Question

PLEASE HELP

Case study

Mrs. Wolford is a 46-year-old female being evaluated at her local walk-in clinic for dyspnea on exertion (DOE). She has noticed a gradual increase in shortness of breath (SOB), fatigue, and daytime sleepiness since “gaining a few pounds” several years ago. She has no known history of illness or disease and does not have a primary care provider. Mrs. Wolford claims she is rarely ill, except for the occasional cold or seasonal allergies, which she treats using over-the-counter remedies. Mrs. Wolford is otherwise healthy and appears in no distress. She is currently unemployed, having left her former position as a teacher several years ago to stay home with her only child, who has required around-the-clock care since birth. Her husband is self-employed, and the family currently carries minimal health insurance except for their child, who is a Medicaid recipient.

Vital signs are T 37.5° C (99.5° F), P 92 and regular, R 22 and unlabored at rest, BP 170/94, with SaO2 of 96% on room air. Her height is 5 feet 5 inches, and she weighs 200 pounds. She complains of occasional headaches, which are relieved with rest and ibuprofen. Mrs. Wolford states she has smoked one pack per day of low-tar cigarettes since the age of 17 and has two or three mixed alcoholic drinks per week, drinking almost exclusively on the weekends. She denies the use of recreational drugs but states her husband “smokes weed.” She does not exercise and has a sedentary lifestyle except when assisting her child with activities of daily living. Her diet is mostly fried foods, diet soft drinks, and very few vegetables or fruits. Mrs. Wolford states she has been “eating more since quitting her job several years back” and has “a sweet tooth for candy and cakes.”

Question:

1. Which two of the three primary components of the Health Belief Model did Mrs. Wolford exhibit by coming to the walk-in clinic for evaluation of her dyspnea on exertion?

2. List three or four risk factors identified in Mrs. Wolford's health history and physical assessment that the nurse should address during this or subsequent clinic visits. Place an asterisk next to preventable lifestyle-related risk factors that Mrs. Wolford can change with mutually agreed-on interventions.

3. List nursing interventions to address each of Mrs. Wolford's preventable lifestyle-related risk factors that the nurse can discuss with Mrs. Wolford before including them in an individualized plan of care.

4. Identify at least three family factors that place Mrs. Wolford at risk for additional concerns.

Answer 1

1. Health consciousness and perceived health risk are the two of the health belief model that the patient exhibited.
2. Her body weight, smoking, drinking alcohol habit, sedentary lifestyle are the risk factors. The nurse should check her weight and ask questions regarding her smoking and drinking alcohol habit and if she is doing any exercise should be addressed during the next visits. All the mentioned risk factors can be prevented.
3. Nursing intervention: Encourage the patient to do some exercises and to follow strict healthy diet by avoiding fried and junk foods, encourage the patient to reduce and stop smoking and drinking alcohol. Encourage the patient to follow a strict regimen to reduce body weight.
4. The family factors are the husband smoking weed, diet of the family and sedentary lifestyle.