Cultural, Spiritual, Nutritional, & Mental Health Disorders
Chief Complaint
(CC) :“Annual physical exam”
History of Present Illness (HPI)
23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle.
Drug Hx :Current Meds: denied
Allergies: No allergies to food or medications.
Family Hx: He has a family history of diabetes, hypertension, and alcoholism.
Review of Systems (ROS)
General: No recent weight gains of losses, fatigue, fever, or chills.
CV: no chest discomfort or palpitations
Integument: history of eczema – not active
MS/Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements
Objective Data
PE: B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6
General: 23-year-old male appears well developed and well-nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress.
HEENT: Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, nasopharynx clear, poor dentition – multiple carries.
Lung: CTA AP&L
Card: S1S2, +II/VI holosystolic murmur; without rub or gallop
Abd: benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.
Ext: no cyanosis, clubbing or edema
Skin: intact without lesions masses or rashes.
Neuro: No obvious deficits and CN grossly intact II-XI
Once you received your case number, answer the following questions:
1. Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
2. Utilizing the five assessment domains, which ones would you utilize on your patients in conducting a comprehensive nutritional assessment.
3. Discuss the functional anatomy and physiology of a psychiatric mental health patient. Which key concepts must a nurse know in order to assess specific functions?

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Specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient in this case may include the patient’s Native American heritage and the potential impact that this may have on his understanding of healthcare and treatment options. Native Americans have historically been subject to systemic discrimination and marginalization, which can lead to distrust of Western medicine and a preference for traditional healing practices. Additionally, the patient’s reported use of marijuana and alcohol as coping mechanisms for his anxiety may indicate a lack of access to or familiarity with other forms of mental health treatment. Furthermore, patient’s history of hypertension and diabetes in the family, which are common among Native American population.
In conducting a comprehensive nutritional assessment, I would utilize the following five assessment domains:
Anthropometric measurements: This includes measurements such as weight, height, and body mass index (BMI) to assess the patient’s overall nutritional status.
Biochemical measurements: This includes blood tests such as serum albumin and hemoglobin to assess the patient’s nutrient status and overall health.
Clinical examination: This includes assessing the patient’s physical appearance, including signs of wasting or edema, as well as any signs of nutrient deficiencies or excesses.
Dietary assessment: This includes assessing the patient’s current dietary intake and patterns, including the types and quantities of foods they consume, as well as any cultural or religious food restrictions.
Psychological and social assessment: This includes assessing the patient’s mental and emotional well-being, including their stress levels and social support system, which can impact their ability to maintain a healthy diet.
The functional anatomy and psychiatry of a psychiatric mental health patient involve understanding the complex interactions between the brain, nervous system, and other bodily systems in the development and manifestation of mental illness. Key concepts that a nurse must know in order to assess specific functions include understanding the different types of mental illnesses and their symptoms, as well as the various pharmacological and non-pharmacological treatment options available. Additionally, understanding the patient’s overall medical history, including any co-occurring physical health conditions, and their social and cultural context can provide important insight into the patient’s mental health status. The nurse should be aware of the patient’s perspective, feelings, and beliefs to provide a holistic care.

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