Unit 4-Discussion Social Determinants of Health.

Unit 4-Discussion Social Determinants of Health.

Unit 4-Discussion Social Determinants of Health. 800w initial response. And 400w for 2 replay to student. 1200w. due 11-22-23 11pm est. 4 references.


· Review the SOAP note see below

· Information on social determinants of health

Consider the knowledge you have gained from this week’s lecture.

Use your lecture materials to determine three priority Social Determinants of Health (SDH) to assess for in the patient represented in the SOAP note. 
NOTE:  Priority may refer to a strength in an SDH category necessary for the individual to attain/maintain health OR the priority may be a challenge in an SDH category identified as needing support or intervention for the individual to attain/maintain health.  

· In paragraph form, construct a discussion that identifies those priority SDHs using data from the objective and subjective data sets where appropriate to support your discussion.

· Include in your discussion some strategies you might utilize to address challenges with or support strengths identified in those three priority SDH.

Please be sure to validate your opinions and ideas with citations and references in APA format.

SOAP notes.

Chief Complaint:
“You all are all morons! I want to go home. There’s nothing wrong with me and I shouldn’t be here. Do
you see that there are alien doctors at the hospital, and they are helping to take over if we don’t do
something to stop them?”
History of Present Illness:
37-year-old female brought into the state psychiatric hospital by the police. The patient attacked a
police officer under the bridge where she is apparently living. The police were investigating a report of
theft of food from a nearby grocery store. The report included information about the thief did not
appear to be making any sense talking about needing food to store for when aliens invade the planet.
The police report that when they went to investigate the reported theft, the patient talked of the city
water supply being poisoned by aliens, seeing aliens under the bridge that look just like her and that
alien men had been raping her.
Depression 5 years ago secondary to the death of her son; reports being on anti-depressants for a few
months; denies history of any other mental health concerns
Complications secondary to arthroscopic knee surgery resulting in long term IV Vancomycin
Lymphoma diagnosed 7 years ago treated with six cycles of chemo with excellent response, in remission
+PPD for six years, treated for 12 months
Family Hx:
Mother diagnosed with schizophrenia at age 36
Maternal grandfather – placed in an ‘insane asylum for hysteria’
Social Hx:
Divorced with a daughter, son is deceased
Homeless – living under the bridge, stating her family disowned her ‘years ago’
Employment history – primary work experience as a nurse aid, reports she has ‘difficulty keeping a job’
Legal history – no history arrests or legal charges

General – denies loss of appetite or recent weight loss
Neuro – reports occasional headache due to ‘surgery performed on her by aliens’
Otherwise ROS is negative
Reports sleep interrupted by aliens entering her space under the bridge, interest is focused on thoughts
of alien invasion and her need to stop it, expresses no guilt, reports feels ‘hyper’ most of the time as she
has to be on the lookout at all times, reports concentrates solely on alien invasion, denies changes in
appetite, reports is constantly on the move, denies suicidal/homicidal ideations
OTC Ibuprofen 400mg PRN HA
Mycins – upset stomach
Bactrim – rash
Physical Examination:
General – thin Hispanic female who appears older than stated age; disheveled in appearance;
BP 143/84, P 82, RR 16, Ht 64 in, Wt 109 lbs, BMI 19
Integument – warm, dry; good turgor; no rashes, ecchymoses or petechiae noted
HEENT – Head is normocephalic and atraumatic, PERRLA, EOMs intact, TMs gray and shiny bilateral,
nares patent without discharge noted, no tonsillar enlargement
Neck – supple without adenopathy, no thyromegaly
Lungs – CTA
Breasts – deferred
Heart – RRR without murmur/gallop
Abdomen – soft, non-distended, active bowel sounds, non-tender, no organomegaly
Genitalia/Rectum – deferred
Musculoskeletal – no gross abnormalities noted
Neurologic – lethargic, DTRs 2+ and equal bilateral, negative Babinski

Diagnostics – Na 140 meq/L, K 4.0 meq/L, Cl 102 meq/L, HCO3 22 meq/L, Bun 14 mg/dL, Cr 0.8 mg/dL,
non-fasting Glu 134 mg/dL, Ca 9.9 mg/dL, PO4 3.2 mg/dL, Total Protein 7.0 g/dL, Mg 2.7 mg/dL, AST 21
IU/L, ALT 15 IU/L, Alb 4.5 g/dL, TSH 2.33, Hgb 14.6 g/dL, HCT 42 %, RBC 4.2 million/mm3, WBC
6000/mm3, Plt 264,000/mm3
Urine pregnancy test – negative; urine drug screen – negative; urine dipstick – specific gravity 1/017, pH
5.8, other parameters negative
Diagnoses are not needed for this assignment.
The assignment directs identification of priority social determinants of health and development of a plan
that ‘address challenges with or support strengths identified in’ the three priority SDH that you
identified in this patient.

Peer Response


Please respond to at least 2 of your peer’s posts with substantive comments using the following steps:

· Construct a response – ideally, one who identified the same 3 priority SDHs that you did and one who did not.

· Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.

· References and citations should conform to APA standards.

· Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.

· Plagiarism is never acceptable – give credit when credit is due – cite your sources.

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria. Collaboration points will be forfeited if you fail to meet the response post guidelines.