Background
Question:
Discuss about the Clinical Performance of Blood Glucose.
The need for redesigning primary health care model to incorporate wide health care access is paramount. Public health nurses are in a position to take care of direct relationship roles which focuses them to understand the history of the patient, family and priorities of health care. The primary goals of primary health care nursing is to incorporate principles of Alma- Ata declaration of ensuring complete physical, mental and social well being of persons, (Dunphy et al, 2015). Nurses have professional, legal and ethical guidelines which entailed satisfactory knowledge which functions well in health care protection of patients. Community health care nurses currently in Australia are working within community settings, occupational settings, general practice and various patient settings platforms. Their roles are promoting health, preventing illness, caring and treatment of the sick and public health, (Townsend & Morgan, 2017). Clinical assessment in the case study has been done using Levett-Jones clinical reasoning model which allows for comprehensive assessment of the patient, (LeMone et al., 2015).
The patient is a 52 year old male patient having mild obesity and type II diabetes admitted to the medical ward with poor diabetes management, obesity ventilation and sleep apnea, he has elevated levels of shakiness, hunger, high blood glucose levels and breathing difficulties coupled with sleep disorder. As part of discharge plan, the following two nursing interventions have been formulated to assists the recovery process of the patient are; smoke cessation recovery for the patient and regulation of blood glucose levels through regular checks. This essay thus will focus on this key two nursing strategies as a community nurse to promote recovery of the patient.
Patient Peter currently has a multiple of risks factors which predispose to many risks associated with type 2 diabetes management. The patient is overweight and often feels fatigued. He has lost his social status due to the obesity issues surrounding his heath. He currently taking insulin Novomix 30B.D , Metformin, Lisinoril, Metaprololl and Nexium medication and has obesity despite the decline from the previous assessments, (Cheng et al, 2017).
Risks factors associated with type II diabetes for the patient relates to weight factors as assessed. Presence of excises fat to the patient exacerbates the responsiveness of if cells to the effects of insulin. Thus this is the reason as to why approximate to 80% of the people develop type 2 diabetes.
The main nursing goal for the patient is to teach the patient to lower the weight levels he is currently. Reducing weight reduces the effects of the disease on the body state.
Action plan is to managing type II diabetes for the patients calls complete patient assistance towards recovery phase. the patient as part of managing type II diabetes at home there is need teach the patient exercise sand offer home care support to facilitate this. Further encouraging and drawing a meal plan for the patient with assistance from nutritional department will be key to ensure that the patient is always maintaining health weight gain, (Rintala et al, 2013).
Case study overview
Thus appropriate actions will be to support the patient at home and further engaging small exercise activities since he is living in isolation’s a community health worker nurse, involving other persons of interest is key for the patient, linking the patient with community health worker to facilitate in the nursing strategies are key to address the needs of the patient, (Ross et al, 2015).
In supporting the patient monitoring and evaluation plan, providing the patient with blood glucose testing kit is essential for close monitoring of blood glucose is key. Taking regular reading s is key assessing HbA1C tests is essential for close monitoring the blood glucose levels regularly. Assesment of high measurement readings for the patient informs the community health care nurse on adjustment of diabetes treatment plan, (Setford et al, 2017).
Teaching the patient how to the take blood glucose measurements is key. Empowering him to do so is crucial in ensuring that the patient is equipped to handle and manage the disease. Supporting insulin therapy plan for the patient is key so as to adjust lifestyle management practices such as exercises and reducing stress levels of the patient, (Seaquest et al, 2013).
Thus supporting the patient on weight management and control of type I diabetes is key for the recovery process. As a health care nurse adherence and offering support to the patient is paramount so as to ensure that health recovery promotion is achieved.
As a community health, nurses reducing the risks factors associated with type II diabetes is key so as not to lead to development of other medical conditions such as cardiovascular disease to the patient. Patient Peter has presented to the GP with symptoms related to high or elevated blood glucose levels, increased hunger and difficulty in breathing. Further on his social aspect, the patient states that he has been smoking for the last 30 years with an average of 20 cigarettes per day. The social assessment of the patient reveals willingness to quit smoking and engage in healthy full life. As nurse supporting the patient in this recovery phase is critical insuring that the patient quit smoking, (ADA, 2015).
The role of a nurse is essential in smoke cessation interventions. Community health nurse makes up the largest of health care workers who interact with the patients outside especially those with lower socio economic status. The nurse ensure that provision of opportunistic and health promotion avenues for the patens. Enabling therapeutic relation for the patient is key to ensure the patient is well supported and advised on progress.
The goal for the patient is to ensure that smoke cessation is achieved through patient education and supported recovery process. Smoking increases the risks of further disease and other smoke related conditions which include lung cancer. Thus as health care nurse it is necessary to support patient Peter on effective treatment plan.
Nursing intervention for smoke cessation advice for the patient is incorporate counselling techniques and offering counselling to the patient and further expounding on strategies for smoke cessation.
Nursing goals and strategies
Nurse plays a critical role in managing the patient smoking habits. They often interact with the patient which gives them an upper hand on smoke cessation. In reference to clinical practising guidelines, patient soften need the health care nurses to assist them in ensuring they engage in smoke cessation plans. A review done indicates that adults who often receive advice from nurses to quit smo0king have higher chances of quitting smoking. Nurses are at the fore front in ensuring that they work and interact with the patients daily. Incorporating this on care plan for the patient by ensuring smoke cessation intervention is key in initiating smoking cessation for the patient, (Ramo et al, 2015).
Smoke awareness cessation makes the nurses and other health care practitioners to intervene on smoke cessation. Thus it is critical to increase awareness and initiate smoke cessation to the patient.
Nursing intervention for the patient to manage this strategy are to incorporate the following 5 As; Ask the patient on the tobacco use- this has shown that the patient has been smoking for the last 30 years smoking 20 cigarettes per day, Advise the patient- the patient is convinced to quit smoking thus needs the support of the nurse to implement the strategy plan. Nurse ought to assess the patient plan to to quit and motivate him on genuine conviction for smoke cessation and lastly is to ensure that the patient status is assessed. The community health nurse ensures that the above five interventions are adhered to so as to ensure that the patient adheres to treatment plan and quit smoking, (Siu, 2015).
Applicable motivation strategies to be utilised include assessing the relevance of quitting for the patient, assessing the potential risks associated, assessing the rewards to the patient, identify barriers to the patient and enhance repetition at every step. These strategies are to strengthen the patient and nurse to ensure that patient centred care is delivered. The intervention support for the patient is to ensure that the patients is supported through cessation strategies by starting on reduction of number of cigarettes sticks per day smoking and then lowering down to lower levels as time goes by, (Taylor et al, 2014).
The nurse plays critical role in ensuring that the patient gets the adequate support needed and resources to quit smoking. Offering counselling for the patient and often home visits are key to ensure that they quit and feel supported for smoking, (Stead et al, 2016).
In evaluating this outcome for the patient, as nurse assessing the smoking rates reduction is relevant. There is need to ensure that the number of cigarettes smoked per day are reduces and alternative avenues are given to the patient. Continuous support for the patient is geared for the patient to feel supported and acknowledged in the program. Ensuring that the patient gets enough dietary plans is ensuring that the patient receives well and managers type II diabetes effectively, (Kim et al, 2015).
Reflectively on this aspect, most smokers just like Patient Peter, at times know the dangers of smoking, however they lack support on how to quit smoking. Patients who smoke often go through relapse stages and remission, motivating them to quit smoking is key to. As nurse there is a need to ensure that resources and support to the patient is facilitated. Appropriate counselling and community based approach to be offered t home is key to ensure that urges of smoking habits are lowered. Thus public health community nurse play critical role for patients like Peter who want to smoke but lack the necessary support to initiate the process.
References
Cheng, L., Sit, J. W., Choi, K. C., Chair, S. Y., Li, X., & He, X. L. (2017). Effectiveness of Interactive Self?Management Interventions in Individuals With Poorly Controlled Type 2 Diabetes: A Meta?Analysis of Randomized Controlled Trials. Worldviews on Evidence?Based Nursing, 14(1), 65-73.
Kim, S. S., Kim, S. H., Fang, H., Kwon, S., Shelley, D., & Ziedonis, D. (2015). A culturally adapted smoking cessation intervention for Korean Americans: a mediating effect of perceived family norm toward quitting. Journal of Immigrant and Minority Health, 17(4), 1120-1129.
Ramo, D. E., Thrul, J., Chavez, K., Delucchi, K. L., & Prochaska, J. J. (2015). Feasibility and quit rates of the Tobacco Status Project: A Facebook smoking cessation intervention for young adults. Journal of medical Internet research, 17(12).
Rintala, T. M., Jaatinen, P., Paavilainen, E., & Åstedt-Kurki, P. (2013). Interrelation between adult persons with diabetes and their family: a systematic review of the literature. Journal of Family Nursing, 19(1), 3-28.
Ross, S., Benavides?Vaello, S., Schumann, L., & Haberman, M. (2015). Issues that impact type?2 diabetes self?management in rural communities. Journal of the American Association of Nurse Practitioners, 27(11), 653-660.
Seaquist, E. R., Anderson, J., Childs, B., Cryer, P., Dagogo-Jack, S., Fish, L., … & Vigersky, R. (2013). Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. The Journal of Clinical Endocrinology & Metabolism, 98(5), 1845-1859.
Siu, A. L. (2015). Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: US Preventive Services Task Force recommendation statement. Annals of internal medicine, 163(8), 622-634.
Stead, L. F., Koilpillai, P., Fanshawe, T. R., & Lancaster, T. (2016). Combined pharmacotherapy and behavioural interventions for smoking cessation. The Cochrane Library.
Taylor, G., McNeill, A., Girling, A., Farley, A., Lindson-Hawley, N., & Aveyard, P. (2014). Change in mental health after smoking cessation: systematic review and meta-analysis. Bmj, 348, g1151.
Setford, S., Grady, M., Phillips, S., Miller, L., Mackintosh, S., Cameron, H., & Corrigall, K. (2017). Seven-Year Surveillance of the Clinical Performance of a Blood Glucose Test Strip Product. Journal of diabetes science and technology, 11(6), 1155-1162.
American Diabetes Association. (2015). 4. Foundations of care: education, nutrition, physical activity, smoking cessation, psychosocial care, and immunization. Diabetes care, 38(Supplement 1), S20-S30.
Dunphy, L. M., Winland-Brown, J., Porter, B., & Thomas, D. (2015). Primary care: Art and science of advanced practice nursing. FA Davis.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
LeMone, P., Burke, K., Dwyer, T., Levett-Jones, T., Moxham, L., & Reid-Searl, K. (2015). Medical-surgical nursing. Pearson Higher Education AU.
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