NURS 6512 Discussion: Diversity and Health Assessments Paper

NURS 6512 Discussion: Diversity and Health Assessments Paper

May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

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Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.

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.
• By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
• 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.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Read a selection of your colleagues’ responses.

By 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.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 2 Discussion Rubric

Post by Day 3 of Week 2 and Respond by Day 6 of Week 2

To Participate in this Discussion:

Week 2 Discussion

What’s Coming Up in Week 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition. You will also begin your first DCE: Health History Assessment which will be due in Week 4. Plan your time accordingly.

Overview of Digital Clinical Experiences (DCE) and Lab Components

Throughout this course, you are required to not only complete your standard course assignments and discussions, but you will also complete DCE and Lab Components that are either structured as optional or required assignment submissions. Please take the time to review your DCEand Lab Components for this course that are required submissions. See the table below and the attached for specific DCE and Lab Components for the course.

Note: Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve a total score of 80% or better, but you must take all attempts by the Day 7 deadline. You must pass BOTH the Health History and Comprehensive (head-to-toe) Physical Exam of at least a total score of 80% in order to pass the course.

Week	Digital Clinical Experiences	Lab Components
Module 1:  Comprehensive Health History
Week 1: Building a Comprehensive Health History
Module 2: Functional Assessments and Assessment Tools
Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment
Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children	DCE: Health History Assessment (assigned in Week 3, due in Week 4)	Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children
Module 3: Approach to System Focused Advanced Health Assessments
Week 4: Assessment of the Skin, Hair, and Nails	DCE: Health History Assessment	Lab Assignment: Differential Diagnosis for Skin Conditions (SOAP Note for differential diagnosis)
Week 5: Assessment of Head, Neck, Eyes, Ears, Nose, and Throat	DCE: Focused Exam: Cough	Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat (Episodic SOAP Note)
Week 6: Assessment of the Abdomen and Gastrointestinal System		Lab Assignment: Assessing the Abdomen (Analyze SOAP Note)
Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System	DCE: Focused Exam: Chest Pain
Week 8: Assessment of the Musculoskeletal System		Discussion: Assessing Musculoskeletal Pain (Episodic SOAP Note)
Week 9: Assessment of Cognition and the Neurologic System	DCE: Comprehensive (head-to-toe) Physical Assessment	Case Study Assignment: Assessing Neurological Symptoms (Episodic SOAP Note)
Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal		Lab Assignment: Assessing the Genitalia and Rectum (analyze SOAP Note)
Module 4: Ethics in Assessment
Week 11: The Ethics Behind Assessment		Lab Assignment: Ethical Concerns

Next Week

To go to the next week:

Week 3

Learning Resources

Required Readings (click to expand/reduce)

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.

 Chapter 1, “The History and Interviewing Process”  (Previously read in
Week 1)
This chapter highlights history and interviewing processes. The authors explore a
variety of communication techniques, professionalism, and functional assessment
concepts when developing relationships with patients.

 Chapter 2, “Cultural Competency”
This chapter highlights the importance of cultural awareness when conducting
health assessments. The authors explore the impact of culture on health beliefs
and practices.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment
and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary
Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019
by Mosby. Reprinted by permission of Mosby via the Copyright Clearance
Center.

 Chapter 2, “Evidenced-Based Clinical Practice Guidelines”

Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy
and asthma management among African-American adults: An interpretative
phenomenological analysis. Journal of Asthma, 51(7), 703–713.
doi:10.3109/02770903.2014.906605
Credit Line: Health literacy and asthma management among African-American
adults: An interpretative phenomenological analysis by Melton, C., Graff, C.,
Holmes, G., Brown, L., & Bailey, J., in Journal of Asthma, Vol. 51/Issue 7.
Copyright 2014 by Taylor & Francis, Inc. Reprinted by permission of Taylor &
Francis, Inc. via the Copyright Clearance Center.

The authors of this study discuss the relationship between health literacy and
health outcomes in African American patients with asthma.

Centers for Disease Control and Prevention. (2015). Cultural competence.
Retrieved from https://npin.cdc.gov/pages/cultural-competence

This website discusses cultural competence as defined by the Centers for Disease
Control and Prevention (CDC). Understanding the difference between cultural
competence, awareness, and sensitivity can be obtained on this website.

United States Department of Human & Health Services. Office of Minority
Health. (n.d.). A physician’s practical guide to culturally competent care.
Retrieved June 10, 2019, from https://cccm.thinkculturalhealth.hhs.gov/

From the Office of Minority Health, this website offers CME and CEU credit and
equips healthcare professionals with awareness, knowledge, and skills to better
treat the increasingly diverse U.S. population they serve.

Espey , D. K., Jim, M. A., Cobb, N., Bartholomew, M., Becker, T., Haverkamp,
D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in
American Indians and Alaska Natives. American Journal of Public Health,
104(Suppl 3), S303–S311.

The authors of this article present patterns and trends in all-cause
mortality and leading cause of death in American Indians and
Alaskan Natives.

Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., & Tanasugarn,
C. (2016). Health literacy, medication adherence, and blood pressure level among
hypertension older adults treated at primary health care centers. Southeast Asian
Journal of Tropical Medicine and Public Health, 47(1), 109–120.

The authors of this study explore the causal relationships between
health literacy, individual characteristics, literacy, culture and
society, cognitive ability, medication adherence, and the blood
pressure levels of hypertensive older adults receiving healthcare
services at primary healthcare centers.

Required Media (click to expand/reduce)

As we begin Week 2, I want to start by saying how impressed I am!  The discussions have been excellent!  All of you should be commended for being so complimentary to your peers, while also initiating stimulating dialogue!  We are going to have a great 11 weeks with the enthusiasm and the effort being demonstrated to date.

Here are some items of interest as we begin another busy week!

Be sure to listen to Dr. Harris’s week module reviews and lectures….they are full of valuable information for assignments/expectations throughout this course.

APA– everyone’s APA looks very good, and I am glad to see so many of you reaching out for additional scholarly citations.  Just some common errors that I have found in the past when I have taught this course, so I will share with you here:

When using quotation marks, you need to list the page number in the intext citation.

When you are citing statistics, you need to reference the statistic at the end of the sentence.

Website citations……

Author/Name of Site. (Year, Month Day). Title of webpage.  Title of Site. (URL address).

Weekly Discussions  It would be helpful to me, as well as your classmates that you start a new thread for your main post, and title it (Last Name, Week 2, Main Post).  This will help us identify what is a main post vs. response.  Also, give as much detail as possible, and support with scholarly references.  In your peer responses you should add to the conversation, and pose questions to further the conversation.

For this week, you will discuss diversity:

·     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?

Case Study Assignments:  The following will be the assignments for this week’s Case Study:

Last Name A-M:

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”

Last Name N-Z:

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; Abortion 0

Shadow Health:  Please be sure to follow the course announcements to assist with your troubleshooting of this tool.  As I receive information, I will be posting it there.

I hope everyone has a great week!!!

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Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Content
Name: NURS_6512_Week_2_Discussion_Rubric

Outstanding Performance Excellent Performance Competent Performance Proficient Performance Room for Improvement
Main Posting:
Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

Points Range: 44 (44%) – 44 (44%)

Thoroughly responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

supported by at least 3 current, credible sources

Points Range: 40 (40%) – 43 (43%)

Responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

75% of post has exceptional depth and breadth

supported by at least 3 credible references

Points Range: 35 (35%) – 39 (39%)

Responds to most of the discussion question(s)

is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of post has exceptional depth and breadth

supported by at least 3 credible references

Points Range: 31 (31%) – 34 (34%)

Responds to some of the discussion question(s)

one to 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 fewer than 2 credible references

Points Range: 0 (0%) – 30 (30%)

Does not respond to the discussion question(s)

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 1 or no credible references

Main Posting:
Writing

Points Range: 6 (6%) – 6 (6%)

Written clearly and concisely

Contains no grammatical or spelling errors

Fully adheres to current APA manual writing rules and style

Points Range: 5.5 (5.5%) – 5.5 (5.5%)

Written clearly and concisely

May contain one or no grammatical or spelling error

Adheres to current APA manual writing rules and style

Points Range: 5 (5%) – 5 (5%)

Written concisely

May contain one to two grammatical or spelling error

Adheres to current APA manual writing rules and style

Points Range: 4.5 (4.5%) – 4.5 (4.5%)

Written somewhat concisely

May contain more than two spelling or grammatical errors

Contains some APA formatting errors

Points Range: 0 (0%) – 4 (4%)

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 Posting:
Timely and full participation

Points Range: 10 (10%) – 10 (10%)

Meets requirements for timely and full participation

posts main discussion by due date

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
Does not meet requirement for full participation

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings

responds to questions posed by faculty

the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

Points Range: 8.5 (8.5%) – 8.5 (8.5%)
Response exhibits critical thinking and application to practice settings

Points Range: 7.5 (7.5%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting

Points Range: 6.5 (6.5%) – 7 (7%)
Response is on topic, may have some depth

Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth

First Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues

Response to faculty questions are fully 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: 5.5 (5.5%) – 5.5 (5.5%)

Communication is professional and respectful to colleagues

Response 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: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues

Response to faculty questions are mostly answered if posed

Provides opinions and ideas that are supported by few credible sources

Response is written in Standard Edited English

Points Range: 4.5 (4.5%) – 4.5 (4.5%)

Responses posted in the discussion may lack effective professional communication

Response to faculty questions are somewhat answered if posed

Few or no credible sources are cited

Points Range: 0 (0%) – 4 (4%)

Responses posted in the discussion lack effective

Response to faculty questions are missing

No credible sources are cited

First Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely and full participation

posts by due date

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
Does not meet requirement for full participation

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings * responds to questions posed by faculty

the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

Points Range: 8.5 (8.5%) – 8.5 (8.5%)
Response exhibits critical thinking and application to practice settings

Points Range: 7.5 (7.5%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting

Points Range: 6.5 (6.5%) – 7 (7%)
Response is on topic, may have some depth

Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth

Second Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues

Response to faculty questions are fully 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: 5.5 (5.5%) – 5.5 (5.5%)

Communication is professional and respectful to colleagues

Response 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: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues

Response to faculty questions are mostly answered if posed

Provides opinions and ideas that are supported by few credible sources

Response is written in Standard Edited English

Points Range: 4.5 (4.5%) – 4.5 (4.5%)

Responses posted in the discussion may lack effective professional communication

Response to faculty questions are somewhat answered if posed

Few or no credible sources are cited

Points Range: 0 (0%) – 4 (4%)

Responses posted in the discussion lack effective

Response to faculty questions are missing

No credible sources are cited

Second Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely and full participation

Posts by due date

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
Does not meet requirement for full participation
Total Points: 100
Name: NURS_6512_Week_2_Discussion_Rubric