This case study analysis focuses on the healthcare complications of Peter Mitchell, including sleep apnea and weight gain due to diabetes. It provides interventions and goals for improving his health.
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Running head: CASE STUDY ANALYSIS CASE STUDY ANALYSIS (PETER MITCHELL) Name of the student Name of the university Author note
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1CASE STUDY ANALYSIS In the care process for terminally and critically ill patients, the most important and crucial part for healthcare professionals is to understanding the link between the healthcare complications of the patient and then prioritizing specific accurate interventions for them (West et al. 2015). In this aspect, they need to understand the crucial healthcare situation and then identifying the intervention depending on the priority to provide the patient with maximum benefit (Lartey, Cummings & ProfettoāMcGrath, 2014). Clinical Reasoning cycle by Levett-Jones, in this aspect, helps the nursing professionals to understand the healthcare situation of the patient by collecting the healthcare cues and then depending upon the patient's assessment and information, determines the needs or priorities of the patient (Levett-Jones, 2017). In this case study analysis, the case study of Peter Mitchell (52) would be assessed who is suffering from prolonged diabetes, extreme risk factors of sleep apnoea, a breathing disorder, and elevated weight. Therefore, the paper would provide healthcare interventions for the two priorities which are his sleep apnoea due to breathing disorder and weight gain due to prolonged diabetes and depressive conditions. The identification of Peterās healthcare complication would commence with considering his healthcare conditions. Peter Mitchell (52) is suffering from critical type 2 diabetes from 9 years and it has created several distresses in his personal and professional life. Upon suffering from adverse conditions, he was referred by his healthcare professional with insulin therapy and physical activities so that his uncontrolled and poorly managed diabetes condition and extreme weight gain could be controlled. He is a chain smoker and is continuing smoking 20 cigarettes every day for 30 years. He used to work in the Moranbah coal mine; however, due to elevated weight and lower self-esteem, he quit his job because he was very concerned about his āBiggish appearanceā. Besides this, the primary reason he quit his job for, was the commencement of insulin therapy, however, due to an inactive lifestyle and decreased physical activity, improper management of diabetes and social stigma increased his weight gain and increased more than 40kg weight. Socially Peter is unable to connect to his peers and society members because of his prolonged health concern and increased social stigma and despite his two sons, he lacks support mentally. Despite this, it is observed in the case study that he is motivated to overcome his health complications and with proper assistance and guidance, he could overcome his elevated weight. Therefore, these are the considerations that would help to collect cues in the following section. The first clue that is observed as the primary source of all the ailments is the prolonged diabetes condition of the patient. The patient was unable to manage his type 2 diabetes due to
2CASE STUDY ANALYSIS which he started gaining weight and increased all the associated and secondary risk factors. Further, due to inability to manage his insulin therapy with his tedious working hours in the Moranbah coal mine he quit his job and hence, he lost his financial independence, and increased the risk factors related to excessive weight gain, and risk factors for sleep apnoea and cardiovascular disorders (Lu et al., 2015). Further, with the increased sedentary lifestyle, his weight increased uncontrollably and he gained more than 40 kg weight. Moreover, this increased weight was the reason for the increased social stigma, depression, stress and other mental healthcare complications due to which the quality of life decreased and the patient decreased his ability to manage his healthcare conditions. Socially and on family grounds, the patient becomes alone and this is also a severe healthcare complication that increases in this situation. Further, another healthcare cue that is identified form the healthcare condition of Peter was his workplace as Moranbah coal mine was another reason due to which his breathing or airway conditions might arise (Kaminsky et al., 2017). Therefore, this was the healthcare cue that increased his risk of sleep apnoea, the risk of cardiovascular diseases and other crucial and severe health complications. Therefore, these were the healthcare cues that could be identified and collected from the healthcare complication of the patient and hence, it would be used to process the information and then prioritize the healthcare issues that would be targeted for the healthcare improvement of the patient (Lu et al., 2015). Upon processing the above-mentioned cues, it was identified that each healthcare complication of the patient was associated with another and due to increased healthcare complication from one reason; he suffered from another healthcare complication. The patient was unable to manage his severe diabetic condition because he was not aware of the healthcare complication, the management strategy and the medication or preventive measures. Hence, poor management of diabetes was observed (Steven et al., 2014). Further, due to his increased risk of breathing healthcare condition due to his workplace in Moranbah coal mine, he suffered from sleep apnoea and cardiovascular healthcare conditions. He quit his job to comply with the proper insulin therapy however, his sedentary lifestyle and improper lifestyle; he started gaining extreme weight, more than 40 kg. Hence, his prolonged healthcare condition, lack of healthcare condition, healthcare literacy, ignorance of his family members and increased mental healthcare complications lead him to suffer from tremendous physical and mental healthcare conditions (Lu et al., 2015). Hence, it was noticed that due to his mental healthcare and physical inabilities, he was suffering from such complications and depending on these; the healthcare priorities would be developed.
3CASE STUDY ANALYSIS After a thorough discussion of the patient situation, his cues and the processed healthcare information, two of his healthcare priorities would be determined. As per the case study, Peter Mitchellās primary healthcare condition is his diabetes condition as his secondary healthcare complications have resulted from the prolonged diabetes condition. Further, as per Powers et al. (2017), the symptoms of shakiness, overeating, hunger, and other healthcare complication was due to his diabetes and obesity condition. Hence, in this situation, his sleep apnoea and his breathing disorder should be targeted for the first priority for the healthcare complication (Kaminsky et al., 2017). For this, the patient would be provided with effective patient education for crucial breathing exercise, changing the patientās orientation in bed and corticosteroids so that patient and his breathing conditions could be relieved (Lu et al., 2015). Further, the second intervention that would be targeted for the patient and his health complication would be targeting his overweight and condition so that he could overcome his healthcare complication through effective weight loss strategies. Hence, these two healthcare complications would be used for the healthcare improvement of the patient and the achievement of these would evaluate the successful implementation of healthcare interventions. To implement the healthcare interventions in the healthcare process of Peter Mitchell, the interventions should be implemented after developing healthcare goals, The achievement of the first priority, the nursing profession would arrange the weight management training for the patient and then in that training diet and lifestyle training would also be included and the goal would be helping the patient with 2 to 3 kg weight loss in the first month of intervention (Steven et al., 2014). Further, these would also aim to decrease the risk factors of secondary healthcare complications and increased activity of the patient would be targeted (DemarkāWahnefried et al., 2015). As per American Diabetes Association (2015), with increased activity, increased diet, and weight management compliance, the patient is able to control their diabetes condition. Hence, this would be the first goal. The second goal would be implementing pharmacological and healthcare literacy for the breathing concern of the patient so that the risk of sleep apnoea and cardiovascular condition could be avoided. These interventions would also be provided for the 1 month period so that the level of improvement could be assessed and changes in the healthcare goals could be carried out (Jordan, McSharry & Malhotra, 2014). The first action plan that would be used to achieve the first goal would be providing the patient with healthcare literacy so that he could comply with the diet, weight management, and physical activity related healthcare conditions. In this action plan, the first two weeks would be healthcare education for patient information about diet and other important strategies and then
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4CASE STUDY ANALYSIS the last two weeks would be providing physical activity intervention. As per Telio, Ajjawi, and Regehr (2015), healthcare literacy for the patients affected with overweight and the diet regime would help the patient to control his diabetes condition. The patient would be provided with healthcare interventions in two weeks sections so that after learning the strategies, he could apply the intervention in his lifestyle so that he could manage his weight and diabetes condition. Further as per Liu et al. (2017), due to physical activity, and increased quality of lifestyle, he would be able to maintain the mental healthcare condition and the risk of depression and stress would decrease. The second action plan that would be implemented for the sleep apnoea and increased breathing concern would be the application of corticosteroid to relieve the smooth muscles or airway so that breathing complication could be overcome. Further, if the patient is not severely affected with a breathing problem, then he would be provided with breathing exercise and reorientation of his position in bed so that maximum air could be provided to the lungs and he could manage his breathing concerns (Lu et al., 2015). Therefore, application of corticosteroid would be preserved for adverse conditions and without that only patient education, breathing exercises and weight management strategies would be applied (American Diabetes Association, 2015). Finally, evaluation of the healthcare intervention and their effectiveness in maintaining patient condition would be assessed in previous and after method and in the processes prior to the commencement of the program and after the completion of the program, their health improvement of the patient would be understood. Further, CBT assessment would be conducted for his mental healthcare condition and for physical healthcare condition his vital signs would be conducted. Therefore, while reflecting on the healthcare situation, I was able to understand that healthcare complication and its connection with each other that raises the patient complication. Further, I was also able to collect the priorities and implemented accurate interventions with the development of SMART goals and then evaluating them within the specific time period.
5CASE STUDY ANALYSIS References American Diabetes Association. (2015). Standards of medical care in diabetesā2015 abridged for primary care providers.Clinical diabetes: a publication of the American Diabetes Association,33(2), 97.DOI: https://dx.doi.org/10.2337%2Fdiaclin.33.2.97 DemarkāWahnefried, W., Rogers, L. Q., Alfano, C. M., Thomson, C. A., Courneya, K. S., Meyerhardt, J. A., ... & Ligibel, J. A. (2015). Practical clinical interventions for diet, physical activity, and weight control in cancer survivors.CA: a cancer journal for clinicians,65(3), 167-189. DOI: https://doi.org/10.3322/caac.21265 Jordan, A. S., McSharry, D. G., & Malhotra, A. (2014). Adult obstructive sleep apnoea.The Lancet,383(9918), 736-747. DOI: https://doi.org/10.1016/S0140-6736(13)60734-5 Kaminsky, D. A., Guntupalli, K. K., Lippmann, J., Burns, S. M., Brock, M. A., Skelly, J., ... & Warren, P. (2017). Effect of yoga breathing (Pranayama) on exercise tolerance in patients with chronic obstructive pulmonary disease: a randomized, controlled trial.The Journal of Alternative and Complementary Medicine,23(9), 696-704. DOI: https://doi.org/10.1089/acm.2017.0102 Lartey, S., Cummings, G., & ProfettoāMcGrath, J. (2014). Interventions that promote retention of experienced registered nurses in health care settings: a systematic review.Journal of nursing management, 22(8), 1027-1041. DOI: https://doi.org/10.1111/jonm.12105 Levett-Jones, T. (Ed.). (2017). Clinical reasoning: Learning to think like a nurse.Pearson Australia.Retrieved from: https://books.google.co.in/books/about/Clinical_Reasoning.html? id=rwc0MwEACAAJ&redir_esc=y. Liu, N. H., Daumit, G. L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P., ... & Gaebel, W. (2017). Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas.World psychiatry,16(1), 30-40. DOI: https://doi.org/10.1002/wps.20384 Lu, S. R., Hong, R. B., Chou, W., & Hsiao, P. C. (2015). Role of physiotherapy and patient education in lymphedema control following breast cancer surgery.Therapeutics and clinical risk management,11, 319. DOI: https://dx.doi.org/10.2147%2FTCRM.S77669
6CASE STUDY ANALYSIS Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., ... & Vivian, E. (2017). Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics.The Diabetes Educator,43(1), 40-53. DOI: https://doi.org/10.1177%2F0145721716689694 Steven, A., Magnusson, C., Smith, P., & Pearson, P. H. (2014). Patient safety in nursing education: contexts, tensions and feeling safe to learn.Nurse Education Today,34(2), 277-284.DOI: https://doi.org/10.1016/j.nedt.2013.04.025 Telio, S., Ajjawi, R., & Regehr, G. (2015). The āeducational allianceā as a framework for reconceptualizing feedback in medical education.Academic Medicine,90(5), 609-614. DOI: 10.1097/ACM.0000000000000560 West, R., Raw, M., McNeill, A., Stead, L., Aveyard, P., Bitton, J., ... & Borland, R. (2015). Healthācare interventions to promote and assist tobacco cessation: a review of efficacy, effectiveness and affordability for use in national guideline development.Addiction, 110(9), 1388-1403. DOI: https://doi.org/10.1111/add.12998