Published Jan 16, 2012
SamB12rn
7 Posts
hello,
i am a bsn student in an online community health nursing course and need some homework help, pleeeeaaase! i am trying to write some nds for the amish community. i have some written, but not sure if they are correct.
i only need 4-5 (already have data from part i assignment), but i can think of several problem areas (just not sure of the wording for the nd for part ii of the assignment). for example, i have:
1. risk for injury r/t environmental hazards
because of their agrarian lifestyle, many injuries to amish occur through farming accidents. buggy accidents are another source of injury (car/horse and buggy collisions).
2. risk for communicable disease outbreak r/t low immunization status
the amish are susceptible to communicable diseases like polio and tetorifice and only 16-26% of amish children have received immunizations against the common childhood diseases.
3. risk for genetic diseases r/t inbreeding
hereditary diseases and birth defects among the amish are caused by inbreeding (intermarriage).
4. altered health maintenance r/t value conflict: ? disinterest in? (cannot find the wording for what i am trying to say here) aeb
because of the religious beliefs of many of the amish, different perceptions of health and illness influence many of their health care practices. for example, illness may be viewed by the some of the stricter amish sects as a failure to function in the work role and there may be a delay in seeking medical treatment.
5. ineffective management of therapeutic regimen: ? prenatal care r/t ? lack of prenatal care aeb
it is forbidden for amish women to practice birth control and they generally do not seek prenatal care (except maybe in last trimester).
6. knowledge deficit ? r/t aeb ? rejection of most health promotion measures?
7. altered growth and development r/t ??? aeb
many of the amish reject preventive medicine and most health promotion measures. this is reinforced by their low educational status, which does not surpass the 8th grade, since higher education is discouraged.
also, can a nursing diagnosis have more than one "related to" in it (i don't think it can)? thank you so much if you can help me with even just part of this!
sam
nurseprnRN, BSN, RN
1 Article; 5,116 Posts
let's back up here. you are being asked to determine nursing diagnoses for a population based on what you have learned about this population. i am not sure whether you have collected any of these data yourself or in the abstract. you can't just make up nursing diagnoses out of whole cloth, though. from your list:
i'm not seeing "risk for genetic disease" in my nanda-i nursing diagnosis list (which is definitive and authoritative).
nor am i finding "risk for communicable disease outbreak," though "risk for infection" is there; the only risk factor i can see that would apply would be "inadequate vaccination," for populations. of course individuals could have other risk factors.
no "altered health maintenance," either, though i do see "ineffective health maintenance," "ineffective protection," and others under domain 1, health promotion. you might want to look at "deficient community health" and see which of those defining characteristics apply to your population. i'm thinking that even though "ineffective health maintenance" might appeal to you, "lack of expressed interest in improving health behaviors" does not mean "lack of interest in doing what i think are important health behaviors." i think you will find that these people are as interested as you are in staying healthy and keeping their children healthy. they just don't do it the way you do.
there are a number of nursing diagnoses related to life principles, domain 10-- you should look at those, too, but you may find that none apply
"knowledge deficit because they reject most health promotion measures"? i am assuming that you mean, "lack of interest in learning," which is an actual defining characteristic ("rejecting most..." is judgmental and is not very client-centric, )
there are only three nursing diagnoses related to g&d: risk for disproportionate growth, delayed g&d, and risk for delayed development. no "altered g&d."
you would have to look at the defining characteristics for all your diagnoses to see if they support the diagnoses made by your assessment.
so you're a little unclear on what nsg dx is; read up on it. get a copy of the nanda-i 2012-2014 and read through its contents to familiarize yourself with what nursing diagnosis is and what it is not.seriously? read up about real nursing diagnoses. you will find this kind of assignment much better at teaching you nursing process than you are getting by making it up as you go along.
a final note: you might want to consider your biases. really. this assignment is, believe it or not, an exercise in cultural nursing...and should be making you look at your own enculturation critically. your bias towards what we might call the us cultural norm on medical (and nursing) care will not help you serve this population. you will find this happen in your encounters with many people of different cultures over your working life.
Jolie, BSN
6,375 Posts
I question your impression of the Amish community's practices regarding obtaining prenatal care. I lived and worked in an area with a large Amish community, and while many Amish women chose to receive their prenatal care at home, they did receive it. Few delivered in hospitals, mostly those with complications. But my own OB had a very large, active and reewarding practice of providing home-based perinatal care to the Amish community. The few who required hospitalization were remarkable for the large, respectful groups of community members who would gather in the family room to pray. Also, I would tend to suspect that their risk for complications was much lower than the childbearing population as a whole, as they tend to eat wholesome, home-prepared foods and do much physical work, lessening the risk of obesity, high blood pressure and diabetes that complicate so many pregnancies these days.
hey, op? how about some feedback on this? any thoughts on what we have posted?