Assessing Diabetic Problem - Essay Example

DEMONSTRATING NURSING MODEL USING PATIENT ASSESSMENT Introduction I assessed 1Mr. Parker who is 50 years old and working as a manager of Bio-safe Constructions. Mr. Parker came with symptoms that have disturbed him for along time but he has not found the solution. I assessed the patient using Ewles and Simnett's Six Dimensions framework. Physically the patient had a problem of excessive weight. He weighed 99 kilograms and was actually overweight. This had resulted from lack of physical exercises due to his sedentary lifestyle. His height was 1.65". Physically he is experiencing problems of polyuria, polydepsia, sweating, and dizziness. His blood pressure was 150/98. Mentally the patient was disturbed by symptoms of disease that he had been experiencing for along time. He was also very stressed at work due to a busy schedule and had resulted to excessive drinking to address his mental problems. He is also disturbed by the fact the he cannot stop smoking. He is chain smoker. Emotionally the client was stable although he showed instances of emotional disturbances. He appeared stressed and thoughtful. He did not have any signs of emotional flare up and was relatively calm. Socially the patient was stable as he showed that he integrated with people at the place of work and outside the work place. Being a manager, the patient interacted with a lot of people. He did no show any signs of social problems. He is a member of two social clubs. Spiritually the patient was stable. He was a follower of Catholic Church and a leader in their church. He did not have any spiritual problem and believed that God would help him heal. In the context of the society, the patient has a stable social life. He is contented with the position he holds in the society being a manager. His relationship with other societal members is also very stable. Care Plan Using the Orem Model of nursing if assessed Mr. Parker to get more information about the development of type II diabetes. Using the following interpersonal skills, I was able to assess Mr. Parker further to get more information concerning his problem. (a) Therapeutic communication I my assessment I was able to talk to Mr. Parker in a way that I showed him that there was a way out of the problem. Therapeutic communication in nursing dictates that you talk to the patient using constructive words which give the patient the hope to recover. The communication process should encourage the patient to the recovery path rather than portraying a doom about their conditions. Mr. Parker had a believer that his life would turn out to be very difficult since he had been diagnosed with a terminal diseases. To get more information about him in order to get the root cause of the disease I created a confidential atmosphere to Mr. Parker by assuring him that there was need to give me all his information in order for me to come up with the best nursing strategy for him to help him solve the problem of smoking and drinking. (b) Active listening To get more information from Mr. Parker, I had to listen to attentively and logically try to connect all the information that he gave me. As I listened to his story I realized that Mr. Parker's problems did no stop with excessive drinking and smoking. His problems went further to include nutritional problems and lack of physical exercises. I realized that being a manager, Mr. Parker was always busy from early morning to late hours working for his company. He lacked time to have physical activities and time to have healthy diets. Through active listening, I was able to gather all the information from him and at the same time related the information to get the root cause of his type II diabetes. (c) Conveying knowledge and information As we talked, I explained to Mr. Parker the relationship between his problems. I explained to him why he had developed the condition owing to his lack of exercises, lack of healthy diets, excessive drinking and smoking. I explained to him that eating junk foods leads to accumulation of fat in the body. Junk food contains calories alone and I explained to that his calorie consumption did not match his calorie spending which led to increased weight. This weight was responsible to development of insulin resistance and consequent development of type II diabetes. I also informed him that excessive smoking and drinking could lead to heart problems and hence there was a need to stop both immediately. Through this parting of vital information, Mr. Parker was able to understand the development of his condition and the subsequent danger that was poised by the smoking and excessive drinking. (Benner et al., 1996, p. 56) (d) Developing rapport and trust with the patient Developing trust and building a rapport with the client is very important if a nurse has to get information from the client. It creates a friendly between the client and the nurse. To get information from Mr. Parker, I had first to introduce myself to him and explain to him who I was and why I wanted to talk with him. I asked him to trust him with the information that he would confide to me and further explained to him that this would be between me and him alone. I had to help him build confidence to tell me what I wanted to know from him. In response I was able to get some very vital information about his lifestyle and told him what I would help him to do. This was very important considering that Mr. Parker is a manager of a big company and may not be used to confiding with people of my calibre. (Kozier et al., 2004, p. 789) (e) Ethical consideration While assessing Mr. Parker, there were some ethical considerations that I had to take into consideration. First of all I made sure that Mr. Parker was in a good state of mind to give me information. This was important to make sure that I got the correct information from him. I also made sure that I did not get too deep into his life such that he could have felt like I was interrogating him. I had to enquire from him only the most important information that was of help to me. I did not have to go deeply to his life. (Kozier et al., 2004, p. 789) From all the information I gathered from him, it was enough for me to make a conclusion about his condition. I realized that his problem started from his busy life. I saw how various lifestyle factors related to cause the current condition that Mr. Parker was experiencing. From the information I learnt the he had a busy schedule all day long. This made him rely on junk foods and also drank a lot of beer. I concluded that he had a nutritional problem that he had to address if his condition was to improve. Planning a healthcare program In planning his nurse care, I realized that Orem model would be the best to provide care for the patient since it would provide for primary care for the patient and also emphasizes rehabilitation where the patient would be independent from me. This would help address the expressed and normative needs of the patient. This was the best model for solving the nutritional problem that Mr. Parker was facing. I informed Mr. Parker that the improvement of his condition depended on his wish. If he felt that he wanted to improve he had to improve on the problems that I informed him about. I made sure that Mr. Parker understood his problem and also the remedies for his problem. (Heitman and Kramer 1998, p. 40-44) Using the developmental self care requisites, I informed Mr. Parker that the improvement of his condition depended on the need for development of his individual health. I only had to help him to readdress his problems and improve his condition. Using the model I realized that there was little I could do about his condition without his input. His problem was more than the health care facility could do for him. Through individual development there was a way out. (Perry and Porter 2001, p. 43) According to Fitzerald (2004, p. 76), educative and supportive modalities and partial compensation were the best one to use in supporting Mr. Parker to improve his physical aspect of heath. Through necessary educative and support, Mr. Parker can deal with problems leading to his physical problem. The assessment model can be described as follows: Air (supportive/educative) - Educate him on the complications like heart diseases that can result from increased cigarette smoking with his diabetic condition. Water (supportive/educative) - Making sure that he is hydrated enough to prevent risks of hyperglycemia or polydepsia. Food (Partial compensation) - Provide a clearly planned diabetic diet that will lead to lowering his blood sugar levels. This would also involve monitoring his blood sugar. Activity (educative/supportive) - Inform the client on the need to have regular physical exercise to help in blood flow, lower blood sugar, lose excess weight, and improve heart condition. (Bulfin and Mitchell 2005, p. 315) Social care (partial compensation) - Talk to Mr. Parker now and them to help reduce tension in him and encourage him to recover quickly. Hazard prevention (Partial compensation) - Inform him of the need to take insulin injection regularly and take to other medicines as prescribed. Ensuring normality (partial compensation) - Collaborating with other medical staff to provide the best recovery regime for him. Assessing diabetic problem According to Keith and Bennett (2002, p. 44-58), diabetes is a condition that leads to accumulation of blood sugar leading to high blood sugar in the body. In assessing diabetes condition in a patient, one must take not of the obvious symptoms of diabetes. These include polyuria which is frequently urination, polydepsia which is frequent thirst, and excessive hunger. Once a patient shows these symptoms, then one should asses the blood sugar level. If the blood sugar is above 7mg/l, the patient should be diagnosed with high blood pressure. If a patient is diagnosed with high blood sugar, then the blood pressure should be assessed. A blood pressure of above 130/80 mm/Hg should be considered a danger to a diabetic patient since into can lead to high blood pressure. In caring for the patient, the blood pressure, the blood sugar should be continuously assesses to check on improvements. (Green and Dougall 2002, p. 35-40) References Benner, P., C, Tanner, & C, Chesla, 1996. Expertise in nursing practice - Caring and ethics, pp. 56. New York: Springer. Bowling, A., 1995. Measuring Health, pp. 67. Buckingham: Open University Press. Bulfin, S. & G, Mitchell, 2005. Nursing as caring theory: Living Care in Practice. Nursing Science Quarterly, Vol. 18, Issue 4. pp 312-317 Fitzerald, M, 2004. Nursing models for practice, pp.76. University of Newcastle, Australia. Green, S. & T, Dougall, 2002. Assessing and screening the nutritional. Journal of Advanced Nursing, Vol. 14(2): 35-40 Heitman, B. & A, Kramer, 1998. Creating a clinical practice development model. American Journal of Nursing, Vol. 98(8): 40-44 Keith, R. & J. A, Bennett, 2002. Assessing Diabetes patient's healthcare needs. The Diabetes Educator, Vol. 28(1): 44-58 Kozier, B., Glenora, E., A, Berman, & S, Snyder, 2004. Fundamentals of nursing: Concepts, Process and Practice, pp. 789. McGill University. Perry, A. & P, Potter, 2001. Canadian fundamentals of nursing, pp. 43. Toronto: Mosby From: Customer to Writer Date: 2008-01-25 17:40 Read More