Assessment of the Patient With Type 2 Diabetes - Assignment Example

Patient Education: Trevor comes to see the doctor Insert Insert 01 April Patient Education: Trevor comes to see the doctor Introduction The Ischemic Heart Disease is responsible for more than 5million deaths in America, a figure that surpasses other causes of deaths in the country. The condition is manifested by narrowing of the vessels that supply blood to the heart, which cause a buildup of plaques in their walls, thus reducing the resistance of blood flow to the heart. In such a case, oxygen supply to the heart is compromised and the patient may present with Angina (NHS, 2013) According to Porta (2005), Type 2 diabetes results when the pancreas becomes defective and cannot utilize the insulin effectively, thus causing résistance. With time, the production of insulin becomes insufficient, leading to similar symptoms as type 1 Diabetes, which may be either gradual or asymptomatic. Assessment The patient is 61years and he has lived in Sydney for most of his life until he was 50 years, when he decided to relocate to his rural place. He leads a sedentary lifestyle and he has not undertaken physical exercises since he was a teenager. In addition, he faces the problem of lacking proper and healthy diet at home, mainly because he does not have a choice of the food he eats but has to accept what his wife prepares for him; occasionally, she provides him with steak and chips from fast food outlets. Risk factors he is involved in include heavy smoking, sedentary lifestyle, and having no control on his diet. The exercise regime is poor, although he admits taking brisk walks at home under pressure from his partner, a ritual that he does not enjoy due to physical discomfort of the exercise and lacks of endurance. He was once asked to be tested for diabetes type 2 but he declined. The physical assessment reveals raised blood pressure and blood sugar while lung field sounds are compromised but can be heard. Other vital signs tested included heart rate, respiratory rate, temperature, and oxygen, which are normal routine checks for his clinical presentation. The initial results from physical assessments make the doctor to order further test for serum cholesterol and fasting blood to confirm the diagnosis. Nursing Diagnosis Investigation reveals raised serum cholesterol and a high fasting blood sugar, which points to the indication of Ischemic Heart Disease and Type 1 Diabetes. From the initial assessment, the patient’s lifestyle predisposed him to the risks of the diseases. The physical exam revealed that the patient could not endure resistance exercise, smokes heavily, and has never been mindful of his diet. Random blood sugar is abnormal, and the vital respiratory signs are compromised. Further examination reveals fasting blood sugar beyond normal limits, which is a diagnosis for Diabetes. Complications of poorly managed cardiovascular disease include hyperlipidemia and diabetes. In Trevor’s case, the two conditions are present. Although the goal to discharge the patient on Arvastain was timely, emphasis should be towards lowering the level of cholesterol in the body in order to reduce the risks of other cardiovascular disease complications (Esselstyn, 2007). The doctor further recommends exercise and diet, which are important in the initial phases of managing high blood pressure. Nevertheless, pharmacological management of the condition should be complimented by moderation of lifestyle, while drug regimen should be secondary, especially when lifestyle management fails. Planning and Intervention This should be carefully executed to ensure that the patient and the primary care givers are informed of how to respond to the outcome of the disease in the best way possible. The patient faces uncertainty in adjusting to his condition, and the initial response should be to help him when recovering from the disease. Responding to change is not always easy. It requires dedication, discipline, and commitment. This programme should be executed in a manner that the communication channels are clearly open, which helps in meeting the requirements for continuous education and establishment of necessary referral links. NHS (2013) reiterates that there are many ways to assist in control of complications that arise from coronary heart disease as vital components of the patient education programs. A good education program should aim at ensuring patients are enlightened bout the occurrence, management and prevention of the disease; it should focus on improving patient’s about the disease, fostering positive behavior change, and improving patient outcomes by enhancing quality of life with minimal hospoitalization (Wilson & Mehra, 1997). Dietary management is one of the key components that keep cardiovascular diseases at bay. Diets should be planned carefully to meet the various needs of patients. A healthy diet should have low fat content and plenty in fiber, and vegetables and water (Esselstyn, 2007). The usual rule is to serve at regular times, which should be enriched by a whole grain diet. Salt intake should be low and the patient should avoid foods containing saturated fats, especially animal fats. Exercise should be regular to improve the circulation of blood from the heart to all parts of the body. This helps in maintaining the blood pressure to the required levels and lowering the accumulation of lipids. Further, exercise will help in maintaining the recommended weight, a requirement that should be met in containing the development of cardiovascular diseases. Risky lifestyle increases the predisposition of cardiovascular diseases; hence, the patient should be encouraged to limit alcohol consumption. If they have to take, men should not exceed four units and women are restricted to three units of alcohol consumption per day. NHS further explains the importance of bringing blood pressure under control, which can be achieved through regular monitoring as well as managing weight and the blood sugar levels. Diabetics are recommended to ensure their blood pressure is within the required limits of 130/80mmHg and lastly, they should following strictly the doctor’s prescription if on drug therapy (NHS, 2013). Esselstyn (2007) recommends a careful eating plan that comprises of a tailor-made diet to patients with cardiovascular disease to prevent the risks of hypertension. This programme requires the patient to consume fruits, greens, cereals, and selected proteins, which includes dairy products. Emphasis should be to keep the dietary requirement to a minimum of 2000 calories daily. In this plan, fiber intake should be increased to keep the digestive system functioning normally. These should be complimented by lifestyle moderation measures to ensure the overall goal of managing cardiovascular disease is achieved (Esselstyn, 2007). Various measures may be outlined to prevent high blood pressure. The first step is to encourage the public to have their blood pressure checked regularly. This allows for timely intervention and improves the outcome of life to those likely to be predisposed to the condition. Moreover, a healthy diet with low saturated fats is also recommended. Weight control is necessary; thus, it is important to maintain a healthy weight that can be achieved through exercise. This goes together with maintaining a healthy lifestyle by limiting alcohol consumption and avoiding/quitting smoking (Porta, 2005). Porta (2005) posits that, in the present world, exercise and insulin are the main options for managing diabetes insipidus. The patient should be educated to balance insulin to match the food requirements in order to meet the daily needs. This would greatly benefit from a better diet and blood sugar monitoring. Managing blood pressure and cholesterol should complement life style changes, which should include a healthy diet, increasing exercises, and drug therapy, if needed. The efforts should seek to reduce the possible risks of diabetes. Other interventions include asking the people at risk to quit smoking and if necessary, the health professional may recommend aspirin prophylaxis to reduce the risks of cardiovascular complications. Before embarking on an education plan, the facilitator must ensure the presence of various components of education including “knowledge and psychomotor skills, current level of self-care, preferred learning style, stress factor that could impair learning, social/cultural/religious beliefs, literacy level, readiness to learn and assessment of abilities” (Weinger & Carver, 2008). Family care recognizes that treatment options sometimes may be limited in managing diabetes mellitus. It is thus important to evaluate carefully and treat accompanying conditions. When left untreated, diabetes insipidus may worsen the patient’s condition and severely affect his/her mental state. In public, known cases should be encouraged to wear identity tags, carefully follow the doctor’s advice, and adhere to the doctor’s prescription, if needed. Those on Demopressin - a drug that help regulate the balance of water - should be helped to acquire adequate supply. Nevertheless, diabetics should be trained to carry their water supply in public to prevent dehydration (Weinger & Carver, 2008). Reamy (2009) points to the need for changing diet from poor eating habits to a healthy eating regime in order to control cases of diabetis. Generally, dietary measures alone are insufficient to cut the risk of lowering cholesterols, and thus they have to be integrated with other measures for effective results. An ideal diet should tailor the requirements of the patient to reduce their consumption of red meat, salt, and fats. The diet should comprise largely of starch, fruits, and vegetables with occasional intake of fish. Sterols, for instance, have been known to gradually reduce the risks of bad cholesterols in blood. Lifestyle management of the condition involves cutting on smoking, weight management, regular physical exercise and lowering the intake of alcohol. It is recommended that patients should be educated to ensure their blood pressure is lowered and does not exceed 140/90 if they are below 60 years of age according to the latest guidelines. This should be discussed with patient’s physician. The patient should acquire a BP machine to monitor his blood pressure at home. Stress is regarded as a predisposing factor to high blood pressure; hence, the patient should be educated to reduce anxiety states. Efforts should be made to discuss the dietary needs with the caregiver, and a DASH diet has been known to benefit those suffering from high blood pressure. Before commencing exercise, it is important to consult the expert to tailor one’s exercise needs to his/her requirements (Weinger & Carver, 2008). Patient education in diabetes insipidus should aim to improve their understanding and equip them with capacity to better understand their condition. It is important to include aspect of self-care into their everyday life and make it fit in the education plan (Weinger & Carver, 2008). The outcome of an effective health care programme will include an improvement in knowledge, better health beliefs, and lifestyle modification, which include improvement in exercise, keeping the required weight, and incorporating better practices in health management. Component of good education content for diabetics should inform aspects of good care, incorporating exercises, diet management, prevention of complications, and building understanding on the carbohydrate needs, which should also include making the patient understand the food content in self-stores to inform better eating habits (Rankin & Duffy, 2005). Conclusion Cardiovascular diseases are some the leading causes of deaths in the developed world. Therefore, there is need to ensure that patient education on such conditions becomes a vital component of a national health care plan. The public awareness of the diseases should form an essential plan of medical intervention to empower the vulnerable population who are largely at risk. Community health seeks to inform the rationale of healthy options among people by correcting previous health beliefs that prevent proper health seeking behaviors. Lifestyle changes have been known to benefit the outcome of cardiovascular and other disease conditions, including diabetes and Hyperlipidemia, which is our focus of study. Success in incorporating non-pharmacological measures requires greater patient cooperation; here, a carefully planned patient education programme can largely improve it. References Esselstyn, C. (2007). Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure. NY, USA: Penguin. NHS. (2013) Coronary heart disease. Retrieved from http://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Introduction.aspx Porta, M. (2005). Embedding Education Into Diabetes Practice. Basel, Switzerland: Karger Medical and Scientific Publishers. Rankin, S., Stallings, K., & London, F. (2005). Patient Education in Health and Illness. NY, USA: Lippincott Williams & Wilkins. Reamy, B. (2009). Hyperlipidemia Management for Primary Care: An Evidence-Based Approach. Berlin, Germany: Springer. Weinger, K., & Carver, C. (2008). Educating Your Patient with Diabetes. Berlin, Germany: Springer. Wilson, A., & Mehra, I. (1997). Managing the Patient with Type II Diabetes. Maryland, USA: Jones & Bartlett Learning. Read More