Educational Plan for MK with Multiple Comorbidities

MK is a patient with multiple health conditions including diabetes, hypertension, chronic kidney failure, asthma, and severe milk protein allergy. She experiences symptoms such as chills, cough, difficulty breathing, and headache. To manage her condition, she must control her weight, engage in regular exercise, follow a balanced diet, and avoid triggers for asthma. Additionally, she must take prescribed medications including Humulin insulin and Advair 100 mcg. The priority nursing care diagnosis is maintaining her oxygen saturation level, with short-term goals including keeping oxygen saturation high and evaluating potential medication allergies. Long-term goals include weight loss, increased physical activity, and a proper dietary schedule.

CASE STUDY 1
CASE STUDY
Student Name:
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Course Name:
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Faculty Name:
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CASE STUDY 2
1- MK is a 70 years old African American female. She is in advanced age which makes her
prone to many disease condition. The common diseases as per ethnicity from which she is
affected are Asthma, Hypertension, Type 2 diabetes and chronic renal failure. (Mullings, L.
(2014).
2- There are many modifiable risk factors for her. She is overweight as per her height.
Overweight is a huge risk factor for not only diabetes but also hypertension. She needs to
control her weight. She is also asthmatic and hypertensive. MK can also go for some
physiotherapy to increase her mobility. Her sedentary life contributes to weight gain.She
needs to take care of her diet. As she requires a low salt and highly nutritious diet.
(Gansevoort et al 2013)
3- Patient came with the complaint of episodes of dizziness and confusion. Patient has an
oxygen saturation of 91%. The Normal levels are from 95% -100%. Low oxygen saturation
might cause the episodes of dizziness and confusion. Also patient is having high BP.
Dizziness can be due to high BP and a side effect of its medication.
In terms of nursing care, it is primarily important to maintain oxygen saturation level as it is
on borderline. The patient needs to be on bed rest to reduce the demand for oxygen by the
body. Oxygen therapy has to be maintained as prescribed. Also to consult an appropriate
health care provider if there is any impairment or the condition worsen.
4- The current condition of the patient is an episode of dizziness and confusion which lasts
for 20minutes. The patient’s oxygen saturation was 91%, which is borderline. Also patient is

CASE STUDY 3
under medication for hypertension and chronic renal failure. Hypertension and chronic renal
failure medication cause side effects like dizziness. This confirms the initial diagnosis.
There may be a requirement of CT scan to evaluate the possibility of stroke. Also as the
patient is present with edema in lower extremities and having chronic renal failure, we
require suggesting for a Kidney function Test.
5- MK is having BP 172/94, normal range is 120/80. The BP is on a higher side. Also,
Pulse is 96, normal pulse ranges for 70years old female will be 60-80. Here the pulse can be
considered high at 96bpm.The oxygen saturation is at borderline 91%. The normal range is
95%-100%. The normal respiratory rate is 16-20. In MK’s case, it is slightly higher at
22.Also, the urinary output is very low 200/ml against the 24 hours normal 2.9 l/day
The following vitals clearly show that MK is having low oxygen saturation causing her
dizziness and confusion. It can be also side effects of the medicines she is taking. Also, pulse
rate and respiratory rates are at the higher side confirming the primary diagnosis. It is
expected with a patient with this diagnosis.
6- Nephrovite- It is a dietary supplement for MK for chronic renal failure. It is used to treat
the poor dietary condition. It might cause a mild stomach upset. But in severe allergic cases it
may cause rashes, dizziness and trouble breathing. It is important to check for this particular
drug allergy by skin test.
Hydrochlorothiazide-This used for the treatment of high blood pressure. It is a diuretic and
does not allow the body to hold much salt which can cause fluid retention. It will help MK to
control hypertension and edema. As a side effect, it may cause pulmonary edema also it there

CASE STUDY 4
can be increased the risk of cholesterol gallstone formation. This drug should not be taken if
the patient is not able to urinate.
Enalapril- This is also used to treat high blood pressure. In MK’s case, it will relax her blood
vessel so that normal blood flow can take place. The main side effects are dizziness and dry
cough. The patient needs to be tested for allergic conditions before taking this drug.
Fluticasone/vilanterol (Breo) 100mcg- This is a bronchodilator used for relaxing muscles. As
MK is having asthma this drug is being prescribed to her. The common side effects are body
pain, chills, cough, difficulty in breathing and headache. Before this drug is prescribed patient
must be tested for severe milk protein allergy.
Humulin insulin- It is a short acting insulin. It works for 24hours. It is given for proper
diabetic control and keeping sugar level low. In the case of side effect it can cause itchy
rashes, trouble breathing, wheezing, rapid pulse, sweating. There can be a skin prick test to
evaluate humulin insulin allergy.
Advair 100 mcg- This is used to prevent asthma attacks.MK is having asthma hence this
medicine is prescribed to prevent any attack. This prevents the release of substances in the
body causing inflammation. Acts as a bronchodilator and prevents attacks. The common side
effects are upper respiratory tract infection, pneumonia and headache. It may unmask allergic
conditions which were suppressed early in life.

CASE STUDY 5
7- Educational Plan for MK
- She will be advised to control weight as it is necessary to keep all her underlying health
conditions especially diabetes in check
- MK will be advised for physiotherapy so that she can be physically more active
- She has to consume a balanced, nutritious and low on the salt diet. This will help her
keeping her weight, and hypertension under control.
- She must stay away from the triggers of asthma.
- Patient family members must encourage the patient for some regular exercise also the
family can help MK to consume a balanced diet as suggested by a dietician.
8- Priority Nursing Diagnoses- The priority nursing care diagnosis for MK will be
maintaining her oxygen saturation level. As it is on borderline. Inform the concerned medical
practitioner about any change in patient’s condition. Keeping a record of MK’s all changing
vitals
Patient centred Goals- In MK’s case, the goals will be short term and long term. The
short term goals will be keeping the oxygen saturation high. Evaluating if she is allergic to
some medicines of her prescription. Long term goals will include Weight loss and increased
physical activity. Also, a proper dietary schedule needs to be followed.( Taenzer et al 2014)
Interventions for each Goal- The intervention for the short term goal will be to keep a proper
record of MK’s condition and contact the treating physician in case of any emergency.

CASE STUDY 6
Intervention in case of long term goal will be preparing a proper diet and weight loss chart for
MK. Also, she requires physiotherapy so that she can do some minor exercises.
Evaluation- Proper evaluation of MK’s condition is necessary. It is necessary to know the
cause of dizziness as it can due to drug allergy. Also, she needs to check her hypertension as
her BP was on a higher side. Her urine output is very low. The condition of her kidneys needs
to be evaluated
Nursing care plan for MK
- As MK is diabetic there will be regular check up for keeping blood sugar normal
- Proper weight management is required to keep all the underlying health problems in check
- A balanced diet is required as she is having Diabetes, hypertension and chronic kidney
failure. All these diseases required following a specific diet.
- As MK is having asthma it is important to control her allergies and triggers for asthma
- Educate MK about her condition and why she requires severe lifestyle changes for a better
life.( Haas et al 2013)

CASE STUDY 7
References
Mullings, L. (2014). On our own terms: Race, class, and gender in the lives of African-
American Women. Routledge.
Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., ... & McLaughlin, S.
(2013). National standards for diabetes self-management education and support. Diabetes
care, 36(Supplement 1), S100-S108.
Taenzer, A. H., Pyke, J., Herrick, M. D., Dodds, T. M., & McGrath, S. P. (2014). A
comparison of oxygen saturation data in inpatients with low oxygen saturation using
automated continuous monitoring and intermittent manual data charting. Anesthesia &
Analgesia, 118(2), 326-331.
Gansevoort, R. T., Correa-Rotter, R., Hemmelgarn, B. R., Jafar, T. H., Heerspink, H. J. L.,
Mann, J. F., ... & Wen, C. P. (2013). Chronic kidney disease and cardiovascular risk:
epidemiology, mechanisms, and prevention. The Lancet, 382(9889), 339-352.