Comprehensive Health Assessment Health assessment is the first step in the nursing process. The purpose of a health assessment is to collect information on patient's health status, obtain baseline information, support system at home, evaluate patient environment, to discover the actual problem, and assess factors that place the patient at increased risk for health problems. Mosby medical dictionary describe health assessment as “an evaluation of the health status of an individual by performing a physical examination after obtaining a health history.Various laboratory tests will be ordered to confirm a clinical impression or to screen for dysfunction. The depth of investigation and the frequency of the assessment vary with the condition and age of the client and the facility in which the assessment is performed.
The person's response to any dysfunction present is observed and noted. ” (Mosby’s Medical Dictionary, 8th edition. © 2009, Elsevier). When collecting information for a comprehensive assessment, nurses use both subjective and objective data.Nurses use several different sources to obtain information by means of observation, lab values, vital signs, chart review, other health care professionals and most important the patient or family members. Patients and family provide very useful information such as current medication, past surgical and medical history, cultural beliefs and any other prudent information related to patient care.
By collecting the information it gives nurses a chance to familiar themselves with individual culture beliefs and form a treatment plan that includes cultural information to care for each individual patient to aid in providing the appropriate care.Certain conditions appear to be more prevalent in different cultures. In the African American culture, there are several high-risk health factors, which include cardiovascular disease, hypertension, elevated cholesterol levels, stroke, diabetes, obesity, and stroke. Due to their social economic status, access to health care may be limited; most times patients of this culture go to the doctor for sickness and never preventive care.
Through generation, several cultural forms of treatment have been use, which includes folk medicine, voodoo, herbs, and witchcraft, and if unsuccessful then they seek medical help.Mr. Henry Comprehensive Health Assessment Mr. Chuck Henry is an African American male a native of Michigan, who has no recoverable medical history or religious beliefs noted.
He is fifty-five years old and weighs 210lbs, blood pressure 160/96. After working in an auto plant for his entire career, he has been laid off a year short of retirement. The severance package he received, and his health insurance the family has is soon to run out. He has reported that he has been having recurring headaches, insomnia and elevated blood pressure.Mr. Henry has had a lack of self; due to financial his problems, his age, current health condition and his lacking resume are holding him back from finding another job.
Because of his financial problems, the Henry’s are unable to pay for his and his wife medical bills and prescriptions. Mr. Henry states, “That between medical and prescription bills for Tameka and himself, he doesn’t know where to turn”. He has also shared concerned that his children do not want to come around, because they consider him and his wife to be depressing.During the assessment Mr.
Henry seems to be concerned about his financial problems, and the security and welfare of his family. In order to conduct a comprehensive health assessment of Mr. Henry, it is important for the nurse to take time out to do a self-reflection of his or her own values, “awareness of the nurse’s personal beliefs is vital in relating to clients from diverse cultural backgrounds” (Boone, 2005 p. 34). By understanding his or her own values, it would allow the nurse to keep an open mind when caring for a patient of different culture.It is important for the nurse providing care for Mr.
Henry to be mature and knowledgeable about the middle adulthood stage of life. Some cultural problems that I would focus on with Mr. Henry are how this culture deals with stress and how Mr. Henry would communicate with a nurse that is much younger than he is, and is of a different culture. It is said that in the African-American culture, stress and trust could be very difficult to establish because of past culturally background experiences such as slavery.I would first introduce myself in a nonthreatening manner, being respectful and address him by Mr.
, and maintain eye contact at all times. After the introduction phase, and trust has been established, I would then proceed to asking general questions, (what, who, and why) allowing him the opportunity to respond. By the use of effective communication, not being judgmentally to him due to his financial problems, and by listening and keeping an open mind will improve communication with Mr. Henry and allow me to gather the information. Based on Erikson's Mr.
Chuck Henry is in the Generativity vs. Stagnation (middle adulthood) developmental stage of life. At this point in Mr. Henry life, he should be retiring enjoying his accomplishment, and he should be spending time with his children, but due to Mr.
Henry lack of education, his only job was at the auto plant until being lay off one year short of his entire retirement, which has placed a financial strain on the Henry’s. Finding a new job was a very difficult challenge for Mr. Henry, he felt that due to his age and appearance he is competing with the younger crowd.He also stated that the few jobs that are “prospects” all results in a big pay cut. Mr.
Henry accepted a job at a local grocery store bagging groceries, which resulted in a pay cut from his previous job. Due to his age and level of maturity, he felt like his new younger co-workers were very immature and did not take their job seriously and they reminded him of his children whom he has not seen for a while. Mrs. Henry Comprehensive Health Assessment Mrs. Tameka Henry married to Mr.
Chuck Henry is also of African American culture, she is fifty-six, and a native of Michigan, has been unemployed for the last four years following a back injury sustained at work. At her, visit her blood pressure 130/86, weight 190lbs height 5’6. She complains of increase in pain, which is not being relief by current medication that was been recently changed at her last visit from Lortab 7. 5mg, every six hours as needed for pain to a new pain med name not mention. Mrs.
Henry stated, “All I am able to do is lie around, watch TV and eat because the pain keeps me from doing anything else”.Mrs. Henry has been getting disability for the last four years and is unable to work due to a back injury, her increase in pain may be a physiologically problem secondary to the financial problems the Henrys are faced with. She recently returned for follow up care, and complains of hot flashes, which are unbearable, and that she cries most of the time.
Due to her inactivity Mrs. Henry have showed increase in weight and blood pressure since her last visit. Next, I would like to explore all needed tools and potential cultural problems to completing a health assessment of Mrs.Henry. Mazanec & Tyler (2003) states that "everybody lives within a‘cultural’ frame and for some it may be easier to fit in with the predominant culture where care is taking place but for others the potential for care to be compromised due to lack of thought or understanding on the part of healthcare individuals can be more problematic".
Some of the cultural problems that I would focus on are how the African-American culture deals with grief, and pain. Because she has isolated herself, establishing communication and trust would be very challenging.It would be very important for the nurse to be very patient, and provide her with needed time to respond to questions. Even sitting closely to the patient may show her that you are concerned and want to help. By being and active listener, keeping the discussion focused on the patient and using open-ending statement for example "I see that you are distressed; can you tell me what you are feeling? " can be a useful tool to establish communication.
Another culturally factor that I would focus on with Mrs. Henry is lifestyle choices on healthy eating.The Center for African-American Health stated" soul food is a vital part of African-American culture. Unfortunately, too much of these deep-fried, buttered, high fat, salty and sugary foods can contribute to high cholesterol, diabetes and obesity". Based on Erikson's Mrs. Henry is also in the Generativity vs.
Stagnation (middle adulthood) developmental stage of life. Mrs. Henry has been forced into early retirement due to back injury four years ago. At this point, in her life, she should have be enjoying her accomplishments and focused on her career and family.Starting menopause, experiencing hot flashes and having changes with her hair is common in this age group. Because of her disability Mrs.
Henry feels that she has failed and been robbed of a chance to complete her life cycle. Due to her inactivity, Mrs. Henry has had some physical changes such as weight gain; she also experienced some thinning of her hair and hot flashes. She has isolated herself, crying most of the time, causing her to be lonely, and show signs of depression. As I conclude my comprehensive health assessment on my virtual family, many factors need to be considered.Having effective communication with your patients and family is a very useful tool, to gather the necessary information needed for patient care.
By familiarizing yourself with your patient's culture and beliefs, prior to providing care will enable you to have a better understanding and guidelines for how to give the patient the upmost care while still sympathizing with them in their circumstances or situation. References Black, D Y (2003) Racial identity, spirituality and health attitudes among African Americans. MA thesis.Central Connecticut State University. New Britain, Connecticut. http://fred.
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