Instructions
Question 1
The case involves a 23-year-old Native American male who is concerned about his lifestyle choices influencing his entry into heaven. In this case, it is important to consider economic, spiritual, behavioral, and cultural factors affecting his health. Socioeconomically, Native Americans face healthcare, education, and employment disparities (Empey et al., 2021). Disparities can stress and affect mental health. Social factors affecting his daily life may affect his anxiety.
Spiritually, the patient worries about his actions impacting entry into heaven. Native Americans’ spirituality is founded on environment, community, and ancestry (Walters et al., 2020). The patient may worry about not going to heaven due to his spiritual suffering. Understanding and addressing spiritual difficulties is essential to holistic health. Lifestyle factors like smoking “pot” and drinking are common anxiety treatments. Cultural, peer, and historical factors influence these behaviors. Effective therapy requires understanding Native American substance use views.
Native Americans are close-knit and culturally united. A family history of diabetes, hypertension, and alcoholism may affect the patient’s health and behavior. Cultural health and well-being attitudes and behaviors must be addressed in patient-centered care. A holistic and culturally competent treatment plan must consider the patient’s economic, spiritual, lifestyle, and cultural factors. Customizing interventions to address these factors improves patient outcomes and well-being.
Question 2
I would use all five evaluation domains to evaluate my patients’ nutrition. Starting with the second domain, to assess body composition and malnutrition or obesity, I would evaluate height, weight, and BMI. Biochemically, I would order albumin, hemoglobin, and vitamin blood tests to measure metabolic and nutritional status in the third domain. The fourth domain would involve a thorough physical examination to detect nutritional symptoms such as muscle atrophy, skin abnormalities, etc. The first domain would assess their food preferences, intake patterns, and habits using meal diaries or recalls evaluating nutritional content. Finally, in the fifth domain one would consider the socioeconomic position, culture, and food availability to contextualize the patient’s dietary choices. These five dimensions would determine each patient’s nutritional profile, diet, and medicines. Comprehensive and individualized evaluations prepare for focused therapy that improves long-term health and nutrition.
Question 3
The complex way the brain operates with neurotransmitter systems and other brain components generates psychiatric mental health patients’ functional anatomy and physiology. Mental wellness is also in the mind’s amygdala, prefrontal cortex, etc. Psychiatric illnesses disorderly energize the prefrontal cortex, which controls impulses and makes decisions. If the amygdala or other limbic system parts malfunction, emotional dysregulation and stress response may worsen. A delicate balance of neurotransmitters, including serotonin, dopamine, and norepinephrine, regulates mood and cognition. Psychiatric diseases like depression, anxiety, and bipolar disorder are typically linked to neurotransmitter abnormalities (Mandal et al., 2022). Finally, disruption of the hypothalamic-pituitary-adrenal (HPA) axis, which regulates stress response, may cause psychiatric disorders.
Physiologically, psychiatric mental health issues alter brain connections and neuroplasticity. Schizophrenia, depression, etc., alter grey matter volume and white matter integrity. Brain immune system cell activation causes neuroinflammation, which is associated with many mental illnesses. Stress-induced cortisol release improves mental health. Chronic stress causes HPA axis dysregulations that raise cortisol, causing mental symptoms and neuronal damage. The gut-brain axis indicates a two-way interface between gut bacteria and the brain, affecting mental fitness. There are more than central nervous system processes, as gut bacteria imbalances are associated with depression and anxiety. Thus, psychiatric doctors must understand mental disease patients’ functional anatomy and physiology.
Nurses must grasp these concepts in order to provide excellent patient care. These concepts involve learning how body systems work and are structured through anatomy and physiology. Reliable assessments require knowledge of lifetime normative fluctuations and deviations from typical trends. It helps nurses recognize symptoms of specific functions, helping them to diagnose and treat health conditions. Cultural competency helps us understand how different cultures affect health perception in different people (Gorczynski et al., 2020). Communication helps nurses gather useful information during evaluation and create therapeutic patient relationships. It also helps nurses think critically to analyze assessment results, make clinical decisions, and change diabetes and hypertension care regimens. Thus, learning these key terms helps nurses evaluate their performance and deliver personalized care to enhance health outcomes.
References
Empey, A., Garcia, A., & Bell, S. (2021). American Indian/Alaska Native Child Health and Poverty. Academic Pediatrics, 21(8), S134–S139. https://doi.org/10.1016/j.acap.2021.07.026
Gorczynski, P., Currie, A., Gibson, K., Gouttebarge, V., Hainline, B., Castaldelli-Maia, J. M., Mountjoy, M., Purcell, R., Reardon, C. L., Rice, S., & Swartz, L. (2020). Developing mental health literacy and cultural competence in elite sport. Journal of Applied Sport Psychology, 33(4), 1–15. https://doi.org/10.1080/10413200.2020.1720045
Mandal, P. K., Gaur, S., Roy, R. G., Samkaria, A., Ingole, R., & Goel, A. (2022). Schizophrenia, Bipolar and Major Depressive Disorders: Overview of Clinical Features, Neurotransmitter Alterations, Pharmacological Interventions, and Impact of Oxidative Stress in the Disease Process. ACS Chemical Neuroscience, 13(19), 2784–2802. https://doi.org/10.1021/acschemneuro.2c00420
Walters, K. L., Johnson-Jennings, M., Stroud, S., Rasmus, S., Charles, B., John, S., Allen, J., Kaholokula, J. K., Look, M. A., de Silva, M., Lowe, J., Baldwin, J. A., Lawrence, G., Brooks, J., Noonan, C. W., Belcourt, A., Quintana, E., Semmens, E. O., & Boulafentis, J. (2020). Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities. Prevention Science, 21(S1), 54–64. https://doi.org/10.1007/s11121-018-0952-z
Peer 2
Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
The impact of culture and lifestyle on healthcare is significant and something to be aware of. Not only is it essential to be aware of the patient’s factors, but it is equally as crucial for the APRN to be aware of their own and not to let that interfere with the care they are providing (Stubbe, 2020). Firstly, it is exceedingly vital to accept and understand this patient’s situation. While she identifies as a lesbian female, she is also pregnant by utilizing sperm from a bank. While this is not the most common scenario, the APRN must treat it with empathy and understanding (Stubbe, 2020). She has multiple piercings and tattoos, which fall under lifestyle and are something to be noted. Regarding socioeconomic factors, it is worth inquiring about her marital status and whether she plans on raising the child by herself or with the help of a partner. Raising a child alone can pose financial hardship and is worth noting here. Finally, she may be presenting with a sexually transmitted disease, so it is necessary to inquire about her sexual activity and whether she is practicing safe sex. Acquiring a sexually transmitted disease while pregnant can pose serious threats to the fetus, so immediate intervention along with education will be warranted in this scenario.
Utilizing the five assessment domains, which ones would you utilize on your patients in conducting a comprehensive nutritional assessment?
While her height, weight, and BMI are all within normal parameters, it is still important to assess her nutrition, especially since she is pregnant. Domain 1 encompasses the assessment of nutrient balance. This involves a food diary or 24-hour diet recall. This will be helpful in understanding how she is nourishing her body and the fetus (Rozanski et al., 2023). It is essential to look out for any emesis or diarrhea as these are both common within the first trimester of pregnancy and can affect her nutrition status as well. Domain 2 is the assessment of body composition. While she is within her parameters, tracking her progress throughout the pregnancy is essential to ensure she is gaining an appropriate amount of weight for herself and the baby. I would also asses Domain 5 involving social determinants that affect nutrition. This would include her age, education level, neighborhood, health status, and healthcare access. By this, I can achieve a better understanding of her access to healthy food, her ability to manage chronic disease or any polypharmacy issues.
Discuss the functional anatomy and physiology of a psychiatric mental health patient. Which key concepts must a nurse know to assess specific functions?
Understanding the functional anatomy and physiology of a psychiatric mental health patient is essential for healthcare professionals, especially nurses, to provide comprehensive care. Firstly, it is crucial to understand neurotransmitters such as dopamine, serotonin, and norepinephrine, as they play a crucial role in mood regulation. The amygdala and hippocampus are involved in emotional processing and memory formation, so dysfunction of these areas can contribute to anxiety and mood disorders. The hypothalamus-pituitary-adrenal (HPA) axis triggers stress response and releases stress hormones (Kuhn et al., 2022). Chronic activation of the HPA axis can contribute to anxiety and depression. It is especially important for the nurse to assess for signs of chronic stress. The frontal cortex is responsible for executive functions such as decision-making and impulse control, meaning the nurse should assess cognitive abilities and look for signs of impaired executive function (Kuhn et al., 2022). Assessing sleep patterns can also point to issues with the pineal gland and circadian rhythms, which can lead to mental health disorders as well (Kuhn et al., 2022).
References
Kuhn, T., Haroon, J., & Spivak, N. M. (2022). A Systematic Approach to Neuropsychiatric Intervention: Functional Neuroanatomy Underlying Symptom Domains as Targets for Treatment. The Journal of Lifelong Learning in Psychiatry, 20(1). https://doi.org/10.1176/appi.focus.20210024
Rozanski, A., Sakul, S., Narula, J., & Berman, D. (2023). Assessment of lifestyle “vital signs” in healthcare settings. Progress in Cardiovascular Disease, 77. https://doi.org/10.1016/j.pcad.2023.02.002
Stubbe, D. E. (2020). Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients. The Journal of Lifelong Learning in Psychiatry, 18(1). https://doi.org/10.1176/appi.focus.20190041