1. Chicago, Illinois

2. Cultural definition; what is……( I don’t understand what I’m being asked

3. Race: African American

4. Length of Time in Country: my whole life

Communication

1. Voice quality: Average
2. Pronunciation and enunciation: Clear
3. Use of silence: Infrequent
4. Use of nonverbal: Kinesics
5. Touch: Accepts touch without difficulty
6. How do you get your point across to others: explainations
7. Do you like communicating with friends and family and acquaintances: yes
8. When asked a question, do you usually respond in words or body movement or both: Both
9. If you have something important to discuss with family/friends, how do you approach: I’ll state I have something important to discuss with you

SPACE

1. Degree of comfort: Moves when space invaded
2. Distance in conversation: 18in to 3ft
3. Definition of space: I don’t prefer close proximity when talking with someone else. I wasn’t raised in a household where a lot of hugs and kisses were given and we prefer it this way in our lives. Not a lot of touching. I would prefer a sitting across the table when speaking with someone. Anything closer will probably make me feel uncomfortable.
4. When talking with family mbrs, how close do you stand: probably about 24 inches
5. When communicating with coworkers and other acquaintances, how close do you stand: Probably 3ft or more.
6. If a stranger touches you, how do you react or feel: uncomfortable and move away
7. If a loved one touches you, how do you react or feel: It’s welcomed, I’ll probably hug them back or kiss them in return, especially my children and husband
8. Are you comfortable with the distance b/t us now: Yes, we’re sitting across from each other so it’s fine.
ORGANIZATION

1. Normal state of health: Excellent
2. Marital status: married
3. Number of children: 4
4. Parents living or deceased: both living
5. How do you define social activities that you enjoy: going out to dinner with friends and family. Also vacationing together
6. What are your hobbies or what do you do when you have free time: I quilt, cook, bake, decorate my house.

Pg 9 from the book continued:

D. Do you believe in a Supreme Being: Yes
E. How do you worship that Supreme Being: prayer
F. What is your role in your family unit/system: Cook, nurturer, housewife
G. What is your role/function in your family: Mother and husband’s partner in all decisions made
H. When you were a child, what or whom influenced you the most: my mother, She was stern/strict and we all looked up to her (my siblings too)
I. What is/was your relationship with your siblings and parents: I’m close to my mom and sister but I don’t speak much with my dad.
J. What does work mean to you: Unnecessary stress
K. Describe your past, present and future jobs: In the past I was a clinical laboratory scientist, presently I don’t work but I was an RN most recently in July of 2018, my future job would probably be a pharmacist if I ever went back to school
L. What are your political views: Democratic, although I think the whole voting stuff is fixed and predictable
M. How have your political views influenced your attitude toward health and illness: Besides, me not believing politicians put enough effort into ensuring everyone has proper medical care regardless of their socio-economic status, nothing.

TIME

1. Orientation to time: present-oriented
2. View of time: Social time
3. Physiochemical reaction to time: Goes to sleep and wakes on a consistent schedule
4. What kind of timepiece do you wear daily: nothing
5. If you have an appointment at 2pm, what time is acceptable to arrive?: 2pm
6. If a nurse tells you that you will receive a medication at…….: 40 minutes

ENVIRONMENTAL CONTROL

1. Locus of control: Internal locus of control
2. Value orientation: Believes in supernatural forces
3. How often do you have visitors at your home: rarely, probably once per year
4. Is it acceptable to you for visitors to just drop in unexpectantly: NO
5. Name some ways your parents or others treated your illness when you were a child: Tylenol and rest, and a visit to the Pediatrician
6. Have you or someone else in your immediate surroundings ever used a home remedy that made you sick: NO
7. What home remedies have you used that worked: I don’t use home remedies.
8. What is your definition of good health: Being able to walk, no pain, no illness, stable mental health, feeling and living in a happy state
9. What is your definition of “poor health”: Needing assistance with walking, poor mental health, sadness, no emotional support

BIOLOGICAL VARIATIONS

Physical Assessment:
Small body frame, brown skin, brown hair evenly distributed, 134 lbs, 5’6 ¾ in,

What diseases or illnesses are common in your family: diabetes, high blood pressure

Pg 10 from book cont:

B. Has anyone in your family been told that there is a possible genetic susceptibility for a particular disease: not to my knowledge.
C. Describe your family’s typical behavior when a family member is ill: Many of my older aunts and uncles will rally around the ill family member. They will come and visit the house. Someone may take the chore of staying with the ill family member to care for them. Generally, no prayers are said—at least not out loud.
D. How do you respond when angry: Name calling, then silent and not speaking to that person who made me angry.
E. Who or what helps you cope during a difficult time: My husband usually makes me feel better by helping me talk things through.
F. What foods do you and your family like to eat: mostly veggies and we love fruit. We don’t really eat red meat often but do enjoy chicken and fish
G. Have you ever had any unusual cravings for:
1. White or red clay dirt: NO
2. Laundry starch: NO
H. When you were a child what type of foods did you eat: My mother mostly raised me on fruits and veggies. Having a burger was considered a treat, as this was red meat, absolutely no pre-sweetened cereal was ever allowed.
I. What foods are family favorites or are considered traditional: We don’t have a favorite food. Most fruits and veggies are thoroughly enjoyed

NURSING ASSESSMENT

This part appears to be something you may have to write up based on my answers. Let me know if you need anything else Sis! 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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