NURS 6512 TJ Pregnant Lesbian Essay

There are three different levels of health promotion, primary, secondary and tertiary. “Primary prevention refers to actions aimed at avoiding the manifestation of a disease” (About, 2018). This would include such things as vaccinations, healthy eating habit or educating on the importance of not smoking. “Secondary prevention aims to reduce the impact of a disease or injury that has already occurred” (Primary, secondary and tertiary prevention | Institute for Work & Health, 2000). In order to do this, it is imperative to detect the problem early on in order to halt the disease process. Secondary prevention would include regular mammograms and pap smears or taking low dose aspirin to prevent a second heart attack or stroke. “Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects” (Primary, secondary and tertiary prevention | Institute for Work & Health, 2000). This is when the damage is already done and care is aimed at lessening the long term effects of the problem. This would include things like physical or occupational therapy following a stroke or heart attack. The levels of prevention can help determine the educational needs for each patient. For instance you would want to educate young people on the dangers of smoking to include primary prevention in your education. Education of secondary prevention would include teaching women how to give themselves breast exams for early detection of breast cancer. Tertiary prevention education would be aimed at individuals following a stroke on how to rehabilitate themselves.

TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over the counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

Week 2 Discussion

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As a provider, it is important to treat all patients with respect and dignity despite any differences in race, ethnicity, socioeconomic status, sexual orientation, or belief systems. The ability to do so is called cultural competence (CDC, 2015). When treating a patient, it is important to recognize these cultural differences when establishing a treatment plan. When a patient feels they are being treated with dignity and respect they are likely to disclose more pertinent health information and trust the provider’s medical opinions. Once the trust/respect of a patient-provider relationship has been broken, individuals are less likely to seek medical treatment in the future. Crawford et al. (2019), recommend using the “LET UP” model for creating cultural competence in patient assessments. This acronym stands for Listen, empathize, Tell your story, Understand, and Psychoeducate. Using this system allows the provider to gain a better understanding of the patient’s situation and to create cultural competence.
In the scenario of a 32-year-old pregnant lesbian, the Nurse Practitioner needs to be sensitive to the patient’s sexual orientation, preferred gender role, and address the patient with the proper pronouns. In doing so, it helps build a strong provider-patient relationship based on trust and respect. It is imperative for providers to become aware of their own biases and educate themselves in order to give culturally competent care to their patient populations (Ball et al., 2019).

The population in the united states is composed of people from diverse cultural backgrounds and this aspect is also duplicated in the healthcare system. To ensure the provision of quality and effective healthcare services to the diverse population, the healthcare providers must be competent, sensitive, and also be aware of the diversity of the patient cultures and other essential beliefs as well as avoid stigmatizing patients based on their cultural differences. When a healthcare provider is culturally competent, he or she accepts the diverse needs of their patients even though the diverse needs may be different from those of theirs. To ensure culturally competent healthcare services, the healthcare providers must be sensitive to the patient’s socioeconomic status, heritage and ethnicity. Distinct from cultural awareness and cultural sensitivity, cultural competence is the ability of healthcare providers to modify their practices such that they effectively meet the needs of the different cultural groups (Sharifi, Adib-Hajbaghery, & Najafi, 2019). On the contrary, cultural awareness and sensitivity highlight the ability to recognize the differences without necessarily modifying practices to meet the various needs of different patients.

Case scenario

The case study presents Mono Nu, who is a 44- year old Filipino patient who started blood thinner medications a period of two weeks ago. The patient is from a low-income household and hence does not afford the prescribed medication. Besides, he has no adequate understanding on the working mechanism of the medications or why they are necessary. In addition, the patient lacks a social support network so that he can maintain his medications. His main diet is fish and tofu, which may lack in some essential nutritional components hence affecting the mode of action of the blood thinner medications.

Cultural Factors

Mono Nu is from the Philippines which makes him have a different understanding of health and wellness contrary to people from the western culture. The culture in the Philippines is such that they rely on family, friends, and faith in God for healing (Cacho & del Castillo, 2022). This culture of health and wellness prevents the Philippines from access to healthcare. The culture of the patient, therefore, has an impact on his health because it can dictate his willingness to adhere to the prescribed medications (Collado, 2019). In addition, the patient does not understand why his medications are producing the anticipated results meaning that the patient might be frustrated or, might be in a state where he feels helpless. His choice of diet however indicates that he appreciates specific diet which is essential to healthy eating. As a health practitioner, some of the most sensitive issues to take into account while interacting with this particular patient include their age, cultural differences in terms of health beliefs, the likelihood of frustrations with the medications, and some potential side effects of medications.

Targeted Questions

What is your level of income? Do you have financial challenges in obtaining your prescribed medications?
Do you understand the mode of action of your blood thinner medications and why they are necessary for your current state?
Are there some cultural beliefs that may negatively influence your willingness to take the prescribed medications?
Do you have any social program that can assist you in obtaining your medications as prescribed?
Are there any other health concerns that you feel that I should be aware of?

References

Cacho, R., & del Castillo, F. (2022). God’s Benevolent Love in the Time of COVID-19 Pandemic: Articulations and Experiences of Select Filipino Youth. Religions, 13(2), 162.

Collado, Z. C. (2019). Challenges in public health facilities and services: evidence from a geographically isolated and disadvantaged area in the Philippines. Journal of Global Health Reports, 3.

Sharifi, N., Adib-Hajbaghery, M., & Najafi, M. (2019). Cultural competence in nursing: A concept analysis. International journal of nursing studies, 99, 103386.

5 assessment questions
Are you in a monogamous relationship?
Have you been in sexual contact with anyone with a known STI?
Can you describe the symptoms you are having with vaginal discharge?
You have a significant family history of diabetes. Have you been experiencing any symptoms of high/low blood sugar? Have you had your A1C levels checked recently?
Who would you consider your support system throughout your pregnancy thus far?
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.). St. Louis, MO: Elsevier Mosby.
Center for Disease Control and Prevention. (2015). Cultural Competence. Retrieved from https://npin.cdc.gov/pages/cultural-competence
Crawford, D. E., Chomilo, N. T., Glusman, M., Patel, M., Krug, L., & Kaplan-Sanoff, M. (2019). “LET UP”: A Systematic Approach to Responding to Cultural Bias in Health Care. Zero to Three, 40(2), 10– 17.

Welcome to week 2!

This week we have the following objectives
Students will:
• Analyze diversity considerations in health assessments
• Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment
Here are the case assignments based on the first letter of your last name
A/B/C/D/E/F/G/H/I/J/K case: 1
JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has ahx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”
L/M/N/O/P/Q/R/S/T/U/V/W/X/Y/Z Case: 2
TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over the counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

To prepare:

• Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
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• Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
• Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

By Day 3 of Week 2

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Day 6 of Week 2

Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.

Rubric Detail

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Name: NURS_6512_Week_2_Discussion_Rubric
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Excellent Good Fair Poor
Main Posting Points Range: 45 (45%) – 50 (50%)
“Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. Points Range: 40 (40%) – 44 (44%)

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“Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. Points Range: 35 (35%) – 39 (39%)
“Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. Points Range: 0 (0%) – 34 (34%)
“Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness Points Range: 10 (10%) – 10 (10%)
Posts main post by Day 3. Points Range: 0 (0%) – 0 (0%)
N/A Points Range: 0 (0%) – 0 (0%)
N/A Points Range: 0 (0%) – 0 (0%)
Does not post main post by Day 3.
First Response Points Range: 17 (17%) – 18 (18%)
“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. Points Range: 15 (15%) – 16 (16%)
“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. Points Range: 13 (13%) – 14 (14%)
“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. Points Range: 0 (0%) – 12 (12%)
“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response Points Range: 16 (16%) – 17 (17%)
“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. Points Range: 14 (14%) – 15 (15%)
“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. Points Range: 12 (12%) – 13 (13%)
“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. Points Range: 0 (0%) – 11 (11%)
“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. Points Range: 0 (0%) – 0 (0%)
N/A Points Range: 0 (0%) – 0 (0%)
N/A Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on three different days.
Total Points: 100
Name: NURS_6512_Week_2_Discussion_Rubric