NR 305-week 2 discussion: Maria is a 40-year-old Hispanic

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)

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, commutes daily, 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
SOLUTION 
  1. What additional assessment data (subjective and/or objective) would you like to gather from Maria? I would like to know what kind of food she is cooking, are the meals balanced? What does she use to cook with, oils/butters/fats/cooking sprays? I would also like to know if Maria takes any time out of her day to exercise. Does Maria wear a fitness tracker? What is her eating regimen? I would also like to know Maria’s medical history; does she have any high blood pressure or high blood sugars? I would also like to know if Maria is on any medication currently either prescribed or OTC. Family history would also be another area I would want to know more about, any family history of a stroke, HTN, I would also want to find out more about how all of this makes Maria feel, how she wants to handle the situation, and what her values are when it comes to her health as these are all parts of collective subjective data (Weber & Kelley, 2018).
  2. What actual health concerns and risk factors have you identified? One health concern would be coronary artery disease. Maria is not consuming nutritious foods and is gaining weight; her blood pressure is high and so is her heart rate. Maria is at risk for a stroke as well if her blood pressure continues to increase.

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