Factors to Promote Health Samples for Students -Myassignmenthelp

Question: Discuss about the different factors of Determinants of Health that has an impact on health and well-being of an Individual. Answer: Introduction: The paper explores different factors of determinants of health that has an impact on health and well-being of an individual. This is done through the case study of Greta Balodis, 75 year old widow with right sided cerebrovascular accident and increased dependence in daily life activities due to fall. The paper highlights the needs for appropriate service for Greta at home by means of assessment regarding her activities of daily living (ADLs). Secondly, the report provides a discussion on the determinants of health factors that has contributed to diagnosis of stroke in patient. Furthermore, the paper also presents the pathophysiology behind the condition and reason for risk of social isolation in the patient. This analysis finally helps to determine the care priorities for Greta in accordance with code of conduct and code of ethics. Nursing assessment: Understanding of ADLS and identified service required Mrs. Greta Balodis is a 75 year old widow who has returned from rehabilitation post a right-sided cerebrovascular accident (VCA). As a nurse visiting Greta for the first time at home, the objective data related to level of ADLs can be collected by means of simple interviewing techniques. By this means, impairment in basis activities of daily living and medication use can be identified. Inquiry about recent case of fall in patient will help to predict level of assistance needed in ADLs. Nurse can also ask Greta whether she needs assistance in feeding, ambulating or toileting. The patient may be inquired about problems or symptoms that interfere with their daily activities. It will also be crucial to collect data related to medication history, surgical history, social history and allergic reactions in patient to assess Gretas ability to manage activities of daily living (Fillenbaum, G.G., 2013). Observation skills would also help to interpret ADL level in Greta. For instance, observation of patients personality and dressing sense would give lot of information about patient ability to personal hygiene and continence management. This strategy would help to categorize ADL performance level into discrete stage of loss. Impairment in personal hygiene is early loss, toileting and locomotion impairment is middle loss and assistance in eating is late stage of loss (Janssen et al. 2014). Nurse can collect the subjective data regarding the level of personal hygiene, continence management, dressing, feeding and ambulating needs by the use of ADL assessment tool. The Katz Index of Independence in Activities of Daily Living is one of the tools that can help a nurse to measure activities of Greta. This tool helps to assess dependence and independence in activities of bathing, dressing, toileting, transferring, continence and feeding. The higher score of 6 will give the indication that Greta has high independence in ADLs, whereas the low score will determine dependency in ADLs. This is a validated tool to assess the level of independence particularly in older patient (Arik et al. 2015). As Greta is a 75 year old patient with right sided cerebrovascular accident, dementia and arthritis and muscoskeletal conditions, she needs assistance in locomotion. Secondly, after she had tripped over a cat, her condition has deteriorated further. This mean she needs high level of support service to help her safely manage basic activities in her home. Rehabilitation service at home will be essential for Greta to reduce her physical disabilities daily activities. The goal of the service would be facilitate daily activities and functional efficiency in patient (Vincent et al. 2007). Home health care service will be particularly important for Greta to improve function, promote greater independence, prevent fall and optimize her well-being. Identified determinants of health The health status of Greta has deteriorated after suffering from stroke and sustaining a fall at home. The diagnosis of stroke in patients might be influenced by the political, social, environmental, gender, genetic and economic determinants of health. The social factor for increasing risk of stroke in Greta is loneliness because she lived alone in her home as her husband had died and her daughter lived away. There was little social support for her due to complex family dynamics. Research also suggests that loneliness is linked to heightened risk of stroke (Nagayoshi et al. 2014). Genetic factor might also be a cause of stroke in Greta if her family has a history of stroke. The psychosocial life of Greta and her advancing age also indicate that she might be affected by financial problem, which might have altered her lifestyle and dietary intake. All this might have exposed Greta to modifiable risk factor for stroke such as poor diet, physical activity and acute emotional triggers in daily life (Vaccarino and Bremner 2017). Hence, overall environment around Greta does not support her in healthy living which has increased her emotional triggers and contributed to stroke. Identified pathophysiology of disease and medication to improve Gretas condition Greta was diagnosed with right cerebral vascular accident and atrial fibrillation for which she had to spent 14 days in acute care hospital. On discharge home from hospital, she was given the following medications: Aspirin PO 100mg daily, Clopidogrel PO 75mg daily,Digoxin 125mcg PO daily. Aspirin is a medication that contains acetylsalicyclic acid that works to prevent thrombus formation in blood by blocking the cyclooxygenase enzyme. This inhibits the synthesis of thromboxane A2 and prevents blood clotting. Hence, this function of the drugs reduces the risk of heart attack and stroke in patients. It has been used for primary and secondary prevention of stroke, angina, atrial fibrillation and coronary syndrome (Halvorsen et al. 2014). For this purpose, the medication was given to Greta. In addition, Clopidogrel 75mg was prescribed to Greta as it is antiplatelet medication that reduces the chance of blood clotting in patients. This significant helps to reduce atherothrombotic events like stroke in patient. This antiplatelet therapy will reduce the occurrence of secondary artherothrombotic events in people who have experienced stroke (Wolff et al. 2014). In addition, Digoxin is given to Greta post discharge because it provided relied from itrregular heartbeats. As Greta suffered from chronic atrial fibrillation, this medication served to address irregular heartbeat and consequently risk for blood clotting. Therefore, the cardiac glycosides medication changes the mineral composition inside heart cell to reduce the strain in heart and promote steady heartbeat (Washam et al. 2015). All these medications aimed to reduce symptoms of stroke and atrial fibrillation in Greta. Cause of risk to social or mental health issues in Greta Greta is at risk of social isolation in her life because of her complex family dynamics. She is a widow and her only daughter Anne cannot provide her much emotional and physical support due to her own family issues. Annes husband is engage in problematic alcohol and drug use due to which Annes and Johns relationship has been scarred. This has an effect of Annes son too as he also displays erratic behavior. Hence, Gretas only source of family support is herself not in a condition to care for her mother. Experience and feelings of social isolation in Greta is an issue considering her advancing age. At this age, she needed full support and emotional attachment from her family. However, in the condition lack of such support she is vulnerable to many risks such as poor health, depression and other mental illness. Ben, Dalgard., and Bjertness, (2012) also provides evidence to the direct relation between psychological distress and emotional support in elderly. Social support act as a mediator between psychological distress and health problems in elderly and lack of this might expose Greta to greater health issues. Hence, in order to increase health and well-being in Greta, adequate community based service should be provided to her reduce stress, enhance her physical health and overcome psychological issues in her life. This will provide her better quality of life as she ages. Legal and ethical responsibilities in care The main responsibilities of health professional towards Greta would be to improve her daily living by means of effective assistive support at home. The key priority would be to provide rehabilitation to reduce her disability, assist her in ADLs, manage her medications and diet requirement and modify environment and provided aids to prevent fall in Greta. As the health care service is meant to be delivered at home, the key code of conducts and code of ethics will be applied to deliver care. The purpose of Australian Home Care is to achieve independence, health and well-being for patient. The ethical and legal responsibility in care according to code of ethics and conduct for residential aged care will include preserving the right of patient to respect, security, cultural identity, and confidentiality. It will be ensured that appropriate standard of care is provided to meet the needs of elderly and support them in their social needs too. These values would help to provide flexible and responsive Aged Care services (Code of ethics and guide to ethical conduct for residential aged care 2017). Conclusion The essay summarized the importance of appropriate social, political, biological and environment factors to promote health and well-being in an individual. The interrelationship between these factors determines the health of an individual as well as the population. This is understood from the case analysis of Greta who suffered from stroke due to poor family dynamics, lack of social support in life, unstable family life and increase in emotional distress. This condition and environment around Greta suggest that she was deprived of basic family and emotional support that she needed at her age. 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Abstract T MP108: A Concentration Response Relationship Between the Active Metabolite of Clopidogrel and its Antiplatelet Activity.