Case scenario:

Aling Moning is a 65 year old widow who has lived alone since the death of her husband 2 years
ago. She retired 1 year ago from her job of 25 years as a secretary. After retirement, she participated in
a health promotion and screening clinic at the Rural Health Clinic. After completing a lifestyle inventory
and screening, the following problems were noted along the categories of health promotion.

Nutrition: 10 lbs. overweight

Exercise: Does no regular exercise
Stress: Cries often, often unable to sleep at night, complains of fatigue and
generally low energy
Relationship: Misses people at work, talks about missing deceased husband
Substance abuse: Take an OTC sleeping pill and one glass of wine before bed.
Self-care: Has not seen a physician since she had a hysterectomy 10 years ago;
never had a mammogram and does not perform breast self-examination; cannot recall
immunization history but sure she has not had any in the past 10 years; has never had a flu shot
of pneumococcal vaccine; recently had the blood pressure taken at a drugstore, and recorded
150/92.

1. List additional assessment data that should be known in each of the categories of health
promotion.

Assessment Data
Health Promotion
The following questions will be asked to collect valuable information about
Category
the client’s health promotion status
 Have you gained weight recently? How much? Over what period of
time?
 Are you now or have you been on a specific diet recently?
 How much water do you drink every day? Do you consume sugary
drinks, caffeine, or alcohol daily?
 What do you typically eat in a 24-hour period?
 Are any members of your family obese?
Nutrition
 Do you prepare your own meals?
 How often per week do you typically eat your breakfast, lunch, and
dinner away from home? Which meals do you eat out?
 What types of food do you typically purchase? What is your
weekly monetary budget? Where do you typically purchase your
food?

 Do you engage in physical activities before retirement?

 What physical activity do you typically perform in a day?
Exercise  How much time do you allot for walking outside or around the
house?

Stress  What particular event or condition triggers your stress levels?

 How do you cope with your stressors?
  Are there any physical complaints aside from fatigue?

 Do you have contact with your family and friends?

 Do you have someone to chat with anytime?
Relationship  How do you feel about your relationship with others?
 Are you involved in any social activities?

 When did your sleeping problem start?

 Have you always been taking sleeping pills?
Substance Abuse  How long have you been drinking wine every evening?
 What effect does your body feel after drinking wine?

 Do you have a primary care physician?

 Where do you seek assistance for your healthcare needs?
 Do you understand the importance of proper nutrition, exercise,
Self-care and immunization?
 Do you know the danger of taking sleeping pills and alcohol
together?

2. How might you determine Aling Moning’s greatest concern?

The nurse can determine the client’s greatest concern by asking, “What is your major
health problem or concern at this time?”. Answering the question will assist Aling Moning
in focusing on her most significant concern. It will also guide the nurse on how they can
help the client.
3. What part does Aling Moning’s motivation play in developing a wellness plan?
Aling Moning’s participation plays an integral role in the management of her health
concerns. The client’s motivation promotes responsibility in taking charge of her own
health care decisions. It is also vital in helping the nurse make an accurate diagnosis and
collaborating on a wellness plan.

4. What conditions or diseases might develop if Aling Moning continues with no changes in her
life?
The following conditions may develop if no wellness actions are taken:
 Excessive weight may lead to physical limitations, diabetes, hypertension, and
heart disease.
 Lack of exercise contributes to obesity, hypertension, and a reduction in bones
and muscles’ strength.
 Emotional stress increases the likelihood of developing depression.
 Relationship concerns may lead to stress, isolation, and drugs and alcohol abuse.
 Combining sleeping pills and alcohol may lead to slower breathing rates and a
slower heartbeat.
5. What might be the first priority for Aling Moning?
Since Aling Moning has not seen a physician for 10 years, she needs to undergo a physical
health assessment to elicit baseline information. Healthcare providers should address the
client’s identified health problems such as excessive weight, inactivity, emotional stress,
sleep problems, and high blood pressure. Disease prevention measures should also be
done through health teaching and immunization.