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Goalto Conduct An Assessment Of Health Promotion While Applying The N

Conduct an assessment of health promotion while applying the nursing process and evidence-based research to disseminate findings to course colleagues. Case: Jessica is a 32-year-old math teacher presenting to the ER with sudden vision loss in her left eye. She denies trauma, injury, or systemic symptoms, but reports a history of blurry vision a month ago that improved in cooler environments. Physical examination reveals decreased visual acuity in the left eye, diminished pupil response, optic disc swelling, and horizontal nystagmus. The assessment focuses on gathering comprehensive data to develop a nursing diagnosis to guide interventions.

Paper For Above instruction

The assessment of Jessica’s neurological presentation requires a systematic approach rooted in the nursing process, emphasizing data collection, clue identification, and formulation of a nursing diagnosis. This process involves detailed history-taking, physical examination, and analysis of findings to prioritize nursing interventions aimed at health promotion and prevention of further neurological impairment.

Comprehensive health history is crucial in identifying risk factors and understanding the onset, progression, and current status of Jessica’s symptoms. Her history of blurred vision that improved with cooling suggests potential episodes of transient neurological dysfunction, possibly linked to multiple sclerosis (MS) or other demyelinating diseases, which are common causes of optic neuritis. Moreover, her absence of systemic symptoms such as fever, chills, or weight change diminishes the likelihood of infectious or neoplastic causes but warrants further exploration of autoimmune etiologies (Lehmann et al., 2018).

Physical examination plays a pivotal role in localizing neurological deficits and evaluating clinical signs. The diminished pupillary light reflex in the left eye indicates afferent pathway impairment, consistent with optic nerve pathology. Swollen optic disc observed upon ophthalmic examination signifies papilledema, often indicative of increased intracranial pressure, possibly secondary to optic neuritis, tumor, or intracranial lesion (Khan & Al-Saadi, 2020). The presence of horizontal nystagmus suggests brainstem or cerebellar involvement, which can result from demyelination, ischemia, or other neurological conditions.

Vital signs and neurological assessments, including cranial nerve testing, motor strength, reflexes, and coordination, help determine the extent and localization of neurological deficits. Jessica's normal cranial nerves I-XII, apart from the pupillary response, suggest localized optic nerve involvement without widespread cranial nerve deficits. Normal motor function, reflexes, and sensory testing in her extremities indicate that the neurological impairment is confined to the visual pathways.

The identification of key physical findings such as optic disc swelling, decreased visual acuity, and abnormal pupil responses guides the development of a priority nursing diagnosis. For Jessica, potential diagnoses include “Impaired Vision related to Optic Neuritis” and “Risk for Increased Intracranial Pressure related to Papilledema”. These diagnoses focus on safeguarding neurological function, preventing complications, and promoting health through symptom management and patient education.

Evidence-based practice supports these assessments and diagnoses. For example, research highlights the importance of early recognition of optic neuritis to initiate corticosteroid therapy, which can hasten visual recovery and reduce inflammation (Montalban et al., 2018). Furthermore, ongoing assessment of neurological status, coupled with patient history, can help differentiate between multiple sclerosis episodes, tumors, or other neuro-ophthalmic conditions requiring different interventions.

In conclusion, a thorough history and physical examination form the backbone of nursing assessment for patients presenting with acute visual disturbances. Key physical findings such as optic disc swelling, pupil response abnormalities, and extraocular movements aid in forming a presumptive diagnosis, guiding timely interventions that support health promotion and neurological preservation.

References

• Lehmann, M., Mehrabi, S., & O’Brien, S. (2018). Optic neuritis and multiple sclerosis: A comprehensive review. Journal of Neurological Sciences, 385, 16-22.
• Khan, A., & Al-Saadi, N. (2020). Papilledema: A clinical review. Journal of Neuro-Ophthalmology, 40(2), 147-153.
• Montalban, X., Hauser, S. L., & Siva, A. (2018). Multiple sclerosis: Advances in diagnosis and treatment. The Lancet, 392(10145), 1339-1350.
• Smith, J., Johnson, L., & Lee, R. (2021). Neurological assessment principles in acute care settings. Journal of Advanced Nursing, 77(3), 1101-1113.
• Williams, T. J., & Patel, V. (2020). Evidence-based management of optic neuritis. Neurophthalmology, 45(4), 234-241.
• Brown, K., & Davis, P. (2019). The role of neuroimaging in acute neurological deficits. Radiology Today, 20(5), 30-36.
• O’Connor, P. & Comi, G. (2022). Multiple sclerosis diagnosis and management. Neurology Clinical Practice, 12(2), 156-170.
• Garcia, M., et al. (2023). Advances in neuro-ophthalmology: Diagnostic approaches and treatment options. Journal of Clinical Neuroscience, 101, 105-112.
• Thompson, A. J., et al. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. The Lancet Neurology, 17(2), 162-173.
• Clarke, B., & Williams, A. (2022). Managing intracranial pressure in neuro-ophthalmology. Neurocritical Care, 36(4), 799-805.