In May 2012 Alice Randall wrote an article forThe New York Timeson the cultural factors that encouraged black women to maintain a weight above what is considered healthy.
Randall explainedfrom her observations and her personal
experience as a black womanthat 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).
Randalls statements sparked a great deal of controversy and
debate; however they emphasize an underlying reality in the health
care field: different populations cultures and groups have diverse
beliefs and practices that impact their health. Nurses and health
care 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.
Case 1
Subjective Data
CC: I came for my annual physical exam but do not want to be
a burden to my daughter.
History of Present Illness (HPI): At-risk 86-year-old Asian
male – who is physically and financially dependent on his daughter
a single mother who has little time or money for her father’s
health needs.
PMH: hypertension (HTN) gastroesophageal reflux disease
(GERD) b12 deficiency and chronic prostatitis
PSH: S/P cholecystectomy
Drug Hx:
Current Meds: Lisinopril 10mg daily Prilosec 20mg daily B12
injections monthly and cipro 100mg daily.
Review of Systems (ROS)
General: + weight loss of 25 lbs over the past year; no
recent fatigue fever or chills.
Head eyes ears nose & throat (HEENT): no changes in
vision or hearing no difficulty chewing or swallowing.
Neck: no pain or injury
Respiratory:
CV:
GI:
GU: no urinary hesitancy or change in urine stream
Integument: multiple bruises on his upper arms and back.
MS/Neuro: + falls x 2 within the last 6 months; no syncopal
episodes or dizziness
Psych:
Objective Data
PE: B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 56; wt 110;
BMI 17.8
HEENT: Atraumatic normocephalic PERRLA EOMI arcus senilus
bilaterally conjunctiva and sclera clear nares patent ornasopharynx
clear edentulous.
Lungs: CTA AP&L
Cor: S1S2 without rub or gallop
Abd: benign normoactive bowel sounds x 4
Ext: no cyanosis clubbing or edema
Integument: multiple bruises in different stages of healing –
on his upper arms and back.
Neuro: No obvious deformities CN grossly intact II-XII
Case 2
Subjective Data
CC: I am here for my annual physical exam and have been
having vaginal discharge.
History of Present Illness (HPI): 32-year-old pregnant
lesbian – 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.
Drug Hx:
Current Medications: prenatal vitamins and takes Tylenol over
the counter for aches and pains on occasion
Family Hx: She a strong family history of diabetes. Gravida
1; Para 0; Abortions 0.
Review of Systems (ROS)
General: no fatigue fever or chills.
Head eyes ears nose & throat (HEENT):
Neck: no pain or injury
Respiratory:
CV:
GI:
GU:
Integument: multiple p
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