4.4.2: FRAME 2- Analyze Cues
- Page ID
- 90029
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Jacklyn is transported to the telemetry unit via wheelchair. The admitting telemetry nurse completes the initial assessment and notices the client is not very talkative, has low energy, and is in low spirits. Jacklyn states she is one step closer to going home and is scared. The telemetry nurse provides emotional support by utilizing empathetic communication. After a conversation with Jacklyn, the nurse states they are going to chart her assessment, review orders and labs, and will be back in the room shortly.
QUESTION: Matrix Multiple Choice
Scoring Rule: 0/1
After reviewing the client information, determine the cues that are relevant or irrelevant to the client’s status. Each row should include a single choice.
| Finding | Relevant | Irrelevant |
|---|---|---|
| Client flat affect and low-spirits | ||
| Diminished breath sounds | ||
| Bowel sounds hypoactive | ||
| Weakness | ||
| Reddened wound borders | ||
| Heart rate | ||
| Temperature | ||
| Pulse oximetry readings (Sp02) | ||
| WBC value | ||
| Hemoglobin value | ||
| Red blood cell value | ||
| Occasional alcohol use | ||
| Occupation | ||
| History of depression |
Putting It All Together
DEBRIEF
Relevant cues include the client's clinical presentation, including diminished breath sounds, lower Sp02 reading, weakness, hemoglobin, and red blood cell values. These clinical presentation cues indicate to the nurse how well oxygen is transported around the body and to the cells. The client's occupation may affect her ability to return to work after her surgery due to physical stressors and lifestyle modifications that will need to be made. Additionally, the client's flat affect, low spirits, and history of depression are relevant to the client's current situation and condition because of the high risk of postoperative depression and the client showing signs of a slower recovery. Feelings of hopelessness and adjustments to an individual's lifestyle after a major surgery are relevant in postoperative cares.
The nurse must recognize and analyze cues from the client to provide holistic care. Utilizing therapeutic and empathetic communication styles allows the nurse to effectively communicate and listen to advocate clients' needs and wishes. Nursing empathy is characterized by the nurses' ability to understand their clients' feelings, experiences, or psychosocial abilities (Wu, 2021). Empathy plays an important role in establishing a positive nurse-client relationship, resulting in favorable nursing care.
RECOGNIZING SOCIAL DETERMINANTS OF HEALTH (SDOH)
The second SDOH domain addressed in this case study is Social and Community Context. Recognizing SDOH are the social conditions in which people are born, live and work, play, worship, and go to school establishes a fundamental understanding into rationalizing health concerns and outcomes of clients. Additionally, SDOH offers a more inclusive view of how one’s geographic location, neighborhood, and access to health care play a critical role in morbidity and mortality. It is expected that SDOH will continue to increase in relevance and integration of client management in acute and community health settings, especially as healthcare organizations seek to achieve equity and decrease health disparities among different populations (Brandt et al., 2023).
The goal of the domain, Social and Community Context, is to increase social and community support. Jacklyn’s commitment to her religious beliefs and relationship with her church can positively impact her recovery and ongoing health and well-being. Jacklyn is experiencing depressive symptoms and may find solace in fellowship with Kingdom Hall members and prayer. This interaction would meet the Social and Community Context objective, increase the proportion of adults who talk with friends and family about their health (HC/HIT-04).
What Do You Think About?
- Relate each of the clinical assessment cues with the client’s low hemoglobin level and further investigate the pathophysiology of oxygenation at the cellular level.
- Compare and contrast empathetic and therapeutic communication styles.
- What are the benefits for Jacklyn to have an Advanced Health Care Directive?