As The School Nurse Working In A College Health Clinic You S

As The School Nurse Working In A College Health Clinic You See Many O

As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic woman in her second year of nursing school who reports a 14-pound weight gain since starting school. She expresses concern about the impact on her appearance and health if this trend continues. Her history reveals that she is an avid cook and enjoys foods that reflect her Hispanic heritage, which may influence her dietary habits. Maria is married with two school-aged children and manages household responsibilities largely on her own, including shopping, cooking, cleaning, and transporting her children. She attends classes for a total of 15 hours per week, along with 12 hours of lab and clinical work. She reports getting about five hours of sleep per night, relying on coffee and diet cola to sustain her energy throughout the day. She states she has no time to relax or de-stress. Her vital signs today are: temperature 98.6°F, respirations 20 per minute, pulse 88 bpm, and blood pressure 148/90 mmHg.

Paper For Above instruction

Introduction

The role of a school nurse extends beyond basic healthcare; it encompasses health promotion, early identification of health risks, and education to foster wellness among student populations. In this context, Maria's case presents a unique opportunity for intervention, focusing on her lifestyle habits, stress management, and overall health risks associated with her current behaviors and vital signs.

Additional Assessment Data

To develop a comprehensive understanding of Maria’s health status, additional subjective and objective assessment data should be gathered. Subjectively, it is important to inquire about her dietary habits, including portion sizes, frequency of traditional Hispanic foods, and her use of dietary supplements or medications. Exploring her physical activity levels, types of exercise, and sedentary behaviors can offer insights into potential weight management issues. Additionally, assessing her sleep quality, laundry and meal preparation routines, stress levels, coping mechanisms, and social support systems is crucial. Objectively, measuring her body mass index (BMI), waist circumference, and recent weight trends would provide concrete data on her weight and adiposity. Conducting blood work to evaluate blood glucose, lipid profiles, and fasting blood sugar levels would help determine her metabolic health. Monitoring her blood pressure over several days or weeks can identify if her elevated BP is persistent. Furthermore, evaluating her mental health status for signs of anxiety or depression is essential, considering her busy schedule and reported stress levels.

Health Concerns and Risk Factors

Maria exhibits multiple health concerns and risk factors that warrant attention. Her recent weight gain, combined with elevated blood pressure, indicates a risk for cardio-metabolic conditions such as hypertension, dyslipidemia, and potential development of type 2 diabetes (American Heart Association [AHA], 2020). Her high-stress lifestyle, inadequate sleep, and reliance on caffeine and diet cola suggest poor stress management and potential caffeine dependence, which can adversely affect her cardiovascular health (Lovell et al., 2018). Her dietary preferences reflecting her cultural heritage, coupled with a sedentary schedule, contribute to her weight gain and metabolic risk factors. The elevated blood pressure, now categorized as stage 2 hypertension per the American College of Cardiology/American Heart Association guidelines (2020), puts her at increased risk for cardiovascular complications.

Opportunities for Health Promotion

Targeted health promotion strategies can help Maria improve her overall wellness. First, nutritional counseling tailored to her cultural preferences—emphasizing portion control, healthier cooking methods, and incorporating more fruits and vegetables—can facilitate weight management and better metabolic control. Education about the importance of hydration with water rather than caffeinated or artificially sweetened beverages is vital. Stress management techniques, such as mindfulness, relaxation exercises, or brief physical activity breaks, can help reduce her cortisol levels and improve sleep quality. Encouraging physical activity that fits into her busy schedule, perhaps through integrating small bouts of exercise or family activities, can promote weight loss and cardiovascular health. Sleep hygiene education emphasizing consistent sleep routines and reducing stimulant intake before bedtime would be beneficial. Additionally, regular monitoring of her blood pressure and follow-up health assessments should be incorporated into her routine. Providing resources for mental health support or stress reduction programs can address emotional wellbeing. School-based programs promoting healthy habits, along with support groups for students balancing academic and family responsibilities, can further support her.

Nursing Diagnosis

Based on identified health concerns and opportunities for intervention, a suitable nursing diagnosis could be:

Risk for hypertension related to elevated blood pressure, high-stress lifestyle, insufficient sleep, and dietary habits as evidenced by BP reading of 148/90 mmHg, reported sleep deprivation, and reliance on caffeine and diet cola.

This diagnosis emphasizes her current health risk and aligns with the NANDA-I classification for risk-related nursing diagnoses. It guides the nurse in prioritizing interventions aimed at reducing risk factors and preventing progression to more severe health problems.

Conclusion

Maria’s case illustrates the importance of holistic assessment and culturally sensitive health promotion within a college health setting. Addressing her lifestyle habits, stress management, sleep hygiene, and dietary practices can significantly impact her health outcomes. Early interventions tailored to her unique circumstances can prevent the development of chronic diseases and support her wellbeing both during her academic journey and beyond.

References

  • American Heart Association. (2020). Heart disease and stroke statistics—2020 Update. Circulation, 141(17), e139–e596.
  • American College of Cardiology/American Heart Association. (2020). Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults.
  • Lovell, A., Viljoen, M., & Cohen, M. (2018). Caffeine consumption and cardiovascular health: A review. Journal of Clinical Hypertension, 20(10), 1423–1429.
  • National Sleep Foundation. (2021). Sleep health and sleep hygiene. Sleep Health Journal, 7(3), 245–258.
  • Bach, C., & Kelly, J. (2017). Cultural influences on dietary habits. Journal of Transcultural Nursing, 28(2), 132–138.
  • Spiegel, K., Leproult, R., & Van Cauter, E. (2019). Impact of sleep deprivation on metabolic and cardiovascular risk factors. Sleep Medicine Reviews, 43, 114–124.
  • World Health Organization. (2018). Obesity and overweight. WHO Fact Sheet No. 311.
  • Sharma, A., & Madaan, V. (2019). Stress and health among college students. Journal of College Student Psychotherapy, 33(3), 191–201.
  • Centers for Disease Control and Prevention. (2020). Strategies for improving health behaviors in college students. MMWR Morb Mortal Wkly Rep, 69, 105–110.
  • Petersen, S., & Saha, A. (2020). Promoting culturally competent care in college health settings. Nurse Educ Today, 88, 104392.

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