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Purpose

This week’s graded topics relate to the following Course Outcomes (COs).

• CO 1 – Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
• CO 2 – Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)
• CO 4 – Identify teaching/learning needs from the health history of an individual. (PO 2)

The Assignment

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.

 

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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.

 

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This week’s graded discussion topic relates to the following Course Outcomes (COs).

Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient’s room for report.

Approximately 1 hour later, you return to Ms. Jackson’s room with her morning pills and find her slumped over the bedside stand in tears. The patient states, “I don’t know what is wrong, I don’t feel right. My back hurts and I’m just so tired. What is wrong with me?” The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.

Just then the nursing assistant comes into the patient’s room to record Ms. Jackson’s vital signs, you take this opportunity to quickly research the patient’s medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the patient’s pulse because “it is all over the place.”

Please address the following questions related to the scenario.

1.What do you suspect is the cause of the patient’s symptoms?

2.Describe the course of action that you will take to confirm this suspicion and prevent further decline.

3.What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.

4.While you are caring for this patient, how will you ensure that the needs of your other patients are 

References: Jarvis, C. (2016). Physical Examination and Health Assessment, 7e. 

Chapter 19. 

Chamberlain College of Nursing (2019) NR305 RN Health Assessment. Week 4 lesson Downers Grove, IL Online Publication

Wood, D. (2018). Atrial Fibrillation. Health Library: Evidence-Based Information. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nup&AN=2009866711&site=eds-live&scope=site

 

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