Promotion: Case Study Monica

Nursing Health Promotion: Case Study Monica

Monica is a 17-year-old African-American female with dangerous lifestyle choices. There are several major health concerns with the patient, including the fact that she has turned to prostitution and has a family history of Type II Diabetes and coronary artery disease. As such, Monica needs obvious interventions to help prevent any serious conditions in her health from getting out of control. Thus, the interventions can be broken up based on her individual characteristics, such as age, gender, family history, and lifestyle choices. The following analysis is a break down of what interventions would ultimately prove most successful.

Monica is at a very tumultuous age. At 17 years old, she is in the middle of her teenage years, which is ultimately a stage of great crisis as the adolescent tries to break through into young adulthood. Thus, there is a higher risk for suicide and depression, as seen in the context of Erikson's developmental stages. During adolescence, teenagers often experience "reduced ego strength and the occurrence of physical and psychological symptoms" which can place them in greater danger of mental illness and even possibly suicide (Kidwell et al., 1995). During the stage of adolescent crisis, it is crucial that teens like Monica have a support system to help them get through any tough times. Thus, the most effective intervention would be to get her into counseling services that can help support her and monitor her mental health during this crucial time period.

As a female, Monica is also at risk for low iron intake which could ultimately result in anemia. During adolescence, "girls first encounter menstrual blood loss," which can ultimately make the situation for iron deficiency even worse (Marx, 1997). This only increases their potential where iron deficiency would become a major issue. This is only augmented with the fact that Monica is African-American as well because there is increased rate of anemia. Here, the research suggests that "menstrual blood loss accounts for a median additional need of absorbed iron between 0.5 and 1mg per day" (Marx, 1997). This creates a situation where a diet already in poor iron could ultimately result in the presence of anemia. It is clear that health interventions are necessary in order to increase the level of iron in Monica's diet. Essentially here, the best intervention would first be the introduction of iron supplement pills. These are easily accessible at any pharmacy or drug store and can be used to help augment the levels of iron in her diet. Additionally, increased health education would also help protect Monica from having dangerously low iron levels. Essentially, "one can assume that iron intake is adequate if iron deficiency anemia is prevented" (Marx, 1997)

There are also risk factors relating to heredity-family disease. The patient has a family history of type II diabetes and obesity. This places her at an elevated risk for developing symptoms and issues herself, especially with her age and lifestyle choices. Here, the research suggests that "since the early 1960s, the prevalence of obesity in female children and adolescents in the United States has more than doubled, with the greatest increase among African-American girls" (Kimm et al., 2002). African-American teens are particularly at risk for developing obesity and diabetes because of combined factors including family medical history as well as a lack of proper exercise. Due to the fact that she is African-American, she also has a potentially increased risk for coronary artery disease. Unfortunately, "adolescents have become less active in recent years" a trend which only augments already present family history of disease and obesity (Kimm et al., 2002). Thus, Monica is only increasing the risk that her family medical history will begin to show up in her own medical conditions as well. Her lack of health education only further continues to place her at higher risks of developing serious conditions that would ultimately impact her for the rest of her life. According to the research, "obesity in teenagers is associated with an increased risk of hypertension and hypercholesterolemia. These increased rates of intake vs. less expenditure of energy in physical activity" only increase the potential for Monica to develop serious heart conditions and Type II Diabetes (Flores, 1995). It is clear that physical interventions must be combined with educational interventions to really provide a comprehensive prevention program in Monica's case. According to the research, "possible targets of structured interventions to increase physical activity among adolescents" (Kimm et al., 2002). It may seem simple to thin of exercise as prevention, but Monica is at the perfect age to use increase physical activity to prevent family medical history from affecting her life in a negative manner. Using increased exercise programs, Monica can use her strength to prevent future medical complications. Here, the research suggests that "cardiovascular disease begins early in life but might be prevented or delayed by primary prevention programs designed for children and adolescents" (Flores, 1995). Introducing Monica to physical interventions that do not feel competitive or forced. One study conducted by Flores (1995) suggested that aerobic dance is a great intervention for African-American teens. Dance feels more like entertainment to teens than a forced physical intervention. Thus, "dance for health has proved to be an effective program to improve fitness and reduce weight in minority adolescents" (Flores, 1995). This combined with health education may help Monica be aware of her dietary and lifestyle choices to prevent a potential heart condition or diabetes to occur.