Evidence-Based Practice - Diabetes Mellitus Type 2, Hypertension, Obstructive Sleep Apnea, Inguinal Hernia Repair, Hyperglycemia, Hypercholesterolemia - Coursework Example

Evidence Based Practice Student’s name Institution Introduction Evidence based practice is a critical component in ensuring effectiveness of health care outcomes. Different populations and persons will have different histories and vulnerabilities towards certain illnesses and diseases (Deutschman & Neligan, 2010). As such it is important to take into account medical history and evidence regarding individual persons and populations in determining critical histories in nursing practice. Nursing practice that does not take into account all these aspects will be ineffective in prescription of medicine and medication which may worsen conditions or even result into death. Diabetes Mellitus Type 2 Aboriginal populations have the highest vulnerability to developing type 2 diabetes mellitus among Australians. This is the most important of aspects that the nurse needs to take into account before making any interventions (Hall & Roussel, 2014). Mr. Armitage is an aborigine and hence is highly susceptible to developing complications with this type of diabetes. A five year history of poorly controlled diabetes mellitus makes this a critical aspect that the medical practitioner needs to focus on. The incidence of diabetes mellitus is 6 times higher in aborigines and Torres Strait islander communities as compared to other Australians (Penn, 2008). This incidence increases from the age of 35 and peaks at ages between 45-54. Mr. Armitage is an aborigine and he is aged 50 years which means he is in a high risk age group for enhanced effects of diabetes mellitus. This makes this the most critical component for the nursing professional to consider in treating Mr. Armitage. However if this illness has been treated well there should not be complications. Nevertheless if the patient has not received adequate treatment this may preclude them to development of coronary related complications (Bunker et al., 2013). It is thus critical for the nursing professional to analyze the history of the treatment of Mr. Armitage since this would help determine what further medication is needed to correct the errors of the past five years. Hypertension His history of hypertension ought to be taken into account in treatment. Aborigines and Torres Strait Islanders also have high susceptibility to hypertension. Having a personal and familial history of coronary heart disease is a critical indicator of what Mr. Armitage is likely to suffer from. His father died of a myocardial infarction (heart attack) aged 78 while his uncle died of a heart attack aged 72. Hypertension is highly correlated to familial history in this population and hence Mr. Armitage has high vulnerability to the same (Hu, 2010). Given that Mr. Armitage is involved in highly stressful work which involves daily one hour commute from his home to his grocery store he may increase hi likelihood of suffering the same. However, given that his father and uncle died aged over 70 years from their coronary related diseases Mr. Armitage may not be in any immediate danger from myocardial infarction. However having a personal history of hypertension may complicate issues further and hence there may be a need to analyze all these factors further in order to prevent them worsening. A nursing professional needs to be proficient in analyzing the histories of hypertension in the family and how these may genetically influence the incidence of coronary heart diseases in Mr. Armitage (Melnyk, 2007). Obstructive Sleep Apnea Obstructive sleep apnea is critical in this instance as related to heart related diseases. Mr. Armitage having a high risk of complications related to coronary diseases has an even heightened susceptibility due to his history of sleep apnea (Mulrow, 2011). His history of sleep apnea may result in complication such as stroke, heart arrhythmias, high blood pressure and heart failure. His history of high blood pressure precludes him to the development of sleep apnea. Sleep apnea has been established to be more prevalent among African Americans, Hispanics and Pacific Ocean Islanders which makes him highly susceptible (Smith et al., 2012). It is critical for the nursing professional to look to whether Mr. Armitage has had treatment for his sleep apnea. It is also important that any precluding factors such as obesity, drinking and smoking lifestyles are recorded. If the patient is found to be involved in any negative lifestyles they ought o be dealt with through counseling. There needs to be physical and medical interventions in order to reduce the risk of obesity, weight gain, diabetes, stroke and clinical depression which increases the risk of cardiovascular disease (Maljanian et al., 2012). It may be as a result of poor medication that Mr. Armitage has developed obesity and diabetes which make him more susceptible to heart disease. Inguinal Hernia Repair Mr. Armitage has a history of hernia and had an inguinal hernia repair ten years ago. A hernia while not necessarily a cause of concern for a man like Mr. Armitage becomes crucial due to his hypertensive history. Hernia usually results from the weakening of muscles resulting in some organs such as the intestine penetrating into the inguinal canal. It may be that the patient has weakened muscles as a result of his sleep apnea which resulted in his hernia problems (Melnyk et al., 2014). However, while in itself hernia is not necessarily a critical condition, it may result in other related complications which Mr. Armitage is highly susceptible to. Hernia medication may call for the use of invasive or non invasive surgery which may result in the formation of blood clots which enhances the risk of cardiovascular disease and complications. The risk of hernia reoccurrence is very real especially if his sleep apnea was not treated well enough. As such the history of how severe the hernia was and how invasive the surgery was will be critical information the nursing practitioner needs to obtain from the patient. This is critical since if hernia were to reoccur, given the multiple issues of obesity, hyperglycemia and hypertension that Mr. Armitage has he may be highly susceptible to heart attack (Deutschman & Neligan, 2010). Hyperglycemia Mr Armitage has had a long history of hyperglycemia having had the symptoms for over two years. Hyperglycemia is a condition which for the most part is as a result of lifestyle choices (Hall & Roussel, 2014). The patient’s lifestyle and the type of food consumed would be important to take into consideration. Mr. Armitage works at his grocery store and lacks any meaningful exercise besides driving to the store. His hyperglycemia may be as a result of his sedentary lifestyle which may result in him being overweight. It is important to know if he has been receiving treatment for the hyperglycemia since lack of treatment may result in kidney, heart and nerve complications. Emotional conflict, work and family stress are leading causes of hyperglycemia (Penn, 2008). Mr. Armitage may have emotional conflict having to be alone most of the time with his daughter living interstate and the other studying part time leaving him mostly alone and maybe feeling unwanted. Being inactive and having had inguinal hernia surgery precludes him to the development of hyperglycemia. The nursing professional therefore has to determine familial history regarding his workplace and personal relations with his family which could be influencing hi hyperglycemia. Hypercholesterolemia This is a condition characterized by high blood cholesterol levels. Mr. Armitage is suffering from hypercholerolemia which makes him a high risk person for the development o coronary artery disease. This makes him very susceptible to the clogging of arteries which may result in the formation of blood clots or the buildup of pressure that may result in him having a heart attack. If the hypercholesterolemia is inherited he is likely to develop other conditions such as tendon xanthomas (Bunker et al., 2013). However familial hypercholesterolemia is not common among the aborigines and hence his may be easily treatable. Nevertheless familial origins cannot be ruled out since hypercholesterolemia is usually a combination of genetic and environmental factors including lifestyle choices. The patient has been living a very sedentary lifestyle in which he spends most of his days at the grocery store hardly exerting himself apart from driving himself there. Since he is diabetic and possibly obese there could be a correlation between these conditions which are resulting in his hypercholesterolemia. While all indications are that Mr. Armitage’s condition is from environmental and lifestyle factors it is important to note that familial hypercholesterolemia may be as a result of recessive autosomal genes (Hu, 2010). It is thus critical for the nursing practitioner to determine the history of the parents in order to determine incidence of recessive hypercholesterolemia genes. Conclusion Professional nursing calls for evidence based practice in the determination of best and effective action to take for each patient. It is critical that the nursing professional be conversant with the histories of the patient whom they are dealing with. Academic knowledge of the conditions presenting themselves in the patient and precluding conditions which impact the given illness are critical in evidence based practice. The practitioner has to analyze and seek out different explanations in seeking to understand a given patient. Th treatment of some conditions such as coronary heart diseases calls for good knowledge of all factors influencing the illness including causes, risk factors, prognosis and how all these contained in patient history can lead to the making of clinical decisions.. As such evidence based practice is a critical component of effective nursing practice. References Bunker SJ, Colquhoun DM, Esler DE, Hickie IB, Hunt D, Jelinek VM. (2013). “'Stress' and coronary heart disease: psychosocial risk factors.” National Heart Foundation of Australia position statement update. Med J Aust, 178:272-6. Deutschman, C. S., & Neligan, P. J. (2010). Evidence-based practice of critical care. Philadelphia, PA: Saunders/Elsevier. Hall, H. R., & In Roussel, L. (2014). Evidence-based practice: An integrative approach to research, administration, and practice. Burlington, MA: Jones & Bartlett Learning. Hu, D. (2010). Evidence-based cardiology practice: A 21st century approach. 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(2012). “Prevalence of hypertension in Kimberley Aborigines and its relationship to ischaemic heart disease: an age-stratified random survey.” Med J Aust, 156:557–62. Read More