Signature Assignment Title: The Holistic Patient Assessment
Over the past years, the primary goal of the patient assessment was on physiological data and psychological data. Nevertheless, in present times the process of assessment has changed drastically to comprise the holistic characteristics of health assessment. Essentially, in holistic evaluation plan, the assessment plan still focuses on physiological aspects as well as other elements such as cultural, psychological, spiritual, and social growth (McIlfatrick, Hasson, 2014) Arguably, holistic health evaluation involves various stages to make sure that the healthcare practitioner assesses the health of the patients comprehensively. The holistic analysis begins by examining the history of the patient which enables the nurse to evaluate the entire physical assessment of the patient where all functions of the body are critically examined to conclude. The next thing involves psychoanalysis which is performed to determine the state of a patient’s mind. It is significant for the assessment to examine details such as abuse and violence (Giger, 2016). Nurses can do the assessment using the approach that is best known to them. For instance, ACCESS tool is one of the tools that can be used by nurses to assess the cultural aspects (Blais et al.,2015). In regards to psychosocial growth, Erikson model can be used to obtain the assessment of the patient. It is also important to ensure that the spiritual aspect of the patient is done using the FICA tool. This paper seeks to perform a holistic assessment on one of my cousins who is 25 years old.
Health History
The patients reported a headache. She stated that she has been feeling a pounding for approximately 2 hours. She reported feeling pulse which was six after being measured on a scale of 1 to 10. However, the patient had not taken any form of medication. Her previous medical history seems good as she was treated on acne only once. The patient has a history of asthma and has been using an inhaler. The patient goes for annual checkups and has been exercising regularly.
Physiological Assessment
The patient has a moderate temperature and her pulse is relatively high. Her respiration as well blood pressure are good. Her mouth, neck, eyes, ears, and nose seem to be in good health. Also, her spine, chest, heartbeat, and neck seem to be normal.
Psychological Assessment
The patient is in good shape and communicates effectively. She also seems relaxed. The patient’s auditory perception is excellent. Her visual percept is also normal and in good shape. Her motor assessment was excellent and her cognition was also good.
Social Assessment
The social assessment of the patient revealed that she supports her relatives and friends. She can obtain help from her family and friends making her feel safe around them. The social assessment shows that the patient gets help from persons around her.
Cultural Assessment
As part of the holistic healthcare assessment, the patient underwent a cultural assessment process. The process was done using ACCESS tool by Narayasamy(Forbes &Watt, 2015). The patient seems to believe so much in painkillers. She also believes that sleep helps to relieve pain.
Developmental Assessment
The model developed by Erikson helps to give an indication of growth among children. For the patient, the development stage is crucial since her age of 25-40 years demonstrates that she is very careful about her health.
Spiritual Assessment
During the spiritual assessment, the patient stated that she highly believed in religious practices and beliefs. The patient is a Roman Catholic and regularly attends Mass and other religious activities. She states that she regularly prays and believes that prayers could change her condition.
Part 2-Holistic Health Assessment and Findings
A holistic assessment was performed on the patient which comprised of physiological, cultural, spiritual, cultural, developmental, and social factors. Conducting a holistic evaluation was important since the analysis of the patient’s medical history and current records showed a part of the information. When other aspects are included in the assessment such as cultural assessment, it is imperative to understand what the patient believes as right and wrong since these beliefs need to be respected ((McIlfatrick, Hasson, 2014). The social aspect of the patient also needs to understand since it helps to ensure that the patient gets social support, especially from family and friends. The development assessment is also important since her age signifies that he is actively healthy.
The holistic approach has helped the medical practitioner to care for the patient wholly. The patient is in the position to communicate about different aspects of life which makes the results of the assessment to be successful. The holistic method makes sure that the levels of assessment are well designed to take care of the patient.
An excellent example of physiological illness is hemochromatosis which is associated with absorption and storage of iron in the body. Individuals suffering from this condition tend to suffer from a large amount of iron in the intestines. The body lacks a mechanism to get rid of the excess amount of iron leading accumulation in the body. The excess iron can be stored in body parts such as liver, ovaries, and heart causing illnesses such as cirrhosis and diabetes. From a holistic perspective, the abnormality could be caused by various factors including psychological and physiological factors. The holistic assessment also helps to check the development, social, and cultural aspects to help in quick recovery.
The Effects of Abnormality in the Body
The abnormality is likely to have an adverse effect on the body. In regards to psychological factor, the patient may become depressed or stressed which may delay a quick recovery. The patient may also be physically affected, especially if the other illness kicks in leading to further complications. In case the patient lacks support and help she need, it may affect her socially since she cannot support herself. The patient is also likely to suffer from developmental issues since at a certain age she might be affected (McIlfatrick, Hasson, 2014)
The Coping Mechanism
The patient demonstrates proper mechanisms of dealing with stress. Specifically, the patient has developed proper mechanisms and strategies which helps her focus and develop a purpose for healing. She constantly uses the defence and regression mechanism to fight stress. The client is also engaging in activities such as Yoga and exercises to help her feel busy daily basis. Additionally, the patient has decided to keep away from stressful situations such as self-denial and alienation. She has also developed a habit which helps to discourage stressful events such as sublimation. It is important to ensure that the stress coping mechanism is working perfectly.
Part 3- Teaching Plan
The teaching plan will be developed to educate the patient on different goals that can be attained to improve her health. Essentially, the patient will be assessed to gauge her performance.
Physiological Assessment
The client will need to understand all the aspects of physiological assessment. The lesson will involve teaching the patient about the features of the body which will be examined during the process including ears, chests, and eyes among others (McIlfatrick, Hasson, 2014). The patient will be requested to mention the parts of the body to be assessed.
Psychological assessment
The patient will be required to understand how psychological assessment is performed. The lesion will involve the function of the mind as well as the cognitive, and motor aspects. During the lesson, the client will be required to explain the difference between motor and cognition characteristics of the mind.
Social Assessment
The client should be able to understand the aspects of social assessment. During the lesson, the patient will be educated on the significance of care, help, and social support. Additionally, the patient will be educated on the functions of social assessment. Fundamentally, the patient will need to provide examples of social care and its importance.
Cultural Assessment
The patient will also need to understand the importance of cultural assessment. The patient will be educated on the significance of observing, respecting, and upholding the cultural practices and beliefs. The client will be requested to mention some of the cultural beliefs she considers important.
Developmental Assessment
The patient will need to understand the importance of developmental assessment. The client will be educated about the Erikson model which will help ger understand the stages of development.
Spiritual Assessment
The patient needs to understand the significance of spiritual assessment as part of a holistic assessment. The client will be taught on various spiritual beliefs in society. The client must also provide examples of spirituals states and systems where she belongs.
References
Blais, K., Hayes, S., Kozier, B., & Erb, L. (2015). Professional nursing practice: Concepts and perspectives. NJ: Prentice Hall
Forbes, H., & Watt, E. (2015). Jarvis’s physical examination and health assessment. Elsevier Health Sciences.
Giger, N. (2016). Transcultural nursing-e-book: assessment and intervention. Elsevier Health Sciences.
McIlfatrick, S., & Hasson, F. (2014). Evaluating a holistic assessment tool for palliative care practice. Journal of clinical nursing, 1064-1075.
Morton, G., Fontaine, D., Hudak, M., & Gallo, M. (2017). Critical care nursing: a holistic approach. Lippincott Williams & Wilkins.
Wu, V., Enskär, K., Lee, S., & Wang, W. (2015). A systematic review of clinical assessment for undergraduate nursing students. Nurse Education Today, 347-359.