Mr. Jacson is an 70 year told Mexican American with a history of smoking and have a history of alcohol abuse , but claims he no longer drinks, epileptic seizures from a right fronto-temporal region for approximately 4 years and a history of heart failure with echocardiography of 50% when diagnosed in January 2003; presumably from hypertension.. He has “hip problems”, so he uses a wheelchair to get from the parking garage to the clinic area. He is being seen in the outpatient department yesterday by a Clinical Nurse Specialist. He was last seen 6 weeks ago and has not been hospitalized or treated in an emergency department setting since his last visit. He states that his breathing ability and energy level are similar to his last visit. He can climb 5 stairs steps before becoming dyspneic. He has 2 pillow orthopnea but no paroxysmal nocturnal dyspnea. Mr. Jacson has fatigue with activities of daily living. He denies chest pain, palpitations, lightheadedness, dizziness, nausea, edema, or difficulties with eating he states that his appetite is fair he eats normally as he uses to eat from his town Mexico with his spicy food. He does not follow the low sodium diet that his provider told him. Mr. Jacson has no known allergies. He is accompanied by a family member to his visit.
Physical exam: alert, cooperative, no jugular venous distension, no hepatojugular reflux, no peripheral edema. Lungs clear, abdomen is soft and nontender, present gastritis, hyperlipidemia and migraine . Heart rate and rhythm are regular, has a 2/6 systolic murmur at the left lower sternal border. • BP, 182/84 mm Hg; pulse, 94 bpm; weight, 212 lbs.; NYHA FC II-III. • Most recent echocardiogram (6 months later): EF, 55%, 2+ TR, right ventricular systolic pressure (RVSP) 42 mm Hg (mild pulmonary hypertension). Left ventricular hypertrophy and abnormal relaxation (Stage 1). Left ventricular end-systolic and end-diastolic diameters are 2.5 cm and 3.6 cm, respectively (normal).
Mr. Jacson lost his wife 2 years ago and didn’t show much emotion at Mary’s funeral. He was always a stoic man. Mr. Jacson initially found comfort in his faith life and the close friends he played cards with at the local coffee shop. He and Mary had three grown children and four grandchildren. All lived out of state; but kept in touch and visited relatively often. While he put on a strong public exterior, Mr. Jacson was devastated. He blamed himself for not being able to save Mary. Maybe he should have encouraged her to relax more, retire sooner or go to the doctor when Mary complained of increasing headaches. He was ashamed of himself for missing his wife so desperately even though it was two years after the stroke. He could not stop thinking about her and he could not shake his despair over Mary. He often had trouble sleeping at night because he would think of Mary. He lost interest in cooking and taking care of the house, but he did it anyway as if on auto pilot. He felt empty and alone. He avoided his friends because he did not want to talk about Mary and felt awkward.
I understand that Mr. Jacson has been residing in her own home, a two-story terrace house, in North Carolina for almost 50 years. He has lived alone since his wife died two years ago following a cardiac arrest. He has two daughters. The youngest daughter Jean has lived with him for the past year, after he lost his job. The eldest daughter Catherine lives on the Gold Coast with her family. Mr. Jacson is a retired school teacher and he and both daughters describe him as a very private man who has never enjoyed having visitors in his home. Mr. Jacson took much encouragement to accept cleaning and shopping assistance once a week after his most recent admission; however, does not agree to increase service provision. Jean has Enduring Power of Attorney (EPOA) Financial paperwork that indicates that Mr. Jacson appointed her under an EPOA Financial two years ago. She does not appear to have initiated an Enduring Power of Guardianship (prior to September 2019) or an Enduring Power of Attorney (medical treatment).
I also understand from conversations with her daughters that Jean and Mr. Jacson have always been very close and that there is a history of long-standing conflict between Catherine and Jean. This was exacerbated by the death of their mother. Both daughters state they understand the impact of the stroke on their father’s physical and cognitive functioning, but they do not agree on a discharge destination. Mr. Jacson lacks insight into her care needs and says he will be fine once she gets back into his own home.
Mr. Jacson state that live have been change for him seen he is living her in the Unites States, for him family remains the most-important element, both in private and in public life. An individual’s status and opportunities are strongly influenced by family ties, from infancy to old age. Mr. Jacson maintain strong links with members of their extended families, including in-laws and “adoptive” relatives—that is, friends of the family who are generally regarded as “aunts” and “uncles.” Mr. Jacson remember having good party with all the family where you can find the elderly, adults, teenagers, and small children attending parties and dances together.
Mr. Jacson tend to make liberal use of avocados (often in the form of guacamole), chili peppers, amaranth, tomatoes, papayas, potatoes, lentils, plantains, and vanilla . Hot peppers and salt are the most-common condiments. Maize tortillas are often served on a plate alongside main dishes, and the smell of toasted or burned corn permeates many households. Dairy products and red meat—often in the form of fried fast foods—form half part of his diet
Among Mr. Jacson preferred desserts are sweet breads (including iced buns and oversized cookies), chocolates, and dulce de leche (caramelized milk, also called cajeta or leche quemada [“burned milk”]). and ice cream.
Mr. Jacson celebrate every year the Christmas holidays and on the Day of the Dead, one of the more-popular drinks is atole (or atol), a hot combination of corn or rice meal, water, and spices.
He enjoyed foods include tortillas (flat bread wraps made from wheat or maize flour), enchiladas, cornmeal tamales (cooked within corn husks or banana leaves), burritos, soft-shell tacos, tortas (sandwiches of chicken, pork, or cheese and vegetables enclosed in a hard roll), stuffed chili peppers, and quesadillas (tortillas filled with soft cheese and meat). Other favorites are soups and spicy stews such as menudo (made from beef tripe and fresh vegetables) and pozole (stewed hominy and pork). Seafood dishes such as pulpo (octopus), chilpachole (spicy crab soup), and ceviche (seafood marinated in lime or lemon juice).
While in rehabilitation, Mr. Jacson interacted with staff and residents, used humor in most social environments, asserted ideas of hope and recovery, and stayed in contact with friends and family members in the community. However, as time progressed, He appeared to be more withdrawn, similar to her life pattern prior to the death of his wife .He isolated in his room between rehabilitation sessions for alcohol abuse , rarely spoke with other resident , and presented with increased anxiety and depression after his wife pass away.
Mr. Jacson is very religious he grows up in with the Catholicism. The virgin of Guadalupe is considered his patron saint. He continues to be celebrated annually with prayers and he travel to Mexico to participate with thousands of pilgrims going to the Guadalupean Basilica where this miracle is said to have occurred.
Mr. Jacson still believe Supernatural powers can cause disease. An example of this is “mal de ojo” or the evil eye, and that God punish us with illness when we do not pray him, reason why he pray God every morning when he wake up .For him diseases caused by supernatural forces, non-supernatural cures are not believed to be helpful and often have poor compliance. Part 2: Interpret the findings in your holistic health assessment data according to pathophysiologic disease states.
• Choose one physiologic abnormality and discuss possible pathophysiologic reasons for the abnormality.
• Look at the abnormality on a holistic basis.
• How does this abnormality impact the other areas of the patient’s life, especially those areas discussed in this course?
• Discuss the client’s stress and coping mechanisms.
• Are they healthy?
• What improvements could be made?
Part 3: Create a teaching plan that addresses the client holistically by applying the assessment data you have analyzed.
• Describe at least one client goal for each of the categories (physical, psychological, social, cultural, developmental, and spiritual).
• How will you teach the client about the goal?
• How will you evaluate your teaching?