Please Complete The Attached Daily Holistic Assessment Tool
Please Complete The Attached Daily Holistic Assessment Tool Dhat For
Please Complete The Attached Daily Holistic Assessment Tool (DHAT) form using the patient profile below:- Report from day shift nurse: Situation: Christopher Parrish is an 18-year-old male who was admitted at 1900 today. His mother visited him at his college dormitory and was very concerned with his health; he seemed weak and had lost weight since she last saw him. She took him to see his primary care provider, and the provider admitted him and has ordered a tube feeding. I placed an 8-Fr, 42-inch feeding tube in his right nares about an hour ago, and x-ray just called and confirmed placement in the stomach. The pump is in his room.
He is up to the bathroom prn; otherwise bed rest. Background: Christopher was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously. He reports fatigue and has recently lost 6 kg (13.2 lb) after he registered at the local college and moved to live in a dormitory. Chris's mom was here earlier, but she is a single parent and has two younger boys, so she had to go home. Assessment: Christopher is awake and alert.
His heart rate and rhythm are regular at 80-85/min. Breath sounds are fine with a respiratory rate at 18/min. His color is a bit pale. Blood pressure is 118/78 mm Hg. He reports no pain and states he's not had much appetite the past few weeks.
His belly is flat and nontender. Bowel sounds are normoactive. Recommendation: Christopher is due for vital signs and assessment. The tube feeding just arrived, and you will need to start it on the pump. He needs 720 kilocalories over 8 hours overnight.
His regular diet is high calorie, high fat, but he wasn't too hungry this evening; just had a bit of his chocolate shake. You will need to give his pancreatic enzymes orally before you start the tube feeding. You should also assess his diet and reinforce patient education on nutrition.
Paper For Above instruction
The following report presents a comprehensive holistic assessment of Christopher Parrish, an 18-year-old male recently admitted to the hospital with a complex medical history characterized by cystic fibrosis and recent significant weight loss. The assessment encompasses physical, psychological, nutritional, and social aspects vital for holistic patient care, aligning with the principles of the Daily Holistic Assessment Tool (DHAT).
Introduction
Holistic nursing care necessitates a broad evaluation of the patient's health status that extends beyond purely physiological parameters. In Christopher's case, this approach is essential due to his chronic condition, recent hospitalization, and recent nutritional deficits. The primary goals are to ensure stability, optimize nutritional intake, and support psychological well-being, which together facilitate recovery and improve quality of life.
Physical Assessment
Christopher appears physically stable, with vital signs within normal limits, though his pallor indicates possible anemia or nutritional deficiency. His heart rate of 80-85 bpm, regular rhythm, respiratory rate of 18/min, and clear breath sounds suggest no current respiratory distress, which is significant given his history of cystic fibrosis. The recent placement of a feeding tube requires careful monitoring of insertion site, patency, and risk for infection.
Abdominal assessment reveals a flat, non-tender abdomen with normal bowel sounds, indicative of baseline gastrointestinal function. Regular assessment of bowel sounds is essential to prevent complications such as bowel obstruction or misplacement.
Psychological and Social Assessment
Christopher reports low appetite over recent weeks, which could be attributable to emotional stress, nutritional deficits, or disease-related fatigue. His pallor and weight loss should be evaluated in the context of chronic illness and recent hospitalizations. Psychosocial factors, including recent transfer to college and separation from his mother, may contribute to emotional distress and should be addressed to promote mental health resilience.
The support system is limited at present, with his mother having returned home to manage younger children. Engagement with social workers or mental health professionals could be beneficial for emotional support.
Nutrition and Hydration
Nutritionally, Christopher's intake has been inadequate, with minimal appetite and only a chocolate shake this evening. His diet prior to admission was high-calorie and high-fat, consistent with cystic fibrosis management, but his recent weight loss indicates insufficient intake. Initiating tube feeding providing 720 kcal over 8 hours aims to address caloric deficits.
Administering pancreatic enzymes before feeding is crucial for proper digestion, given his cystic fibrosis. Reinforcing dietary education is necessary to prevent further weight loss and optimize nutritional status.
Medical Management and Recommendations
The immediate priorities involve initiating the tube feeding on the pump, monitoring for signs of intolerance or complications, and ongoing vital sign assessment. Regular evaluation of his fluid and electrolyte balance is mandatory, considering his recent weight loss and nutritional status.
Monitoring for any signs of infection at the insertion site and respiratory stability is fundamental, especially given his cystic fibrosis history. Psychological support and nutritional counseling should be integrated into his ongoing care plan.
Conclusion
Holistic assessment of Christopher Parrish highlights the importance of multidimensional nursing approaches in managing patients with complex chronic conditions. Addressing physical stability, nutritional needs, and emotional health simultaneously ensures a comprehensive care strategy tailored to his specific needs, thereby facilitating optimal recovery and well-being.
References
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- Gordon, M. (2018). Assessment of the holistic patient. Nursing Standard, 33(12), 45-52.
- Johnson, L. & Smith, R. (2020). Nutritional management in cystic fibrosis. Respiratory Medicine, 162, 105-110.
- Lee, A., & Riddell, S. (2017). Psychological support for adolescents with chronic illness. Journal of Pediatric Nursing, 35, 43-50.
- Martins, P. & Costa, P. (2021). Managing weight loss in hospitalized patients. Clinical Nursing Research, 30(3), 227-237.
- National Comprehensive Cancer Network (2018). Expert panel guidelines on nutritional support. NCCN, 1-65.
- Patel, V. & Taylor, K. (2018). Cystic fibrosis management strategies. Pediatrics, 142(Suppl 2), S102-S109.
- World Health Organization (2020). Holistic health assessment: A guide for practitioners. WHO Publications.
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- Zachariah, S., & Patel, P. (2022). Tube feeding protocols in acute care. Clinical Dietetics, 37(2), 147-154.