Health Status - Research Paper Example

This paper tackles the evaluation of the health status of a particular client based on five measures all involving self analysis, with the end in view of formulating at least three nursing diagnoses geared towards curbing risks to health and enhancement of the client’s health status. Each diagnosis will endeavor to alleviate the effect of various stressors on the health of the client. Data pertinent to the framing of the nursing diagnoses were gathered using reliable metrics and both personal and clinical information from the client. An “Events Evaluation” of the client was completed using all three scales of Stress Assess, as well as the Lifescan, and the Live Well. The events evaluation overall score from the five scales was found to be 20.8%, which may be qualitatively interpreted from the scoring chart as “low” in terms of potential for distress. However, further analysis revealed that three areas in the assessment fell within the moderate to high levels of the chart, and constitute areas of concern for potential distress. These three spheres of possible distress include college ranking at 69.5%, family at 30.5% and the environment at 30%. The evaluation score on college is bracketed under high potential for distress, while the corresponding scores on family and environment may be categorized as moderate potentials for distress. It is, however, believed that if the client’s condition remains unattended or if the patient is not subjected to clinical intervention, areas within the moderate to borderline potential for distress level can cause physical symptoms. A thorough background of the client’s personal and clinical profile is critical for an appropriate diagnosis. At this juncture, therefore, relevant information about the patient is disclosed. CMP is a 29-year-old, white, well nourished and well developed female. Currently observed signs and symptoms include nervousness, feet-tapping, constant moving and almost constantly talking, which are all manifestations of a high level of anxiety. The client is also complaining about insomnia. The client narrates about her usually futile struggles to “shut off her brain” and maintains getting only four to five hours of quality sleep. Lack of restful sleep on the part of the client has already taken its toll in terms of decreased attention span in class and a diminished learning capacity. Client intimated being on a 20mg Paxil regimen for anxiety. However, the client also admitted that she is having problems about religiously maintaining her medication schedule. There are instances that the client misses filling in her prescriptions. Without regular medication, the patient confessed of her frequent mood swings and her difficulties in falling and staying asleep. As if to further confound her woes, when the client is able to maintain her medication routine, the prescription tends to hold back her appetite. With her appetite suppressed, the client admitted spending a day or two without meals. The practice, however, results in light headedness, and at times total blackouts. Grounded on the foregoing events assessment and the client’s personal and clinical sketch, this paper will examine three nursing diagnoses en route to the design of efficient interventions. The nursing diagnoses which will be elucidated in the following discussion are: (1) Anxiety, (2) Risk for Imbalanced Nutrition-Less Than Body Requirements, and (3) Risk for Infection, particularly colds or flu. The most critical nursing diagnosis from this assessment is getting the patients anxiety under control. Once anxiety is controlled, there will be sufficient leverage to address concerns pertaining to risk for imbalance nutrition-less than body requirements, as well as the risk for infection, otherwise, the common cold or worse, flu. Nervousness, insomnia, shortened attention span and mood swings point the nursing diagnosis clearly towards the direction of anxiety. The immediate goal should, therefore, be to help the patient maintain a regular and consistent anxiety medication schedule. To wit, the patient is to take 20 mg of Paxil at exactly 2000 hours everyday for the next four weeks until February 28, 2009. Improvement must then be monitored. The next goal for the patient is to acquire the 7 basic problem-solving skills and apply them during times of increased anxiety. The patient must be able to apply these 7 basic problem-solving skills throughout the entire spring semester from January 30-May 7, 2009 in managing stressful situations. The third and final goal to control anxiety involves the maintenance of a regular sleep schedule. The client will need to go to bed every night at 2130 hours and stay asleep for 7-8 hours until the end of the spring semester May 7, 2009. By maintaining a regular sleep pattern the client will experience longer periods of rest and increased levels of concentration in school. The next two nursing diagnoses stem from the first diagnosis - Anxiety. Discounting the presence of anxiety, the client is otherwise in good health. However, medically induced suppression of appetite and eventualities of stomach upset drive the client to go without food for days, hence there is an imminent risk for imbalanced nutrition-less than body requirements. Skipping meals also tend to bring about vitamin or mineral deficiencies. Hence, an unbalanced nutrition also precipitates the risk for infection, because the body’s natural immune system is dependent on its nutritional status. It is also evident that for the client concerned, the risk for infection may be traced back to poor nutrition and high level of anxiety. It is important to emphasize at this point that even if the anxiety prescription is a major factor leading to skipping of meals, weaning the patient from anxiety medication is definitely not an option. Instead, the patient needs to identify 4 daily nutritional requirements by April 4, 2009 and incorporate them into her daily meals. These nutritional requirements should stimulate the appetite and regulate the function of the digestive system to prevent cases of upset stomach. In cases where stressful events can be anticipated, such as an exam, the client willneed to eat at least 2 slices of toast (toast can be substituted by nutritional items/BRAT diet) and water to help settle her stomach until May 7, 2009. The client should maintain proper nourishment by staying within 5lbs of her minimum body weight until April 4, 2009. Though the common cold is typically linked to "being cold," studies revealed that a run-down immune system is more likely the cause. Furthermore, researchers have established a definite link between stress and illnesses ranging from colds to cancer (AFP, 2005). Researchers also discovered that during periods of stress, the body releases a hormone called neuropeptide Y (NPY), which undermines the bodys immune system and leads to illness (AFP, 2005). It was claimed that when NPY gets into the bloodstream, cells in the immune system are endangered since NPY prevents cells in the immune system from seeking out and destroying pathogens in the body (AFP, 2005). Due to the client’s high level of anxiety and poor eating habits, she is at an extremely high risk of contracting infections like the common cold. The client will, therefore, need to wash her hands for at least 15 sec with an antibacterial soap prior to every meal until April 4, 2009. The client will also need to drink at least 36 oz of water per day until April 4, 2009. REFERENCES AFP (2005). Australian Scientists Find Proof that Stress Makes You Sick. Retrieved 2009, Newsmine.org. January 27 from http://newsmine.org/content.php?ol=nature-health/health/stress-can-cause-common-cold-or-cancer.txt. Fukuda, Hiromi, Ichinose, Takamichi, Kusama, Tomoko, Yoshidome, Atsuko, Anndow, Kazuyo, Akiyoshi, Nobuko and Shibamoto, Takayuki (2008, October). The Relationship Between Job Stress and Urinary Cytokines in Healthy Nurses: A Cross-Sectional Study. Biological Research for Nursing 10(2), 183-191. Sauter, Steven, Murphy, Lawrence, Colligan, Michael, Swanson, Naomi, Hurrell, Joseph Jr., Scharf, Frederick Jr., Sinclair, Raymond, Grubb, Paula, Goldenhar, Linda, Alterman, Toni, Johnston, Janet, Hamileton, Anne and Tisdale, Julie (2007). Stress . . . At Work. National Institute for Occupational Safety and Health. Publication No. 99-101. Retrieved 2009, January 27 from http://www.cdc.gov/Niosh/stresswk.html. Read More