. Healthy People Initiative (graded) The topic this week asks you to apply what you have learned to the following case study. As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic who is in her second year of nursing school. She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. After conducting her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. She is married with two school-age children. She attends class a total of 15 hours per week, plus she must be present for 12 hours of labs and clinical. She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children. She states that she is lucky to get 6 hours of sleep per night, but that is okay with her. She lives 1 hour from campus and commutes each day. Using Healthy People 2020 and your text as a guide, answer the following questions. ▪ What additional information would you like to gather from Maria? ▪ What are Maria's real and potential health risks? ▪ Why is Maria's culture important when obtaining the health assessment? ▪ Pick one of Maria's health risks. ▪ What would be one reasonable short-term goal for this risk? ▪ What nursing interventions would you incorporate into Maria's plan of care to assist her with meeting your chosen goal? ▪ Please provide rationale for your selections.. Professor and Classmates, While assessing Maria, a 40-year-old, married Hispanic mother of two, nursing school sophomore that appears to be concerned with a recent weight gain of 14 pounds, I would ask for additional information. I would ask Maria for her general health history as well as her family health history. I would assess her baseline weight and height; body mass index. I would questionher activity level and if she exercises, how often? I would want to know her eating patterns, any dieting? I would also want to inquire if she had any food intolerances, or allergies. If she was taking any medications or supplements. I would ask if she was a current or previous smoker, any alcohol intake and when her last menstrual period as well as the possibility of pregnancy. I would also assess Maria’s stress level and coping habits, is she feeling depressed, overwhelmed, anxious? Her emotional status can contribute greatly to her health, it is important to find a balance, health as defined by Jarvis 2016 is “the balance of the person, both within one's being (physical, mental, or spiritual) and in the outside world (natural, communal, or metaphysical). Potential health risks for Maria due to her age, recent weight gain, and busy schedule are many. Her real risks include hypertension, coronary artery disease, dyslipidemia, and osteoarthritis. Maria is at potential risk for stroke, pulmonary emboli, myocardial infarction, and diabetes. Considering that she is Hispanic she would have an increased risk for obesity (Slattery et al 2006). It is important to acknowledge a patient’s cultural and examine the influences this may have on her activity, and food choices. Her culture also carries her traditions regarding health and willingness to modify her behavior and food choices. Culture would influence her diet and cooking styles. Understanding what is acceptable for Maria in this topic will make reaching any goals easier. Does her family (mother, sisters, grandmother) have significant health history. Ask her if she knows about or would be interested in low fat, low salt and low cholesterol cooking. Preventative care is the foundation of the Healthy People Initiative. I would consider diabetes to be a real risk for Maria because of her recent weight gain and low activity level. I would suggest a short-term goal for Maria would be to plan her meals in advance. Adding a few healthy meals and low carb options to her diet a few times a week would be beneficial to lowering her blood sugar, and increasing her energy level. I would suggest Maria packs healthy snacks, since she is always on the go. Scheduling some time for exercise may be difficult for Marias packed schedule, so I would recommend brisk walking when going from place to place. A short-term goal would be to plan healthy meals ahead of time, and to do about 15-20 minutes of brisk walking every day. A healthy diet and exercise will greatly reduce Maria’s real risk of diabetes.My interventions would be; I would recommend Maria keep a food diary, that included her weight and measure. This would serve as a mirror so that Maria can fine tune her habits. Plan small healthy meals ahead of time (packing lunch for the week ahead of time would potentially save some time so Maria can snag some extra sleep). Adding fruits and vegetables to her diet will lower her sugar and fat intake and will also help with losing weight and decreasing other cardiac risk factors. I would go over the potential causes for Maria’s recent weight gain as well as ways to modify these causes. I would recommend 20 minutes of brisk walking at minimum daily to decrease Marias blood sugar levels. References Jarvis, C. (2016). Physical examination & health assessment (7th ed.). Philadelphia, PA: Saunders. Slattery, M., Sweeney, C., Edwards, S., Herrick, J., Murtaugh, M., Baumgartner, K., & ..Byers, T. (n.d). Physical activity patterns and obesity in Hispanic and non-Hispanic white women. Medicine and Science In Sports And Exercise, 38(1),