Fiji Cultural Spiritual Nutritional & Mental Health Disorders Case Study Questions

Description

Cultural, Spiritual, Nutritional, & Mental Health Disorders

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.

CASE STUDY#2

Once you received your case number, answer the following questions: CASE STUDY#2

Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are.
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?
Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are.
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?

Submission Instructions:

Your instructor will assign you your case number and you will post on the case number you have been assigned. CS#2
You will reply to the other two case studies (One of each).
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.

****Please note, I also need 2 peer responses to reply to the other two case studies (One of each). It can be any additional comment or adding additional information (100 words)******

Case 1

Case 2!!!!!

Case 3

Subjective Data

Chief Complaint
(CC)

I came for my annual physical exam, but do not want to be a burden to my daughter.

I am here for my annual physical exam and have been having vaginal discharge.

Annual physical exam

History of Present Illness (HPI)

At-risk 86-year-old Asian male who is physically and financially dependent on his daughter, a single mother who has little time or money for her fathers health needs.

32-year-old Hispanic/Latina pregnant lesbian her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank.

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.

PMH

Hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency and chronic prostatitis

PSH

S/P cholecystectomy

Drug Hx

Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and Cipro 100mg daily.

Current Meds: prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion

Current Meds: denied

Allergies

No allergies to food or medications.

Family Hx

She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

He has a family history of diabetes, hypertension, and alcoholism.

Review of Systems (ROS)

General

+ weight loss of 25 lbs over the past year; no recent fatigue, fever, or chills.

No fatigue, fever, or chills.

No recent weight gains of losses, fatigue, fever, or chills.

Head, Eyes, Ears, Nose & Throat (HEENT)

No changes in vision or hearing, no difficulty chewing or swallowing.

Neck

No pain or injury

Respiratory

no chest discomfort or palpitations

no urinary hesitancy or change in urine stream

Integument

multiple bruises on his upper arms and back.

multiple piercings, and tattoos. Old scars related to cutting

history of eczema not active

MS/Neuro

+ falls x 2 within the last 6 months; no syncopal episodes or dizziness

no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements.

no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements

Objective Data

B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8

B/P 128/76; Pulse 83; RR 16; Temp 99.0; Ht 5,6; wt 128; BMI 20.98

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, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.

Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition. Piercing in her right nostril and lower lip.

Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, nasopharynx clear, poor dentition multiple carries.

Lungs

CTA AP&L

Card

S1S2 without rub or gallop

S1S2, +II/VI holosystolic murmur; without rub or gallop

Abd

benign, normoactive bowel sounds x 4

benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.

external genitalia intact, no lesions or masses. White copious discharge with an amine odor; no cervical motion tenderness; adnexa intact.

Ext

no cyanosis, clubbing or edema

Integument

multiple bruises in different stages of healing on his upper arms and back.

intact without lesions masses or rashes.

Neuro

No obvious deformities, CN grossly intact II-XII

No obvious deficits and CN grossly intact II-XII

Submission Instructions:

Grading Rubric

Your assignment will be graded according to the grading rubric.

Discussion Rubric

Criteria

Ratings

Points

Identification of Main Issues, Problems, and Concepts

Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.

Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.

Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.

Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.

5 points

Use of Citations, Writing Mechanics and APA Formatting Guidelines

Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.

Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.

Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.

Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.

3 points

Response to Posts of Peers

Distinguished – 2 points
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.

Fair – 1 point
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.

Poor – 0 points
Student provided no response to a peer’s post.

2 points

Total Points

Resources
Textbook(s)
1.Rhoads, J., Demler, T. L., & Dlugasch, L. (2021). Advanced health assessment and
diagnostic reasoning (4th ed.). Jones & Bartlett Learning.
ISBN: 9781284170313
2.Shadow Health. (2020). Digital clinical experience (Version 2019_07) [Software].
ISBN: 9780989788809
3.American Psychological Association. (2019). Publication manual of the American
Psychological Association (7th ed.)
ISBN: 9781433832154

POST1

Cultural, Spiritual, Nutritional, & Mental Health Disorders Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.Asian culture practices what is called filial piety. In terms of culture, filial piety has typically been seen as the answer in Chinese societies and it is seen as a cultural and philosophical aspect of Chinese society that honors and worships its elders and ancestors and shows deference to them (Woo, 2020). With this case the father is dependent on his daughter physically and financially for his healthcare needs. Children are expected to help and support their parents, who have the right to request financial support from their children, according to various Asian cultures (Woo, 2020). This may become a burden for the patients daughter as she has very little income to provide for his health care needs. However, since older people don’t want to burden their children, there are issues with such restrictions (Woo, 2020). As seen with this patient he is reluctant to attend his annual physical exam. Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are. The subjective data, objective data, assessment, and plan (SOAP) format is the method that is used the most frequently to document the history and physical. Any details or facts presented by the patient or documented on the chart are included in the subjective portion (Rhoads & Petersen, 2020). Identification information for the patient, the primary complaint, a review of the systems, a history of the current disease, past medical history, medications, allergies, and family and social histories are all included (Rhoads & Petersen, 2020).Subjective Data Case Study 1: Chief Complaint: “I came for my annual physical exam, but do not want to be a burden to my daughter.” History of Present Illness: At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. PMH: Hypertension, gastroesophageal reflux disease, b12 deficiency and chronic prostatitis. PSH: S/P cholecystectomy. Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and cipro 100mg daily. General: Weight loss of 25 lbs. over the past year; no recent fatigue, fever or chills. Head, eyes, ears, nose & throat (HEENT): No changes in vision or hearing, no difficulty chewing or swallowing. Neck: No pain or injury. GU: No urinary hesitancy or change in urine stream. Integument: Multiple bruises on his upper arms and back. MS/Neuro: + falls x 2 within the last 6 months; no syncopal episodes or dizziness. The information noticed by the examiner while doing the examination is included in the objective part, along with any recent laboratory or diagnostic test findings (Rhoads & Petersen, 2020).Objective Data Case Study 1: Physical Exam: B/P 188/96; Pulse 89; RR 16; Temp. 99.0; Ht. 5,6; Wt. 110; BMI 17.8. HEENT: Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous. Lungs: CTA AP&L. Coronary: S1S2 without rub or gallop. Abdomen: Benign, normoactive bowel sounds x 4. Extremities: No cyanosis, clubbing or edema. Integumentary: Multiple bruises in different stages of healing – on his upper arms and back. Neurological: No obvious deformities, CN grossly intact II-XII.The assessment section includes the overall evaluation that combines the information from the subjective and objective components to produce a diagnosis (Rhoads & Petersen, 2020). The plan specifies the course of treatment for the primary complaint, any current comorbidities, and/or any other conditions (Rhoads & Petersen, 2020). 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?The postcentral gyrus’ somatosensory cortex is known for playing a crucial function in the processing of sensory data from many sections of the body (Kropf et al., 2019). The recognition of emotional significance in a stimulus, the creation of emotional states, and the management of emotion are all processes and a crucial function of the somatosensory cortex. (Kropf et al., 2019) The somatosensory cortex undergoes structural and functional changes in people with mental illnesses like major depression, bipolar disorder, schizophrenia, post-traumatic stress disorder, anxiety and panic disorders, specific phobias, obesity, and obsessive-compulsive disorder that are linked to abnormal emotional regulation (Kropf et al., 2019). Changes in gray matter volume, cortical thickness, inappropriate functional connections with other brain regions, and changes in somatosensory cortices are frequently seen in people with mood disorders (Kropf et al., 2019).The nurse should be knowledgeable about the anatomy and function of the human brain because the primary emphasis of mental health assessments is the evaluation of cerebral function. The cerebrum, cerebellum, and brainstem make up the brain (Rhoads & Petersen, 2020). Each lobe of the cerebrum’s two hemispheres, which are further divided into lobes, has a separate purpose (Rhoads & Petersen, 2020). The cerebral cortex, which makes up the outer layer of the cerebrum, is in charge of general movement, visceral functions, perception, behavior, and the integration of these processes. It also contains higher mental functions (Rhoads & Petersen, 2020).ReferencesKropf, E., Syan, S. K., Minuzzi, L., & Frey, B. N. (2019). From anatomy to function: the role of the somatosensory cortex in emotional regulation. Brazilian Journal of Psychiatry, 41(3), 261269. https://doi.org/10.1590/1516-4446-2018-0183Rhoads, J., & Petersen, S. W. (2020). Advanced Health Assessment and Diagnostic Reasoning: Featuring Simulations Powered by Kognito (4th ed.). Jones & Bartlett Learning.

POST2

Socioeconomic, spiritual, lifestyle, and other cultural factorsSocioeconomicThe patient is a 23-year-old Native American male well nourished and developed. It implies that the patient has a sustainable source of income and livelihood whereby he can afford basic needs and food. His social life is relatively low since he finds it hard to share his situations with others. It is explainable from his recent behavior of smoking “pot” and drinking as an alternative to helping him.Spiritual The 23-year-old Native American male is a religious individual who firmly believes in the teachings. It is because he finds it a sin to smoke and drink, which is highly condemned in religion. He has an idea that when he stops these habits, he will have a chance to go to heaven as part of life after death.LifestyleThe patient’s lifestyle is quite unpleasant, even though he finds the actions as a refuge to heal his situation. He has adopted habits of smoking ‘pot’ and alcohol consumption which are harmful drugs to the body. Essentially, these are not suitable approaches to deal with situations such as stress and depression. The immersion into these addictive habits describes his coping with conditions such as depression(Rhoads & Petersen, n.d.). According to the patient, the lifestyle is unpleasant, and he finds it challenging to avoid, which explains his cultural upbringing.Subjective, Objective, Assessment, Planning Approach Subjective The chief complaint is that a 23-year-old male says he has been having anxiety and needs help to get out of the condition. Currently, he has significant concerns with his smoking and drinking habits, which he cannot stop on his own. In this case, he has developed fear concerning his lifestyle and life after death.Objective The patient has a family history of alcoholism, diabetes, and hypertension. The patient appeared nervous due to frequent pacing in the room and fidgeting. He appears well-developed and well-nourished. However, the patient does not indicates signs of acute distress. The head and all major head organs are in normal condition and have no trauma causes. The HEENT examination also shows that the pupils are equal, round, and reactive to light and accommodation. The Extraocular movements are intact. There is a mild yellowish pigmentation of the sclera. Normal nasal patency and nasopharynx clear. The patient has poor dentition with multiple carriers. He has normal heart sounds of s1 and s2. He has a faint but easily audible holosystolic murmur +II/VI without a rub or gallop. There is a presence of benign and demonstrates normoactive bowel sounds. The Hepatomegaly is 2cm below the costal margin.Assessment History of diabetes, hypertension, and alcoholism. Enlarged liver, which is bigger than expected. Yellowish pigmentation of the sclera. Impression: alcohol use disorder and psychological problems.Plan Administer treatment for psychological problems such as therapy and medication. Encourage a program of detoxification and withdrawal that’s medically managed. Refer to a psychologist who will provide effective psychological counseling and continuous support. Oral medication such as Naltrexone will block the good feelings acquired from alcohol use, reducing the urge to drink.Functional anatomy and physiology The brain comprises gray masses and white fibers in a complex interrelation and arrangement that enable its functionality. Alterations such as drug intake affect the structure and functionality of the various components of the brain. The gray matter is responsible for receiving sensory impulses and registering them while the white matter transmits the impulses. Abnormal functionality, such as inadequate blood flow, can alter the organ causing mental disorders (Fazl and Fleisher, 2018). Empiric observations on movements in the nervous systems suggest that many kinds of neural activities result in different reflex actions. However, external alteration can primarily affect the brain’s standard functionality and reflex actions. Examination of the brain is possible through modern technology such as brain lesions, Microscopy, and electroencephalography. These technologies have advanced the brain’s anatomy whereby physicians can determine the etiology and pathogenesis of complications such as depression. In actuality, these conditions are unknown to the human eye hence the relevance of advances such as neuroimaging. A decrease in the volume of gray matter in the brain indicates certain disorders such as major depressive disorder.ReferencesFazl, A., & Fleisher, J. (2018, April). Anatomy, physiology, and clinical syndromes of the basal ganglia: a brief review. In Seminars in pediatric neurology (Vol. 25, pp. 2-9). WB Saunders.Rhoads, J., & Petersen, S. Advanced health assessment and diagnostic reasoning.

POST3

The Purnell Model for Cultural Competence and its relevance for advanced practice nurse There are different cultures in the United States, and practitioners must be culturally competent to provide high-quality care to all patients. Different cultures have variations in what is acceptable and those that are not. For example, male doctors should not care for female patients in Islam. Cultural competency tries to minimize such discrepancies that can negatively impact the quality of patient care. Hence, Larry Purnell developed the Purnell Model for cultural competence to help caregivers care for culturally diverse patients. Purnell Model is built up of spheres with twelve components that address people’s various cultures. Healthcare practitioners can provide high-quality patient care when considering the domains (Purnell, 2020). The innermost sphere represents the patient, followed by another part representing the family. The following circle discusses the features of community-based healthcare. The extreme portion represents the global society. Furthermore, the model discusses several aspects of communication, relationship development, religion, and other topics such as ecology (Purnell, 2020). The Purnell Model is relevant for advanced practice nurses since it helps provide high-quality patient care. It lays the groundwork for the advanced practice nurse to learn about the various factors that make up patients’ cultures (Purnell, 2020). Furthermore, this framework provides a foundation for the nurses to examine clients’ cultural information to decide the appropriate care to aid their rehabilitation (Purnell, 2020). Moreover, this method of caring aids patients’ recovery processes and removes the possibility of prejudice and bias throughout the service delivery process.The importance of effective communication that promotes cultural competencePromoting culturally competent communication in healthcare can eliminate racial and ethnic differences in high-quality care (Henderson et al., 2018). The United States is a diverse society, and caregivers must be able to interact successfully with persons from many cultural backgrounds. Communication that fosters cultural competency is essential because it enables caregivers to deliver high-quality care to every patient, resulting in excellent patient satisfaction and care (Kaihlanen et al., 2019). A high satisfaction rating enhances patient retention in an institution. Without effective communication, the health industry would not provide high-quality care due to the segregation of the facilities, exacerbating health inequities (Henderson et al., 2018).Furthermore, effective communication promotes understanding different cultures eliminating discrimination against patients by care providers (Kaihlanen et al., 2019). Care providers will be able to provide high-quality care to everyone since they will understand what different cultures perceive in terms of healthcare. Patients from minorities, for example, will not face any prejudice while obtaining treatment.Continued education, cross-cultural encounters, and particular tests can help health care personnel improve their cultural competency for effective communication. These efforts assist in keeping their thoughts open and free of preconceived assumptions or judgments about specific cultures or regions (Kaihlanen et al., 2019). Finally, the world is becoming a global village due to globalization, increasing the need for more culturally competent care providers (Henderson et al., 2018). Thus, nurses should be culturally competent to communicate with patients from different ethnic backgrounds to provide the best care.ReferencesHenderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: A concept analysis. Health & Social Care in the Community, 26(4), 590603. https://doi.org/10.1111/hsc.12556 (Links to an external site.)Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training. BMC Nursing, 18(1). https://doi.org/10.1186/s12912-019-0363-x (Links to an external site.)Purnell, L. D. (2020). The Purnell Model and Theory for Cultural Competence. Textbook for Transcultural Health Care: A Population Approach, 1959. https://doi.org/10.1007/978-3-030-51399-3_2 (Links to an external site.)Module 1 Discussion.docx ReplyReply to CommentCollapse SubdiscussionUy, Doris Uy, Doris YesterdayJun 28 at 7:48pmManage Discussion EntryThe Purnell Model for Cultural CompetenceCultural competence is a vital component of the health care climate due to the existence of many ethnicities and the need for various health services. The arrangement of comprehensive and more modified healthcare services that depend on the social qualities and convictions of the patient is right now the underpinning of healthcare practice. Larry Purnell planned a social capability model when addressing college understudies about social changes. The model contains twelve ideas that impact culture, including the individual, the family, the local area, and the worldwide society (Botelho & Lima, 2020). The advancement of social capability needs well-being experts to keep up with social skills. This segment will assess the pertinence of social power for the advanced practice nurse and the significance of viable options that advance social skills.Purnell’s model is appropriate for cutting-edge healthcare providers during the evaluation, arranging, and forming of practical interventions to promote patients, family, and community well-being. The twelve concepts are helpful for nurses since they play a part in cultural competence performance. Purnell indicates that nurses must gain awareness of differing opinions and convictions without letting this aspect affect healthcare delivery. The model also motivates nurses to be aware of personal beliefs and values and how it differentiates existing nursing values. Self-awareness is beneficial when delivering culturally competent care (Botelho & Lima, 2020).Nurses should promptly incorporate introspection and consideration to determine their attitude towards patients from a varied ethnic backgrounds and address their personal beliefs. This is very important since this can act as a barrier to delivering quality care, mainly when providing services to a diverse population. Also, the nurses can understand the patient’s perspective, which helps help them evaluate the patient’s behavior and beliefs that may affect care (Abrishami, 2018). Knowing helps achieve cultural competence; nurses should learn about different cultures and recognize the patient’s perspective.Communication is essential when one is working with diverse cultures. A nurse can improve cross-cultural communication by adopting vital components like active listening and evaluation, being attentive to the patient’s non-verbal cues, and comprehending how they perceive their condition and the health treatment they are supposed to receive. Effective communication between the patients and the health care providers is a vital component of quality health care. The nurse will be able to understand patients’ attitudes, beliefs, and behaviors that affect health and assist the nurses in improving access to high-quality health care (Sharifi et al., 2019).The health care providers must develop a strategic plan to improve, implement, and evaluate the program structure and enhance the progression of cultural competence goals. It is long believed that nurses have the knowledge and skills to communicate culturally sensitive concerns (Sharifi et al., 2019). Culturally sensitive communication shows understanding and respect for people and encourages patient and family satisfaction. If contact is not culturally profound, the patients and family may not get satisfied with their concerns and care received, an amplified risk of miscommunication and cultural differences that leads to poor quality of treatment (Abrishami, 2018).ReferencesAbrishami, D. (2018). The need for cultural competency in health care. Radiologic Technology, 89(5), 441-448. http://www.radiologictechnology.org/content/89/5/441.short (Links to an external site.)Botelho, M. J., & Lima, C. A. (2020). From cultural competence to cultural respect: A critical review of six models. Journal of Nursing Education, 59(6), 311-318. https://journals.healio.com/doi/abs/10.3928/01484834-20200520-03 (Links to an external site.)Sharifi, N., Adib-Hajbaghery, M., & Najafi, M. (2019). Cultural competence in nursing: A concept analysis. International journal of nursing studies, 99, 103386. https://www.sciencedirect.com/science/article/pii/S0020748919301853 (Links to an external site.)

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