Question

A 23-year-old woman was admitted to your institution with abdominal pain with nausea and vomiting for the past 2 weeks. She immigrated to the United States 1 year ago from a Latin American country, has limited English skills, and has not been able to work. As her nurse, you attempt to engage her in conversation. She rarely makes eye contact and has a flat affect. You note that she is holding onto a rosary

1. What pertinent data can you gather based on available patient information?
2. What factors should the nurse consider to be related to this patient’s access to health care?
3. What questions should you ask yourself when caring for this patient?
4. How might the human dimensions guide the nurse for this patient’s care plan?

Answer 1

1.she can be asked for her menstrual history as these signs and symptoms can cause menstrual irregularities. she can also cause infection or any inflammatory conditions.

2.

Environmental determinants of health and disease are pervasive and integral to the assessment, diagnosis, intervention, planning, and evaluation components of nursing practice. However, environmental factors that affect health are commonly overlooked in routine patient assessments. When environmental health concerns are missed, an opportunity for prevention is lost, and public health is less well served.

Although not every illness has an environmental etiology, nearly everyone will have a health problem related to an environmental hazard for which evaluation or advice is appropriate in terms of good nursing practice. It is important in nursing practice to identify not only the hazards that contribute to a current diagnosis (e.g., exposure to lead-contaminated dust resulting in elevated blood lead levels, and outdoor ozone or indoor allergens exacerbating childhood asthma), but also those that have not yet caused illness but are amenable to intervention (e.g., friable asbestos, radon, formaldehyde gases from building materials, and carbon monoxide and nitrogen oxides from poorly ventilated furnaces). By taking a proactive approach, nurses can initiate preventive actions to abate hazards before they manifest as disease. Thus, consideration of environmental health concepts as a core nursing function will vastly strengthen nursing's contribution to disease prevention

3.

· When did the vomiting begin? How long has it lasted? How often does it occur?

· Does it occur after you eat, or on an empty stomach?

· Are other symptoms present such as abdominal pain, fever, diarrhea, or headaches?

· Are you vomiting blood?

· Are you vomiting anything that looks like coffee grounds?

· Are you vomiting undigested food?

· When was the last time you urinated?

Other questions you may be asked include:

· Have you been losing weight?

· Have you been traveling? Where?

· What medicines do you take?

· Did other people who ate at the same place as you have the same symptoms?

· Are you pregnant or could you be pregnant?

· Do you use marijuana? If yes, how often do you use it?

4.

Assessment:	Program uses a standardized assessment tool for diagnosis and treatment planning
Attention to mental health:	Program assesses adolescent’s mental health and addresses concerns proactively
Comprehensive, integrated treatment	Program assesses and proactively addresses factors related to the adolescent’s substance use such as physical health, education/vocational status, victimization, legal involvement, and sexual health.
Family involvement	Program directly involves family in the treatment and recovery process.
Developmentally informed programming	Program utilizes developmentally-appropriate approaches to treatment.
Engage and retain adolescents	Program implements strategies for actively engaging adolescents in the treatment process.
Staff qualifications and training	Program staff are experienced and receive ongoing training to ensure the delivery of highest quality treatment.
Person-first treatment	Program delivers treatment that is personalized and sensitive to issues pertaining to cultural background, gender, sexual orientation, and other identity markers.
Continuing care and recovering supports	Program provides accessible, ongoing services to sustain long-term recovery.
Program evaluation	Program has comprehensive protocols for evaluating the quality of treatment.