Please select one of the following case studies and complete the chart.
You are expected to role play the selected scenario with a family member to gather necessary data to complete the chart. For each person described in the following situations, discuss the developmental/age, socioeconomic, ethical considerations, and cross-cultural considerations that should be considered during the gathering of subjective and objective data, and the provision of health care. Discuss any additional information that might be needed before a judgment or diagnosis can be made.
- A. E. is a 35-year-old African American female, and is 5 months pregnant presenting to the office today for a routine prenatal visit. She complains that her neck feels swollen and that she has been feeling nervous and tired. She also complains about the heat, excessive sweating, and how she “can’t seem to get cool during these summer months.” She attributes all these complaints to her pregnancy.
- J. L. is a 55-year-old Caucasian female who had a CVA within the past week. J. L. is easily frustrated, anxious, fearful, and her speech is slurred. She needs verbal cuing for any task she is asked to carry out. She eats only food on the left side of the tray and responds only when approached from the left side.
Components of assessment | Subjective Diagnostic Reasoning (list key questions — use PQRSTU pneumonic) | Objective Normal vs. (must note pertinent body systems to be examined) | Differential diagnoses (list 3) Nurses diagnosis (list 1) | List relevant labs and diagnostic studies (if any) |
Normal | Differential | |||
Abnormal Findings | Nurses Diagnosis | |||
Developmental/age considerations:
Socioeconomic considerations:
Cross-cultural considerations:
Ethical considerations:
Additional info needed to formulate actual diagnosis:
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Answer:
Introduction:
The following is a case study scenario that nursing students can use to gather necessary data to complete the chart regarding the developmental/age, socioeconomic, ethical considerations, and cross-cultural considerations that should be considered during the gathering of subjective and objective data and the provision of healthcare. The case study includes a pregnant African American female complaining of swollen neck, fatigue, and nervousness, and a 55-year-old Caucasian female who had a CVA within the past week.
Components of assessment Subjective Diagnostic Reasoning Objective Differential diagnoses Nurses diagnosis List relevant labs and diagnostic studies (if any)
Normal vs. abnormal findings
A. E.: 35-year-old African American female, 5 months pregnant Pregnancy-related fatigue, inability to tolerate heat, excessive sweating, swollen neck area PQRSTU mnemonic method should be used in gathering key questions. Normal findings in some systems- cardiovascular, pulmonary, and abdominal. Abnormal findings in endocrine and reproductive systems. Possible differential diagnoses include thyroid disorder, pregnancy-induced hypertension, and preeclampsia. Possible nurse diagnosis: Fatigue related to pregnancy. Additional information needed to formulate an actual diagnosis includes hormone level and thyroid function tests, ultrasound, and blood pressure measurements.
J.L.: 55-year-old Caucasian female who had a CVA within the past week. Speech slurred, anxiety, fear, and easily frustrated. Eats only on the left side of the tray and responds only when approached from the left side. Key questions should be used from PQRSTU mnemonic method. Abnormal findings in neurological, musculoskeletal, and cardiovascular systems. Differential diagnoses may include stroke, brain tumor, and vertigo. Possible nurse diagnosis: Impaired physical mobility related to the left-sided weakness. Additional information needed to formulate an actual diagnosis includes CBC, MRI or CT scan, renal function tests, and electrolyte panel.
Developmental/age considerations: Different age groups have varying risks, and healthcare providers need to take note of these. Therefore, it is correct that the student has identified A.E as a pregnant female and J.L. as a 55-year-old female experiencing the effects of CVA.
Socioeconomic considerations: Healthcare costs are not constant, and without proper insurance poses a challenge to accessing medical care. As such, for A.E, the student should consider insurance information and for J.L., age and disability insurance.
Cross-cultural considerations: Culture impacts how healthcare is provided, and different cultures will require different health practices. Therefore, considering A.E.’s African American culture, the best approach should incorporate the unique needs within the African American community. For J.L.’s case, cultural and language barriers need to be addressed.
Ethical considerations: The student should remain within the established ethical guidelines in providing healthcare services to the patient, avoiding discrimination of any kind.
Additional information needed to formulate an actual diagnosis: Both patients may need additional lab and diagnostic studies, as outlined in the tables above, to help an actual diagnosis.
Conclusion:
As seen above, understanding various patient-specific considerations is crucial in providing effective healthcare. Addressing developmental/age, socioeconomic, ethical, and cross-cultural considerations provides the necessary foundation for effective patient care.
