Topic 2: Holistic Health Assessment

The home care nurse is seeing a 68-year-old Vietnamese woman for an initial visit. The patient was discharged from the hospital with a diagnosis of congestive heart failure (CHF). The home health nurse notices the patient's blood pressure is elevated, and the patient has a productive cough. The patient speaks very little English. However, the patient's daughter is present and able to interpret. The nurse completes a full health assessment, including a review of medications, and notes that the patient was prescribed a diuretic and a beta-blocker for blood pressure regulation. The daughter shares with the nurse that her mother does not like taking medications and chooses to take herbal remedies instead. Upon assessment, the patient's vital signs are: T 98.6 P 76 R 20 BP 160/80, 02 saturation 94%. The patient's lungs are positive for scattered rhonchi in the upper bases, clear in the lower bases, rhonchi clears with cough. The patient's heart rate is regular with no audible murmurs, +2 edema bilateral in the lower extremities. The patient denies pain (Jarvis, 2012).

The nurse understands that culture and alternative medicine are playing a role in the patient’s current health and health decisions; however, the nurse is hesitant about asking further questions because he does not want to offend the family.

• Identify and describe at least two priority areas of a holistic health assessment the nurse must consider when planning the patient interview. Provide a rationale for your choices.
• How can the healthcare provider show respect for the patient’s culture and health beliefs while working toward resolution of her health issues? Provide a rationale for your decision.
• Should the patient be encouraged to take the prescribed medication? Why or why not?
• When considering the holistic model how does the family play into your assessment and the care that you provide. Provide a clear rationale for your steps to include or not to include the family.

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