Developing a Plan of Care for a Patient with Type 2 Diabetes and Hypertension

Running head: NURSING
NURSING
Name of the Student:
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Introduction
The essay would develop a plan of care for Mr.Jameson, who had been suffering from
type 2 diabetes and hypertension. The main aim of this essay is to examine the needs and the
evidence based care for patient with complex health and social problems. The clinical
judgement and the decision making will be supported by the national policy guidelines.
While chalking out the care plan the local community needs in relation to the patient will also
be assed in the essay. The essay would commence by providing a brief overview of the case
scenario, followed by a vivid discussion exploring the relevant theories and the concepts
supporting the assessment planning and the delivery of the health care interventions. The
background of this essay would give a descriptive idea of the journey and the life style of the
patient, including the medical cues, past medical history, the present situation, an idea about
the personal and the social history of the patient. The discussion part of the essay would
further review the complex needs of the patient from the biophysical perspective. The essay
would further explain the local community services required for addressing the complex
health care needs of the patient. The essay would also evaluate the role of the nurses in the
assessment and planning of the delivery of health care to the patient and would critically
analyse role of the nurses in providing care the patients with changes in the dependency level
and the health care needs of the patient. All the facts should be supported by the evidence
based literary sources.
Background
The case study is about Mr. Jameson, who is a 63 years old African- Carribean suffering
from Diabetes type 2 and hypertension. Mr. Jameson has had poor glycaemic control and his
glucose level was found to be elevated. On diagnosis the blood sugar level has been found to
be more than the standard level. The BMI of Mr. Jameson is 36, which is towards marginal

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obesity. The blood pressure of Mr Jameson is 190/100 which is much higher than the normal
value. He had been receiving Angiostenin converting enzyme (ACE) inhibitor for many
years. Recently, he had been facing with some problems with his visions. Mr. Jameson had
been working as a long distance lorry driver and have diabetes for long 15 years. He could
not control his diabetes probably due to his work role and hence could not adhere to
medication regimen and had missed several clinical appointments. He did not even bother to
test his blood sugar level regularly in spite of being given a blood sugar testing kit from the
clinic. His father had lost vision for the last few years, which could have been due to high
diabetes and have died of stroke three years ago, that indicates that his father would have
similar conditions as Mr. Jameson. Mr. Jameson is married and has four children from 19 to
35 years old and he is married and stays is a three bedroom house at London. Mr. Jameson’s
diabetes is triggered by his sedentary life style and his inclination towards fried food.
Unhealthy fats, sweetened beverages, processed grains increases the risk of type e diabetes
(Diabetes, U.K.2015). Once he gets back from work, he likes to go to a pub with his friends
and consume lots of fried foods. Jameson’s wife also suffers from type 2 diabetes, but has a
good glycaemic control. Jameson has put on more weight and is a bit depressed, and had been
planning to retire soon. Mr. Jameson’s sedentary life style and living on fried foods has
probably increased the blood glucose level in the patient.
Hence the, clinical priority of Mr. Jameson is, his uncontrolled diabetes and
hypertension. Other comorbidities associated with this are his increasing weight, depression
and impaired vision. Other clinical priorities involves health care access to the entire family
as, since it is known from the case study, Jameson’s wife has also been suffering from
diabetes type 2 and hence education to should also be provided to her , helping her to control
her diabetes . Mr. Jameson, had been working as a lorry driver and he is a father of four
children, which signifies that they were not economically affluent. Nutritious fresh fruits and

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vegetables should be consumed instead of ready-made, fried food (Hsu et al. 2015). It might
be due to his economic constraints that he has to live on fried food and cannot afford fresh
food. Hence the care plan for the patient and the family would be cost effective and should
suit the economic condition of the patient. The care plan should serve beneficial for the entire
family as children might get diabetes due to the shared genetic factors combined with the life
style influences (eating habits and physical activities).
Discussion
Theories
Patients with diabetes are the people suffering from chronic diseases who are adapted
to deal with the varied health care needs and the arising fear. One of the important aspect of
adapting to chronic illness is to screen and take measures during the early stages of the
disease, as this facilitates the acceptance of the disease and the early identification and
management of the potential complications (Buckingham et al. 2017).
Patients suffering from diabetes are afraid of the socio-economic effect of the disease
and the decline of the economic and the occupational status. This can be linked to the fact
that Mr Jameson had been trying to quit his job. According to a study by Papaspurou et al.
(2015), it has been found that drivers with diabetes are faces difficulties while driving which
can be linked to hyperglycaemia.
Huang et al. (2014) have stated that diabetes causes a reduction in the life expectancy
with an augmented rates of mortality and morbidity due to Some health complications linked
to nephropathy, retinopathy, the and neuropathy and the enhanced risk of the diseases like
cardiovascular diseases and poor quality of life. Hence Jameson’s might feel depressed owing
to the fear that he might not live more.