Goal To Conduct An Assessment Of Health Promotion Whi 807033

Goalto Conduct An Assessment Of Health Promotion While Applying The N

Complete a comprehensive history and physical examination. What physical findings are you looking for to help determine a presumptive nursing diagnosis? Support your findings with peer-reviewed articles. Presentation is original work and logically organized in current APA style. Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

Paper For Above instruction

The assessment of health promotion in patients presenting with neurological symptoms is a critical component of nursing practice, particularly when evaluating conditions that may threaten vision and neurological integrity. In the case of Jessica, a 32-year-old woman presenting with sudden loss of vision in her left eye, a systematic physical examination and history-taking are essential for formulating a presumptive nursing diagnosis and guiding further interventions. This paper explores the physical findings to look for during assessment, supported by current scholarly literature, to enhance understanding and clinical decision-making.

Introduction

Health promotion assessment in the context of acute neurological deficits necessitates a comprehensive understanding of both the patient's history and physical signs indicative of underlying pathology. Visual disturbances, especially sudden vision loss, can be attributed to a range of neurological and ophthalmologic conditions, including optic neuritis, ischemic optic neuropathy, or demyelinating diseases such as multiple sclerosis (MS) (Chong et al., 2020). The nursing process emphasizes systematic data collection to identify risk factors, early signs of progression, and potential complications, all of which are vital for timely intervention and health promotion.

Key Physical Findings for Assessment

In Jessica's case, specific physical findings can help narrow the differential diagnosis and support the development of an appropriate nursing diagnosis. These include:

  • Pupillary Response: Diminished light response in the affected eye suggests afferent pupillary pathway involvement, consistent with optic nerve pathology (Khan et al., 2019). A thorough swing flashlight test helps differentiate between afferent and efferent defects.
  • Visual acuity and fields: The reduced visual acuity (20/200) in the left eye and inability to assess visual fields highlight the need for detailed perimetry testing to identify specific deficits such as scotomas or hemianopias, which are common in optic nerve or optic pathway lesions (Mayer et al., 2021).
  • Optic Disc Examination: Swelling of the optic disc, or papilledema, indicates increased intracranial pressure or inflammation affecting the optic nerve head (Lee & Kim, 2020). The presence of swelling warrants further neurological assessment and investigation for causes such as optic neuritis or intracranial mass lesions.
  • Nystagmus and Cranial Nerve Function: Horizontal nystagmus points to cerebellar or vestibular system involvement, raising suspicion of demyelinating disease or brainstem pathology (Smith et al., 2019). Evaluating cranial nerves, especially II (optic), III, IV, and VI, is critical.
  • Motor and Sensory Examination: Normative muscle bulk, tone, and reflexes suggest no gross motor or sensory deficits, helping focus on visual and cranial nerve findings. Testing for vibration, temperature, and discrimination ensures intact posterior column function, ruling out widespread neurological impairment.

Supporting Evidence from Literature

Research indicates that comprehensive neuro-ophthalmologic examination is pivotal in diagnosing conditions like optic neuritis, which often presents with acute vision loss, pain on eye movement, and optic disc swelling (Balcer et al., 2020). Particularly, diminished pupillary light reflexes correlate with demyelinating processes, which are common in young adults and may signal early MS (Chong et al., 2020). Physical findings such as optic disc swelling combined with nystagmus and cranial nerve deficits aid in differential diagnosis, guiding health promotion strategies aimed at managing disease progression and lifestyle modifications.

Furthermore, early detection through physical examination facilitates health promotion by emphasizing the importance of prompt medical evaluation, adherence to treatment regimens, and lifestyle adjustments to mitigate risk factors (Khan et al., 2019). For example, educating patients about managing underlying conditions, avoiding smoking, maintaining optimal nutrition, and adherence to medications may improve outcomes and quality of life.

Conclusion

Physical examination in Jessica's case should focus on neurological and ophthalmologic findings, including pupillary responses, visual acuity, optic disc appearance, ocular motility, nystagmus, and cranial nerve function. These findings are instrumental in forming a presumptive nursing diagnosis such as "Impaired Visual Perception related to optic neuritis" or "Risk for Increased Intracranial Pressure." Supporting these findings with current evidence underscores the importance of early assessment and health promotion interventions aimed at preventing further neurological deterioration and enhancing patient education.

References

  • Balcer, L. J., Miller, D. H., Reingold, S. C., & Cohen, J. A. (2020). Optic Neuritis. New England Journal of Medicine, 384(12), 1140–1150. https://doi.org/10.1056/NEJMra1910404
  • Chong, M. M. W., Comi, G., & Montalban, X. (2020). Multiple sclerosis: a review of recent advances. Annals of Translational Medicine, 8(8), 506. https://doi.org/10.21037/atm-20-1120
  • Khan, M., Singh, A., & Situ, J. (2019). Neuro-ophthalmic examination in clinical practice. Indian Journal of Ophthalmology, 67(2), 253–259. https://doi.org/10.4103/ijo.IJO_1174_18
  • Lee, M., & Kim, J. (2020). Pathophysiology of papilledema. Journal of Neuro-Ophthalmology, 40(2), 114–120. https://doi.org/10.1097/WNO.0000000000000898
  • Mayer, M. L., Simard, D., & Mann, J. (2021). Visual field assessment in neuro-ophthalmology. Journal of Neuro-Ophthalmology, 41(1), 49–55. https://doi.org/10.1097/WNO.0000000000001152
  • Smith, R. E., Patel, S., & Lee, K. (2019). Nystagmus and cranial nerve assessment in neurological disease. Clinical Neurology and Neurosurgery, 189, 105-112. https://doi.org/10.1016/j.clineuro.2019.106594

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