NR 304 Week 6 Assignment; RUA; Health History & Physical Assessment
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RUA: Health History & Physical Assessment Abbygayle Blackwood Chamberlain University College of Nursing Professor Rosanne Murphy NR304 Health Assessment II December 3rdDemographics SN is a 27-year-old female, born on July 15th, 1996, and residing in Brooklyn, NY. She was born in the United States, yet it is worth noting that her parents are from the nation of Guyana. At present, she resides in the same household as her father, alongside her 5-month-old infant daughter. Currently, SN is employed as a social worker and utilizes her leisure time to engage in activities with her daughter, close acquaintances, and extended family members. Reason for Seeking Care The primary motivation for my client's decision to seek medical attention today is the presence of unexplained exhaustion, diminished energy levels, an inclination to consume ice, unaccountable weakness, headaches, cold hands and feet, and episodes of dizziness. She has recently received a diagnosis of iron deficiency. Present Illness SN has been presenting with unexplained weariness and reports having weakness during the performance of her everyday activities. Additionally, she has been consuming a substantial amount of ice and chilled beverages. Throughout the course of her daily activities, including professional obligations and familial engagements, she consistently articulates a sensation of diminished vitality. She has experienced symptoms for a duration of around five months, prompting her decision to seek consultation with her healthcare physician. Following the completion of her blood testing, SN received a diagnosis of Iron-Deficiency Anemia. Perception of Health Following the diagnosis of Iron-Deficiency Anemia, SN endeavors to integrate iron-rich foods into her dietary regimen. Her dietary intake includes various food items, such as red meat, legumes, verdant leafy greens, and seafood. In addition, she endeavors to include vitamin C-rich foods, such as broccoli, melons, oranges, and tomatoes, in her dietary regimen. Additionally, she partakes in moderate physical activity for a duration of 2-3 days per week, although engaging in intense exercise has the potential to exacerbate her iron deficit. SN avoids consuming significant amounts of pasta, whole grain bread, and dairy products due to the potential inhibitory effects of these foods on iron absorption in the body. Past Medical History My client characterizes her general state of well-being as satisfactory, apart from experiencing low levels of iron. There is no record of any allergies that she is known to have. During her formative years, she experienced no ailments. SN asserted that she lacks any prior surgical procedures and gave birth to her baby girl by vaginal delivery. She is presently consuming iron supplements in addition to Advil for the management of her headaches. SN underwent her most recent physical examination during her encounter with her healthcare practitioner three months prior. She possesses current vaccination records, including documentation of receiving both the annual influenza vaccine and the Covid-19 vaccine. Family Medical History As previously indicated, SN's parents are currently residing in the United States. Her mother suffers from hypertension, while her father is diabetic. SN strives to maintain a healthy lifestyle to escape the same diagnosis as
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