This week’s graded discussion topic relates to the following Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
CO2 Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)
CO3 Utilize effective communication when performing a health assessment. (PO 3)

Amira is a 27-year-old Syrian refugee who has been residing in a local homeless shelter since her arrival here in the United States 4 weeks ago. She was brought into the emergency room this morning via squad after being found by a shelter employee sitting in a pool of blood on the bathroom floor crying and holding her abdomen. Due to her limited English speaking abilities, she is unable to provide specific details as to her complaints but the shelter employee states that she has recently stopped eating and has not looked well for the past couple of days.

Based on the limited information provided, please answer the following questions.

How will you prioritize your care of Amira, what assessments will you complete, and in what order? Please provide rationale for choosing this order.
Are there any cultural beliefs/practices that must be taken into consideration when planning her care?
Considering her symptoms of abdominal pain and bleeding, is it possible that her status as a homeless refugee is a causative or contributing factor to her illness? Please provide rationale for your response.

Solution:

How will you prioritize your care of Amira, what assessments will you complete, and in what order? Please provide rationale for choosing this order

Receiving Amira to the ED, my priority of care in the following order would begin with initiating communication. Upon learning that Amira has limited English, I would be sure that while speaking with her I am giving her trusting eye contact and reassuring touch to affirm her safety with me. I would place Amira on 2 liters oxygen, take her vitals (I’m concerned with Amira’s blood pressure, as she has lost quite a bit of blood), establish intravenous access (18 to 20 gauge, as in addition to Amira needing fluids, she may also be in need of a blood transfusion). I’d initiate lab collection for CBC, BMP, as well as, type and screen. All while providing compassionate care and collecting vital information, I would also be doing a physical assessment on Amira. Where is the blood loss coming from (vaginally or rectally)? Assessment of Amira’s abdomen would begin in the following order, as not to alter bowel sounds: Inspection, does anything look abnormal, is there distention? Then auscultation, listening for bowel and vascular sounds, followed by percussion and then palpation……Please click the Paypal icon below to purchase full solution for only $5