NR 305 Health Assessment for the Practicing RN Weeks Discussion

Exploring the Nurse’s Role in Health Assessment

Depression

Mental health applies to a person’s level of cognitive functioning and emotional functioning.  No one can be completely healthy without “mental health.” (Weber, Kelley, 2018)  I have chosen depression as the mental health topic I would like to address this specific topic as this is something that hits close to home.  I have struggled with depression off and on for a while now as well as have family history, as I remember as a child my Mom struggled with it as well.

Depression is one of the most common mental health disorders in the United States.  Many Americans who could benefit from treatment do not seek out treatment, those that do usually go through outpatient services of counseling and medication. (Alang, McAlpine, 2020)

When completing a web search regarding access to health care services for depression google came up with a list of many different groups that offer counseling and mental health services for the community.  They have counselors, psychologists and psychiatrists.  There are also inpatient services through Unity Point Hospital called Robert Young.  During nursing school I did get the opportunity through our mental health rotation to have clinicals at Robert Young which provided so much hands on knowledge and educational opportunity.  Robert Young inpatient services offered for both adults and adolescents covers the entire mental health spectrum as well as alcohol and drug treatment.

Follow-up Questions:

1. Subjective information that may need further in-depth assessment would be: family history, their current lifestyle and health practices (if alcohol is consumed and if so how much/frequency, sleep patterns, energy levels, current medications, use of any recreational drugs, etc.) as well as the persons support systems.  Objective information would be: vital signs outside of normal limits, assessing the information received by having the patient complete the quick inventory of depressive symptomatology screening tool (Weber, Kelley, 2018)  for any concerns, any abnormality within the head-to-toe physical assessment.
2. Using the quick inventory of depressive symptomatology (Weber, Kelley, 2018) would definitely cover many of the basic foundation questions/concerns to assessing the patient for depression and the level of severity of the depression.
3. As stated above I found multiple locations that offer counseling, psychologists, as well as psychiatrists that are able to offer expert medical services both outpatient and inpatient to be able to address a person’s depression.  Honestly I feel that my current geographical location has much more availability for mental health treatment than most areas within the midwest.  Considering I have had to seek out assistance for myself as well as for my son, I did not have a difficult time locating the services both of us needed.  Not to mention it helps that my insurance covers mental health as that is a concern/issue for many that if they do not have insurance coverage they are not able to get the mental health help they need.

References:

Weber, J., Kelley, J., (2018). Assessing mental status including risk for substance abuse. Health Assessment in Nursing 6th ed., 6, 70-80.

Alang, S., McAlpine, D., (2020). Treatment modalities and effectiveness of treatment among adults with depression. Health Services Insights. 13, 1-7. Retrieved from: https://eds-b-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=4&sid=63442c3f-9dcb-4aa6-acd8-d2e5ce5baab9%40pdc-v-sessmgr01Links to an external site.

Google search: “quad city health care services for depression” https://www.google.com/search?q=quad+city+health+care+services+for+depression&rlz=1CAPPDO_enUS782US785&oq=quad+city+health+care+services+for+depression&aqs=chrome..69i57.6515j0j8&sourceid=chrome&ie=UTF-8

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 5 – Explore the professional responsibilities involved in conducting a comprehensive health assessment and provide appropriate documentation. (PO 6)

Discussion

The nursing process is utilized in a variety of nursing roles and health care settings. Whether you are working in direct patient care, telehealth, or in a leadership role – the basic model is the same! Take this opportunity to share how the nursing process is utilized in your own practice settings! Hint: Your assigned readings will be helpful in formulating your answers.

Please answer the following question in your initial post:

Describe how you apply the first step (assessment) of the nursing process in your current practice setting. If you are not currently practicing as an RN, you may use an example from a prior clinical or work experience. Include the following information:

Briefly describe your practice setting and the typical patient population.

Provide examples of key subjective and objective data points you collect.

Describe how you document your findings. Is there technology involved?

Describe your process of data analysis. What is the end result of this process? (i.e., Do you formulate nursing diagnoses and care plans, collaborate with others and/or make referrals?)

NR305 Health Assessment for the Practicing RN

Week 2 Discussion

Assessment for Health Promotion

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)

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.

What additional assessment data (subjective and/or objective) would you like to gather from Maria?

What actual health concerns and risk factors have you identified?

What are some opportunities to promote health and wellness for Maria?

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!)

NR305 Health Assessment for the Practicing RN

Week 3 Discussion

Exploring Popular Diet Trends

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 unexpected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)

CO 4 – Identify teaching/learning needs from the health history of an individual. (PO 2)

CO 5 – Explore the professional responsibilities involved in conduction a comprehensive health assessment and provide appropriate documentation. (PO 6)

Discussion

A distant cousin approaches you at your family reunion and says, “Great to see you! I heard you are a nurse. My friend is having success with the (insert selection from list below) and I am wondering what you think about it? Should I give it a try?”

Choose one of the following to consider in your response:

Paleo Diet

Anti-inflammatory Diet

Mediterranean Diet

Vegan Diet

Ketogenic Diet

In your discussion post, please include the following information:

Briefly describe the diet you have selected to consider.

Share how you would respond to your cousin. Please include questions you would ask, and your advice/recommendations.

NR305 Health Assessment for the Practicing RN

Week 4 Discussion

Community Access to Mental Health Services

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 4 – Identify teaching/learning needs from the health history of an individual. (PO 2)

Discussion

Access to mental health services is a hot topic in U.S. Healthcare. Do you know what resources are available for clients seeking care in your own community? Select one mental health related condition from the list below. Conduct a web search to identify health care services within your community aimed specifically at addressing this condition.

Choose one:

Depression

Suicidal ideation

Opioid addiction

Answer the following questions in your post:

When reviewing a client’s health history and physical examination record, what are some findings (subjective and objective) that may indicate a need for further in-depth assessment for the condition you selected above?

Describe a focused specialty assessment tool you could use to screen the client for this condition.

What resources did you find in your community that address this issue? What type of services do they provide? Were there specific resources or services you were hoping to locate, and could not? Please explain.

NR305 Health Assessment for the Practicing RN

Week 5 Discussion

Assessing for Family Violence

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 4 – Utilize effective communication when performing a health assessment. (PO 3)

Discussion

A 10-year-old child named Elizabeth is brought into the emergency department by her mother. The mother appears anxious but sits quietly next to her daughter in the waiting room. When called into the triage area, the mother gives a history of coming home from work to find Elizabeth sitting on the couch watching television. Elizabeth did not go to the door to greet her or look toward her when she said hello. The mother thought the daughter’s behavior was odd because she always greeted her at the door with a hug. As she approached Elizabeth, she noticed that she was clutching her right arm as if in pain. The mother asked what was wrong, but Elizabeth remained silent. Then she said “Nothing is wrong.” The father is sleeping upstairs. The mother gives a family history of having an alcoholic husband who usually drinks himself to sleep. She said he has abused Elizabeth physically and psychologically in the past, and she brought her to the emergency room because she fears he has hurt her. When Elizabeth is asked about the abuse she appears scared, insecure, and withdrawn.

What considerations should be made by the nurse, to provide a physically and emotionally safe environment for the interview and assessment of this client who has experienced domestic abuse?

In your response, include some special considerations that should be taken when interviewing a child

NR305 Health Assessment for the Practicing RN

Week 6 Discussion

Providing Culturally Competent Nursing Care

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 3 – Utilize effective communication when performing a health assessment. (PO 3)

Discussion

This week you have your choice of three discussion topics! Select the one that most interests you and answer the corresponding questions completely.

Remember to reference both the book or lesson, and an outside scholarly source.

Option #1:

You are the nurse assessing an Orthodox Jewish client with peptic ulcer. The client is strictly religious and refuses to eat the food provided at the health care facility.

Describe how you would further assess and provide care for this client.

What steps could you take to increase your cultural competence, if you were not familiar with this faith?

Option #2:

You are the nurse caring for a client with Crohn’s disease. The client believes he is being punished by God. The client is spiritually distressed and cannot come to terms with the illness.

How would you respond to this client?

What are some identified risk factors for spiritual distress, and recommended interventions?

Option #3:

Describe a time in your clinical nursing practice when you have cared for a client of cultural, religious, or spiritual practices different from your own.

What were some of the challenges you faced caring for this client?

What steps did you take (or could you have taken) to ensure the patient received culturally/spiritually competent care?

NR305 Health Assessment for the Practicing RN

Week 7 Discussion

Assessment Techniques

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 4 – Identify teaching/learning needs from the health history of an individual. (PO 2)

Discussion

In Week 6 you demonstrated a head to toe assessment of an adult participant. This week you and your classmates will reflect on the assessment you performed for your video assignment, and also apply this week’s lesson on family assessment.

Please consider the following in your initial post:

Reflect on the assessment you performed for the video assignment. Perhaps you might compare your performance now, to how it might have been different when you were a brand new nurse? Or share something you learned (or were reminded of) by participating in this activity?

Based on your observations, do you feel that patient assessments performed in practice are as thorough as they should be? Explain your answer.

This week’s lesson focuses on assessment of families and introduces specific assessment opportunities for racially diverse, same sex, and adoptive families. Select one of these three non-traditional families. How would your assessment technique change to be sure that you were competently caring for a member of this type of family unit? This may include questions you would add to the health history, or ways in which you would communicate.

NR305 Health Assessment for the Practicing RN

Week 8 Discussion

Case Study or Share an Experience

Purpose

This week’s graded topics relate to the following Course Outcome (CO).

CO 2 – Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO #1)

Discussion

This week you have two options for your initial discussion post. Select the option that is best for you! Please remember to use and credit the lesson or required NIH website (there was not a textbook reading this week), AND one outside scholarly source.

Option #1 – Case Study to Consider

Ann and Michael have been married for 55 years. Ann is 80 years-old, and suffers from lung cancer and advanced Alzheimer’s disease. She currently resides in a nursing home, and often does not recognize Michael when he visits. Last night she was admitted to the hospital with difficulty breathing. Today, you are the nurse caring for Ann, and her physician is suggesting surgery to remove part of her lung to potentially slow the progression of her cancer. Michael is feeling unsure about this course of treatment, and asks for your advice and guidance.

How would you respond to Michael and serve as advocate for your patient?

Option #2 – Share a Related Experience

Share with your classmates a time when you cared for a patient at the end of their life. This may be a time when you assisted the patient (or their support system) with decisions related to end of life care; or a time when you were present for the death of a patient.

What were your observations related to this experience? Do you believe it was a peaceful death? What went well? Can you think of anything that could have made the experience better for the patient and/or family?