What preventative care measures can be taken during a health assessment for this patient?

  

NITIAL POST: COMPREHENSIVE HEALTH ASSESSMENT PATIENT #2
The patient profile I have been assigned is a 35-year-old white male with a history of morbid obesity with disabilities in a rural setting. This is a new patient whom I am assuming I have never met before. The first step is to build a relationship with the patient, this fosters trust between the nurse and patient. A primary objective is to discover the details about a patients concern, explore expectations for the encounter, and display genuine interest, curiosity, and partnership. Identifying underlying worries, believing them, and trying to address them optimizes your ability to be of help (Ball, J. W., et al. 2019). A thorough health history is important as it lays the groundwork to not only build a relationship, but to efficiently diagnose a health issue or illness, and treat these health issues and illnesses.
Communication with this age group needs to include non-medical jargon so the patient will understand the information presented. Medical jargon can be used but needs to be followed up with what the medical term means. Open ended communication is important to use, this gives the patient the ability to fill in the blanks with pertinent information. For example, asking the patient why they came to see you today, what health concerns they want to talk about, and keeping the conversation going by asking if there is anything else they would like to talk about. This can be added numerous times during the assessment to keep the patient talking about issues they may have.
Information needs to complete a health assessment can include, past medical history, family medical history, social history, present medications, lifestyle considerations like alcohol, drug use, and smoking history. A head-to-toe assessment also needs to be completed to determine if there are any other issues needed to address. This patient would need education regarding lifestyle changes needed related to obesity. A referral to a dietary consultant may be needed if the patient is ready to make changes to their diet. Patients who reside in rural areas have less access to nutritious foods due to distance needed to get to a store where they can buy these foods. Many rural areas have quick marts where people can get fast food, not necessarily nutritious foods.
Obesity can cause many other health risks including HTN, Diabetes, Joint issues, difficulty breathing, Sleep Apnea, skin issues like yeast infections, wounds, and Stroke. Obese patients can also have trouble with ADLs as the inability to care for themselves is common due to decreased energy and inability to complete personal cares. This patient is noted to have disabilities; this can be related to joint issues and inability to ambulate, bend, reach, and general muscular and joint problems.
In relation to a risk assessment, I would use preventative care including personal history, laboratory screening tests to rule out Diabetes, Prostate Cancer, Hypercholesterolemia, Infection, and a Comprehensive Metabolic Panel to determine if the patient had any blood related abnormalities and determine if the patient had any problems with kidney or liver function. I would also determine if the patient had any issues with Alcohol, Tobacco, or drug use as use of these can lead to disease. In my communication with the patient regarding these issues I would be sure to tell him I ask all my patients these questions. Sullivan, D.D. (2019) states, Approaching these matters in a nonjudgmental, professional, matter of fact manner should enhance patient disclosure of sensitive information.
Questions I would be sure to include in my health assessment:
1. How are you feeling today?
2. What would you like for us to do today?
3. What do you think is causing your symptoms?
4. What are your coping mechanisms when you feel sad, scared, or angry?
5. Do you have people in your life whom you can talk to?
I feel it is important to not only assess a patients physical well-being, but to also assess if they are happy with their lives and feel heard, happy, and involved in their own care.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). 1(1-21). St. Louis, MO: Elsevier Mosby.
MediLexicon International. (n.d.). Morbid obesity: Symptoms, treatment, and outlook. Medical News Today. https://www.medicalnewstoday.com/articles/320460#complicationsLinks to an external site..
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). 2(19-29). Philadelphia, PA: F. A. Davis.

Introduction:

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A comprehensive health assessment is a crucial step towards efficient diagnosis and treatment of a health issue or illness. In order to conduct a successful assessment, building a relationship of trust with the patient is essential. Communication is key, and using non-medical jargon is necessary to ensure that the patient can understand the information presented. In this article, we will be discussing the health assessment of a 35-year-old white male with a history of morbid obesity and disabilities in a rural setting.

Description:

Patient #2 is a 35-year-old white male with a history of morbid obesity and disabilities in a rural setting. As a new patient, it is essential to build a trusting relationship with him. This means listening to his concerns and displaying a genuine interest in his health and well-being. It is equally important to communicate using non-medical jargon, as the patient may not understand complex medical terms. Open-ended communication is key, and the patient needs to be encouraged to share any issues he may have.

A thorough health history is important in identifying underlying health concerns and determining appropriate treatment. As such, the patient’s past medical history, family medical history, social history, present medications, and lifestyle considerations such as alcohol, drug use, and smoking history will be noted. A head-to-toe assessment will also be conducted to identify any other health issues that need addressing.

Education is essential in addressing the patient’s obesity-related health risks. The patient will need guidance on lifestyle changes that need to be made. A referral to a dietary consultant may be needed to ensure adequate nutrition. Of particular concern for rural patients is the difficulty in accessing nutritious foods. Obesity can lead to other health risks such as hypertension, diabetes, joint issues, breathing difficulties, sleep apnea, skin issues, and stroke. Obese patients may also struggle with ADLs due to decreased energy levels and difficulty with personal care.

A risk assessment will be conducted, including laboratory screening tests, to rule out conditions such as diabetes, prostate cancer, hypercholesterolemia, and infection. A comprehensive metabolic panel will also be performed to determine if the patient has any blood-related abnormalities, which may impact treatment options. By conducting a thorough health assessment, appropriate preventative care can be identified and implemented, leading to better health outcomes for the patient.

patient has any risks for cardiovascular disease.

Objectives:
1. Build a relationship with the patient to foster trust.
2. Discover the patient’s concern, explore expectations for the encounter, and display genuine interest, curiosity, and partnership.
3. Conduct a thorough health history to efficiently diagnose health issues and illnesses.
4. Communicate in non-medical jargon for better patient understanding.
5. Use open-ended communication to encourage the patient to provide pertinent information.
6. Complete a head-to-toe assessment to identify any other issues that need to be addressed.
7. Provide patient education regarding lifestyle changes needed related to obesity.
8. Refer the patient to a dietary consultant if necessary.
9. Conduct a risk assessment using preventative care techniques.

Learning Outcomes:
1. Demonstrate effective communication skills to build a trusting relationship with the patient.
2. Identify the patient’s concerns, expectations, and potential partnership opportunities.
3. Utilize appropriate questioning techniques to identify underlying worries and address them accordingly.
4. Conduct a thorough health history, including past medical history, family medical history, social history, present medications, lifestyle considerations, and head-to-toe assessment.
5. Explain medical terminology in non-medical jargon for better patient understanding.
6. Use open-ended communication to encourage the patient to provide pertinent information.
7. Identify the risks associated with obesity.
8. Develop a patient-centred care plan to address obesity and any other identified health issues.
9. Demonstrate the ability to conduct a risk assessment using preventative care techniques.

Solution 1: Implementing Lifestyle Modification Programs

One possible solution to improve the health of the patient profiled above is to implement lifestyle modification programs. Given that the patient has a history of morbid obesity, it is important to focus on changing his dietary habits, reducing the consumption of fast and processed foods and increasing his intake of nutritious foods. A referral to a dietary consultant can be made to assist the patient in making healthy dietary choices. Additionally, the patient can be educated on physical activities he can engage in to help with joint issues and obesity. Encouraging home-based exercises, such as stretching or resistance training, can be effective in improving the patient’s overall health and well-being. By implementing such programs, this patient, and others in rural areas with similar health issues, will have the necessary tools to make effective lifestyle modifications to improve their health.

Solution 2: Improving Accessibility to Nutritious Foods in Rural Areas

Another possible solution is to improve accessibility to nutritious foods in rural areas. It is common for patients in rural regions not to have access to nutritious foods due to the distance needed to get to a store where they can buy these foods. This can result in an increase in fast food consumption and a lack of essential vitamins and minerals, which can lead to various health issues. One potential solution could be to build stores that focus on providing nutritious foods in rural areas. Additionally, there can be financial incentives for small farmers in rural areas to grow fruits and vegetables. These incentives can be through funding, subsidies, or grants that enable them to cultivate and sell fresh produce to the community. By having access to nutritious foods, the patient profiled above and others in rural areas can make significant changes to their overall health and well-being.

Suggested Resources/Books:
1. Comprehensive Health Assessment: A Student Workbook – by Cynthia M. Phelan
2. Health Assessment in Nursing – by Janet R. Weber and Jane H. Kelley
3. Clinical Guide to Comprehensive Women’s Health – by Bindu B. John and Kathryn A. Ganske

Similar Asked Questions:
1. How can a comprehensive health history help in efficient diagnosis and treatment of health issues?
2. What are the challenges of communicating with patients in non-medical jargon and how can they be overcome?
3. How can healthcare professionals address the issue of limited access to nutritious foods for patients residing in rural areas?
4. What are the health risks associated with obesity and how can they be prevented or managed?
5. What are the best preventive care measures for patients with a history of morbid obesity and disability?

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