Patient Assessment and Nursing Care: A Comprehensive Report

This report provides a detailed analysis of patient assessment and nursing care, highlighting the challenges of communication, particularly with patients from diverse cultural backgrounds. It emphasizes the importance of culturally competent care and effective communication strategies to build trust and rapport. The report explores how primary healthcare principles, such as accessibility and patient education, impact patient management, including wound care, diabetes management, and fall prevention. It underscores the role of nurses in providing holistic care, including lifestyle modifications and connecting patients with community resources. The report concludes by summarizing the importance of addressing communication and cultural barriers to ensure high-quality patient care and positive health outcomes. Furthermore, it emphasizes the need for nurses to be well-prepared to handle these challenges effectively in order to ensure patient satisfaction and improved health outcomes.

Running head: PATIENT ASSESSMENT AND NURSING CARE
PATIENT ASSESSMENT AND NURSING CARE
Name of the student:
Name of the university:
Author note:

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A communication issue that is pertinent for this client:
Communication is powerful tools by which every practice nurses can not only educate
patients about their healthcare activities develop therapeutic relationship with the patients. With
effective communication, practice nurses can develop connection with the patient on an
emotional level that gradually helps in developing trust of the patient in the nursing professionals
(Smolowitz et al., 2015). With the development of effective bond, patients rely on the nurses and
develop better adherence with the treatment and medications that the practice nurses prescribe
them for their betterment. They are able to explain their concerns and issues easily by which they
can overcome different anxiety, depression, loneliness, fear and many others. The Practice nurses
are the first line of professionals who initiate the caring procedures and therefore they have to be
very careful that the patients develop high level of satisfaction when they visit the primary health
care centers for guidance over their disorders (Mueller et al., 2015). In the case of the patient, it
is seen that she is a resident from Bangladesh and her English is broken and not easily
understandable by the nurses. Moreover, the patient feels embarrassed when she is asked to
repeat again thinking that she is failing miserably and her self-esteem is getting affected. The
practice nurses of the primary healthcare center are also not able to understand her concerns that
are creating a communication barrier. Some practice nurses have talked with her creating eye
contact and such non-verbal communication aspect affected her self-respect. Asians consider
communication with eye contacts to be rude and this makes them feel that the speaker is
disrespecting them (O’hagan et al., 2014). Therefore, in such scenario, the nurses need to not
only develop culturally competent communication skill but also be compassionate and try their
best to make the patient comfortable. She would be requested in a humble manner to speak
clearly with one word at a time that will help the nurses to understand her concern. The practice

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nurses would also talk to her in easy language with simple syllables and without the use if any
technical jargons so that she can understand the professionals effectively. Proper body language
should be maintained according to their traditions so that the patients do not feel disrespected
(Powell et al., 2017). Moreover, practice nurses should keep in mind a number of factors while
communicating with the patient. Researchers are of the opinion that patients should never be
interrupted mid way while they are speaking with the professionals. When individuals are
interrupted in between their interaction, they feel that the professionals do not respect them at all.
They feel that they are powerless and therefore, the professionals are not listening to them. This
makes them feel depressed and anxious and their self-esteem is hurt (O’Hagan et al., 2014).
Once, the patients get hurt they never feel to comply with the interventions proposed to them and
hence the result of the intervention are not as successful as was expected by the nursing
professionals. Therefore, while the patient of the case study is treated, the practice nurses should
provide importance to listening to the patient attentively (Poitras et al., 2018). This would help
the professionals to understand the real concerns of the patient. Once the professionals realize the
main issues that the patient is concerned of, then the professionals would be able to plan
important interventions that would align with the demands of the patient (Kourkota &
Papathanaosiou, 2014). Thereby, effective communication would help the professional to
provide quality care that would increase patient satisfaction. Moreover, effective communication
has the capability to connect with the patient at an emotional level by which the patient will
develop trust on the professionals. Once the patient starts relying on the practice nurses, she will
also adhere with the treatment procedure successfully (O’Halloran, Worall & Hickson, 2015).
The expectations and dignity of the patient would be met that have the capacity to result in
positive health outcomes of the patient. With effective communication, patient safety is also

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ensured. Therefore, after ensuring culturally competent communication, the practice nurses
should perform their role of writing the records and keep the notes of the patient up to date. They
should then liase with the other professionals, GPs and other healthcare centers to ensure
effective care to patient that matches the need of the patient. After developing effective
therapeutic communication, the practice nurses should take the samples of the patient and check
her pulses, blood pressure and temperature (Poitras et al., 2018). The role of practice nurses is
also to give advice to the patients along with educating them by providing information about
health conditions and ailments and this would ensure Maryam to understand the lifestyle
modification she needs to stay healthy. The role of practice nurse is also to provide emergency
first aid and treatment and they should clean the wounds of the patient and dress them well. All
these could be only achieved when effective communication is established with the patient.
How the principles of primary health affect the client’s management:
Primary healthcare can be defined as the essential form of healthcare that remains based
on scientifically proven as well as socially acceptable methods and technology that make
universal healthcare accessible to every individuals and every families in the community. Public
education is one of the most important aspects of primary healthcare that remains followed by
proper nutrition, clean water and sanitation, maternal as well as child health care, immunization,
local diseases control, drug provision, accessible treatment and many others (Stanhope &
Lancaster, 2015). As mentioned, accessibility to healthcare is one important aspect for the
primary healthcare center and nurses should put importance to it while treating the patient.
Ensuring accessibility to healthcare that are culturally competent, easily available and affordable
irrespective of gender, age, ethnicity and others is one of the most important principles of

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primary health care centers and therefore practice nurses also have to fulfill their responsibility
as they are one of the most important representatives of the primary health care centers
(Smolowitz et al., 2015). The patient was of different religion and ethnicity and she might not
have easy access to the primary healthcare centers and therefore practice nurses should help them
to overcome the barrier and get easy access to their guidance. The main benefits of primary
healthcare is the improved quality of care, focusing on prevention of diseases, early management
of health conditions, reduced need for specialist care, effective communication and others
(Ashley, Halcolm & Brown, 2016).
In case of the patient, it is seen that the patient does not have knowledge about blood
glucose level management. Therefore, she should be made to understand the pathophysiology of
diabetes in easy ways and then she should be taught how to monitor her blood glucose level
herself. Proper medication and setting of reminders should be also taught to her (Bos et al.,
2015). Moreover, she is obese which might lead her to several threatening disorders like
cardiovascular disorders, hypertensions, osteoarthritis and many others. Therefore, the practice
nurses should refer the patient to a dietician who can help her with diet plan and ensure that she
undertakes regular exercises. She would be also given appointment to monitor her wounds and
accordingly allocate next set of intervention if required. Wound management should be taken
care as researchers are of the opinion that wound healing is delayed in old age (Gould et al.,
2015). As the individual is quite old, therefore professionals should take extra initiative in
management of her wound. Practice nurses of the primary healthcare centers are well trained to
manage wounds and dress them properly and therefore the patient would be attained by the
practice nurses on a bi-weekly basis to monitor, evaluate and dress her wounds as per required
(Mueller et al., 2015). Moreover, she is quite old and may have issues with her activities of daily

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life as both her son and daughter in law remains busy throughout the day. Therefore, as he is
weak right now, she might not be able to maintain herself well. Therefore, the primary healthcare
service provider may help the patient as well as the family member by giving them a list of
reference where they can seek for additional help for either social worker or community nurse
who would be helping the patient to maintain her daily activities. Primary health care ensures
public and community participation where it tries to involve the resources of the community to
promote health and address the health problems from the grass root level and thereby helping the
patient to live well through developing access to the community resources like the help of social
workers and community nurses would help her to get well faster (Powell et al., 2017). Moreover,
the patient had already experienced fall once already and therefore precaution need to be taken
so that the same situation does not occur once again. Therefore, the primary healthcare providers
should teach her family members of the different arrangements that they should take to make the
environment of her house safe from any fall hazards. The healthcare professionals should advise
them to attach bed rails, handrails and similar other supporting bars (Maclean et al., 2017). They
should always keep the patient’s pathway free from any clutters so that the risk of fall reduces.
Moreover, use of nonskid soles and slippers should also be advised. The patient should not be
given too loose clothes as that might make her vulnerable to fall. This education about fall
management is also one of the responsibilities of the practice nurses in primary healthcare
centers. Such centers ensure health promotion of patient by advising them with proper lifestyle
intervention and risk management behaviors that would keep them safe from any accidents and
illness. Moreover, care should be taken that the patient adheres with the intervention plan
provided to her (Oh et al., 2015). However, the patient should be also assisted for short walks in
companion with the social worker so that she does not lose her mobility completely. Often

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researchers have stated that many patients develop fear after fall and therefore they completely
stop walking as they suffer from the fear of falling and subsequent suffering (Osborn et al.,
2015). Therefore, both the family member and the social care worker should be very careful that
she does not lose her confidence to walk and try to maintain her independence as much as
possible (Gomes et al., 2017).
Conclusion:
From the above discussion, it is clearly seen that patients coming from different cultures
can cause several challenging situations for nurses. They can cause communication barriers,
ethical barriers as well as cultural challenges as well. Cultural barriers may result as the patient is
from different culture and does not want the professionals of western culture to treat her.
Therefore, the professionals need to use culturally competent care so that the care provided to the
patient matches with her cultural traditions, inhibitions and preferences. Moreover, cultural
awareness and cultural sensitivity also enhances job satisfaction of the patient. Communication
barriers may also result, as the patient is not comfortable while interacting with the healthcare
professionals. She is also not fluent in English and hence this may affect communication.
Therefore, professionals should develop effective therapeutic relationship so that they can
develop trust and rapport with the patient through effective communication. Once the patient
starts relying on the provider of care, she will start adhering with the care plans and will
coordinate with the providers. Primary healthcare nurses should prepare themselves in ways by
which they can handle each of the barriers successfully and provide care that would ensure high
quality service for the students. In the case, the practice nurses would be treating the wounds of
the patient and dressing them. They should also refer her to dieticians and allocate social workers

7PATIENT ASSESSMENT AND NURSING CARE
for her. Community resources should be made accessible to her and it is one of the aspects of the
primary healthcare centers to ensure accessibility of healthcare to patients irrespective of her
caste, creed and religion and also manage public as well as community participation that involve
community resources. Another important responsibility of practice nurses is to promote health
through education and development of health literacy. Therefore, they should educate Maryam in
ways by which she becomes able to understand her disorders and becomes capable to take her
medications properly. The most important intervention that would be given to the patient is her
diet management. Moreover, she is also not seen to have no knowledge about her diabetes
management and therefore she should be properly educated about how she can assess her blood
glucose level effectively. Moreover, she should be able to take her medication and insulin for
diabetes at the right time so that she does not have severe incidents that require hospitalization.
She is also vulnerable to fall in the future and therefore, care should also be taken so that she
does not fall again in her home.

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