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Roldan, Sarah

Oct 29, 2020 at 14:18

Cultural, Spiritual, Nutritional, & Mental Health Disorders

The therapeutic relationship between providers and their patents is important when creating wholistic care plans. The role of a clinician who is building a health history for a 32-year-old pregnant lesbian is one that is very patient specific. The patient in this case study has been without complication thus far in her pregnancy. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank.

The specific socioeconomic, spiritual, lifestyle, and other cultural factors must always be considered when building a health history. In this example, it can be states that the lesbian lifestyle must be addressed due to its effect on the patients’ health. It has been observed that she is having vaginal discharge. Discussing proper hygiene and protection when in a sexual lesbian relationship can improve overall health. Asking how the patient will parent the patient and if they are considering having a partner is also important for their mental health as well. Pregnancy is already a challenging experience but going through it alone can be a challenge on its own as well. Research indicates that there has been a relationship between sexual orientation disparities in pregnancy and birth outcomes (Everett et al., 2019). There are more still births and other complications in bisexual and lesbian women (Everett et al., 2019). This may be due to multiple partners, but further research is still needed to truly understand the health of the LGTBQ community (Everett et al., 2019).

Furthermore, it is important to utilizing the five assessment domains when conducting a comprehensive nutritional assessment. These are described as food/nutrition related history which are the food and nutrient intake, medication, food and supplies availability; anthropometric measurements which include height, weight, and BMI; biochemical data, medical tests and procedures; nutrition-focused physical findings such as appetite, muscle and fat wasting, swallow function; and client history (Donini et al., 2017). For this specific patient, I would utilize which ones would you utilize on your patients in food/nutrition related history, biochemical data and client history. Being that she is pregnant, it is important to encourage to continual use of the prenatal vitamins. Moreover, being that there are markings on her arm, blood and urine such as Tylenol level and drug toxic level results would be important to understand if she actually is stable at the moment. It always important to ask the patient if they have access to basic health needs and provide resources as necessary.

Furthermore, a clinician must also discuss the functional anatomy and physiology of a psychiatric mental health patient. The key concepts must a nurse know in order to assess specific functions stems from the basic fact that mental health assessment involves an assessment of the organic functioning of the brain. Assessing family history will also tell the clinician that the patient is at risk and would need further evaluation. Screenings and questionnaires such as the Folstein Mini-Mental Status Examination allow for the provider to gage the need for immediate psychiatric resources for the patient as well (Rhoads & Petersen, 2021). In the case of the patient discussed, the markings on her arms of past cutting allow for the clinician to have an idea that the patient at one point was not mentally stable. Addressing the patient in a non-judgmental way further building on the therapeutic relationship that creates a trusting environment is best when considering mental health evaluation. The patient needs to feel safe to be able to divulge their feelings and the provider must be able pick on things not said as well to see the overall picture of the patient.

References

Everett, B. G., Kominiarek, M. A., Mollborn, S., Adkins, D. E., & Hughes, T. L. (2019). Sexual Orientation Disparities in Pregnancy and Infant Outcomes. Maternal and child health journal, 23(1), 72–81. https://doi.org/10.1007/s10995-018-2595-x

Donini, L. M., Leonardi, F., Rondanelli, M., Banderali, G., Battino, M., Bertoli, E., Bordoni, A., Brighenti, F., Caccialanza, R., Cairella, G., Caretto, A., Cena, H., Gambarara, M., Gentile, M. G., Giovannini, M., Lucchin, L., Migliaccio, P., Nicastro, F., Pasanisi, F., Piretta, L., … Muscaritoli, M. (2017). The Domains of Human Nutrition: The Importance of Nutrition Education in Academia and Medical Schools. Frontiers in nutrition, 4, 2. https://doi.org/10.3389/fnut.2017.00002

Rhoads, J. W., & Petersen, S. W. (2021). Advanced health assessment and diagnostic reasoning (3rd ed.). Burlington, MA: Jones & Bartlett Learning.