The nursing process is used as a problem-solving framework to plan and provide
safe, patient-centered care to patients and their families. The incorporation of
growth and development and cultural concepts in the planning and provision of
care promotes patient safety and ensures quality
Eriksons adult growth and development theory
Jane Vuong is a Vietnamese 24 year-old
single woman who is living in the United States on an academic visa. She has
been attending the local university for two years, studying cellular biology as
an undergraduate. She comes from an affluent Vietnamese family. Her parents are
paying for her education and want her to come back to Vietnam with her doctorate
and take over the research lab owned by her uncle.
Jane is a straight “A”
student and spends much of her time studying. She makes extra money by working
part-time in the molecular biology laboratory in the university campus research
center. She takes the subway or rides her bicycle to get around.
enjoys working out doing Quan Khi Dao at the local martial arts school. One day
while working out, she feels a severe tightness in her chest and says she is
having difficulty breathing. Susan, a regular attendee in the class, brings Jane
to the emergency department where you work. You note that Jane is having trouble
speaking, appears anxious, and her lips are dusky. You are able to hear a
wheezing sound when she breathes.
She denies a history of asthma but says that
she has some allergies which she generally treats with herbs. Susan takes you
aside and tells you that she has noticed over the past month that Jane has
seemed out of breath after taking the stairs up to the martial arts studio and
that she no longer rides her bike to the studio.
Because of the severity
of her symptoms, the doctor decides to admit her for evaluation and observation.
The physician orders supplemental oxygen, a chest X-ray, blood tests, and a
regular diet. Her anticipated stay is two days.
Once on supplemental
oxygen, she is better able to communicate, and you begin to do a general
assessment and take a history. Here are some of your
Diet: Jane states that she is proud that she only eats a
traditional Vietnamese diet of fresh vegetables, chicken, rice and noodles. Much
of the food she eats is prepared with Nuoc mam (fish sauce), soy sauce, sour
lemons, bean sprouts and scallions. She prefers to eat Banh Khuc (rice ball),
Banh Cuon (rolled rice pancake), and Pho-bo (beef and noodle soup). You note
that she is very slender, verging on being underweight.
Jane states she is a Mahayana Buddhist. She goes to the Buddhist temple early
each morning for meditation and communion with her dead ancestors. She says her
meditation brings blessings from her ancestors, and they watch over her and help
her succeed and stay healthy.
Health history: Jane admits she has
had a dry cough for several months which she attributes to allergies. She says
her allergies have kept her from riding her bike to work. She continues to smoke
1 pack of cigarettes daily and says smoking doesn’t bother her. She laughs and
says she could never quit because her roommate smokes too.
earlier she tested positive for Hepatitis B. The diagnosis surprised her since
she didn’t have any symptoms. She denies drug use but admits to being sexually
active. She reports having 5 sexual partners in the past six months. She states:
“I meet guys at the college bar and we have weekend flings. I like it this way,
so I don’t have to be involved in any type of long-term relationship, which can
make life really complicated.” When asked if she uses protection, she shrugs and
says, “Sometimes.” She claims that no one told her that Hepatitis B was sexually
transmitted, but she isn’t worried because she says she is over it
Exam: During her examination, red circular burns are found on
Jane’s chest. On Jane’s back, there are reddened abrasions. When asked about
these strange marks, Jane explains that she was having difficulty breathing
earlier in the week, and went to a Vietnamese medicine man who treated her with
“coining” on her back and “cupping” on her chest to remove the bad air. He also
gave her an herbal mixture and told her to boil it and breathe the steam from
the mixture three times daily. She says it really helped her.
primary nursing diagnosis is “impaired gas
Eriksons adult growth and development theory
A. Write an analysis paper with at least one reference
(suggested length of 2 pages).
1. Summarize (suggested length of 1 paragraph) Jane’s
2. Explain how Jane’s history and behavior relate to each
of the following theories:
• Erikson’s adult growth and development theory
• Freud’s adult growth and development theory
• Maslow’s needs theory
3. Explain how each theory in part A2 is relevant to Jane’s
plan of care.
4. Discuss how the nurse will adapt care to meet Jane’s cultural
a. Justify each adaptation.
5. Explain how the nursing process will assist the nurse in
planning Jane’s care, including at least one specific example.
B. Given Jane’s history, select two additional nursing
diagnoses from the below list. All of these diagnoses are reasonable diagnoses
for Jane; you are not evaluated on which one you select.
• Knowledge Deficit
• Ineffective Denial
• Activity Intolerance
• Alterations in Health Maintenance
1. Using the attached Nurse Care Plan Templates, complete a
nursing diagnoses chart for each of the two diagnoses you have
chosen with the following information:
a. Subjective data that support the diagnosis
b. Objective data that support the diagnosis
c. Problem (nursing diagnosis)
e. Signs and symptoms
f. Two short-term patient outcomes to be achieved before
g. One long-term patient outcome to be achieved two weeks to six
months after discharge
h. Nursing interventions that describe what the nurse will do to
help the client meet each short-term and long-term
Note: Interventions must be culturally and developmentally
appropriate when applicable.
i. Rationale for each nursing intervention, including why
this nursing intervention is relevant to helping the patient achieve the
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