the nurse should prepare the things she will be using. Although the list of equipment for both adult and child are basically similar, there will be some differences. For example, the pediatric client may need a neonatal, infant, or pediatric blood pressure cuff. The techniques used to assess the vital signs also vary among the age group (Registered Nursing, 2020). During assessment, the nurse should also be aware of developmental milestones for children. The nurse should reassure parents or caregivers that there are variances, although any extended delay in achieving the milestones should be reported to the pediatrician (Falkner, A., 2020).
Children are dependent upon adults for their welfare, Teaching and communication should involve the parents and caregivers for a family-centered care. Often direct communication and recommendation to other community sources provides the best advice (Falkner, A., 2020). Knowledge of Erikson’s psychosocial stage of development is essential for the nurse to be able to make a working plan on how to assess and communicate with the child depending on the child’s stage of development (Falkner, A., 2020). The initial encounger with the nurse is the best opportunity to build trust with the nurse. Use of open-ended questions will provide information and build upon that trust (Falkner, A., 2020). The nurse should include the children in the communication. Using of understandable vocabulary and avoiding medical jargons, active listening, being aware of verbal and non-verbal cues and be culturally aware of the child and family’s needs (Burks, J., 2016). Providing anticipatory guidance and a walkthrough on what you will be doing will usually gain cooperation. If the procedure will cause discomfort be honest. Tell them how long the assessment will last (Burks, J., 2016). Use of age-appropriate toys and questions will foster cooperation and communication. Showing interest to the child and what the child has to say should be encouraged. Mke the child feel important. This will help the child feel comfortable and establish rapport (Belleza, M., 2017). When dealing with teenagers, the nurse should be aware that they need to be treated with respect. The nurse should communicate with them with privacy, away from their parents or siblings. This will allow the teenager to provide answers pertaining to sexuality, drugs and alcohol use, and other topics they might not feel comfortable discussing when others are around (Falkner, A., 2020).
Resources:
Decision-making is a constant process for those in leadership roles. An effective leader must be able to understand the daily problems that arise and present solutions beneficial to the organization, employees, and associated community or stakeholders. In a health care organization, this includes patients and their families. In a 1,000-1,250-word paper, discuss the aspects that help leaders make effective and ethical decisions in health care.
A minimum of three academic references from credible sources are required for this assignment.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
The scenario is that of an 86-year-old Asian male patience that depend on his daughter for financial assistance, and in taking care of him . However, his daughter is a widow without enough resources or the ability to fully take care of her father. She is poor herself. Improving the quality of life for the old Asian male by identifying his most important health needs and recommendation through thorough health assessment is key. Older adults being more vulnerable to diseases due to low immunity, should be considered for a safe socioeconomic, cultural, spiritual and lifestyle that may prolong their life.
The first step is for the Nurse Practitioner to develop a respectful and trusting relationship with the patient, in other to obtain a detailed and accurate health history, making sure to use available translator if the patient does not speak English. The future PMHNP should engage in effective communication, such as patience and active listening because the Patient may need more time to process information before answering questions. Also, the NP should not use judgmental or non-patronizing language, in other to develop a connection with the patient (Ball, 2015).
Specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient
Socioeconomic factors: The 86 year old man is financially unable to provide for himself, and is dependent on his daughter, who is a widow and is financially unable to provide for her father, therefor, the patient is socio-economically poor, and may lack a good living standard in relation of having balanced diet, meeting medical expenses and other maintenance that may improve his quality life. The NP has to consider these socio-economic factors while assessing the Patient.
Lifestyle Factor: due to low income status, and lack of financial support from his daughter, the 86 year old Asian man most like lives a low and poor quality of life, which may have contributed to his detoriating health status, lack of of constant medial care, good nutrition and clean healthy environment. The treatment and recommendation from the NP should factor the patient’s lifestyle during treatments.
Cultural factors: Culturally, Asians are known to be very reserved and secretive when it comes to personal health. Such strong cultural factor may influence the patient’s decision is not open about his needs to his daughter and subsequently, to a healthcare professional, The NP must figure out a way to gain his trust. Also, culturally, Asians are mostly group-oriented people that place importance on family connection as the primary source of identity (Carteret, 2010). Asian children are also known to take care of their elderly parents, but in this scenario, the patient’s daughter is equally poor and has difficulty fulfilling her role of a provider and may create emotional burden both for both parties. Religious and cultural practices such as Buddhism for Asians should also be incorporated in managing health.
The Nurse Practitioner may need to make referral to community resources to additional financial and physical needs for the patient and his daughter. The NP should maintain cultural sensitivity while assessing the patient.
Applying cultural competency and diversity are two important factors to consider in treating patients. As an NP, we should have knowledge of different cultural backgrounds, and apply it to the unique needs of the patients while delivering high-quality care. Being culturally competent helps in developing a trusting relationship between the patient and health care provider. This includes being reflective and aware of your own feelings, biases, experiences, and lack of knowledge (Ball, 2015). Cultural competence in nursing involves being curios of, and respect for a patient’s beliefs and values (Ball, 2015).
Targeted questions:
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.
Carteret, M. (2010). Cultural Values of Asian Patients and Families. Divi. Retrieved from
Centers for Disease Control and Prevention. (2015). Cultural competence. Retrieved from
https://npin.cdc.gov/pages/cultural-competence
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
REPLY QUOTE EMAIL AUTHOR
Read Chapter 9
1. Try taking a different route to class the next time it meets. Before you do this, think about how many changes, large and small, you will have to make to do this.
a-Will you have to leave earlier to be in class on time?
b-Will you meet different people on your way to class?
c-See different sights?
d-Would you change your route to class on the day of the final exam?
e-Why or why not? Summarize the positives and negatives of this small change. Relate your responses to this change to the way staff nurses feel when an administrator makes what he or she thinks is a “minor” change.
2. Think about a change that has occurred in your life. Some examples may be a change of role, a move, a marriage, a birth, a divorce, or a death.
a-How did you react to the change?
b-Would you have reacted differently if you had had more information?
c-Using Lewin’s model, describe the basic elements in the situation and how you eventually achieved a comfortable outcome.
Provide examples of experimental and nonexperimental research design. Contrast the levels of control applied to each.
1) What are anabolic steroids? Why are they abused?
2) Why do some people crave drugs more than others?
Each question should be more than 100 words. (need to be done separately)
No plagiarism
proper citation and reference In Apa Formate
Part I: Write your Philosophy of Health
This week’s discussion board assignment requires you to write and share your personal philosophy of health. Your philosophy needs to be at least 250words long. Since this is a personal statement, it is appropriate to write in first person tense (I, you, me etc.). If you use any sources, such as an inspiriting quotation, be sure to use APA format to document the quotation and cite it in a reference list at the end of your statement. Quotes do not count in the 250-word minimum. Be creative, succinct, and clear. I would like to read your unique thoughts.
As a future health professional, it’s important to explore your own views about health. There is no doubt that as you go along in your academic major, and have experiences in the field, that your philosophy will change. However, as you begin your journey into health education, you should summarize your views thus far as a starting point. You can use this written health philosophy for your professional portfolio and expand and change your health philosophy as you learn and experience more.
Medications
All data addressed for medications your client received that day in clinical
Rationales appropriate for your client
