Case Study on Peter Mitchell

Running head: CASE STUDY ON PETER MITCHELL
Case Study on Peter Mitchell
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1CASE STUDY ON PETER MITCHELL
Prioritization of care in severe patient healthcare conditions is the effective
mean using which healthcare professionals could understand the patient situations
which should be targeted to provide them with rapid and effective treatment (Morley
et al., 2014). In this aspect, the Levett- Jones clinical reasoning cycle helps to identify
the patient crucial conditions and then by collecting the cues identifies the priority
areas upon which action plan related interventions should be applied (Giger, 2016). In
this essay, the prioritisation of nursing care for Peter Mitchell has been discussed
with the application of clinical reasoning cycle of Levett Jones. It is identified that
Peter is suffering from poorly managed diabetes (since last 9 years) and extreme
overweight due to which secondary health complications such as depression, social
isolation, sleep apnoea has been acquired. Hence, the primary aim of the essay would
be using the clinical reasoning cycle and its steps to target two nursing priorities for
the patient such as his prolonged diabetes and associated hypertension and his
overweight condition due to lack of physical activities and improper diet.
Assessing the condition of patient is the primary steps of the Levett Jones
clinical reasoning cycle, as through this the healthcare professional would be able to
identify the current or past patient condition that could lead to present healthcare
complication. From the case scenario, it is observed that, Peter Mitchell is 52 year old
male and he is suffering from diabetes type 2, obesity ventilation syndrome and sleep
apnoea. Peter was admitted to the medical ward along with symptoms like increased
hunger, shakiness, diaphoresis, high blood glucose level and difficulty in breathing. From the
information it is also observed that, he is regular smoker for last 30 years. As he is obese, in
his previous admission he was suggested high protein diet for reducing his weight. However,
he never wanted to do any exercises as he thinks it is very difficult for him. A physiotherapist
also instructed him to do light exercises which he had to perform continuously in his house.
From the social history of Peter, it was noted that, he was jobless and after losing his jobs,
he had gained more weight. Due to his weight, he also faced difficulties to find a new job.
Therefore, he lived alone in his house as his two sons seldom visited their father.
The second step of clinical reasoning cycle is to collect important cues from
the provided patient considerations so that using those cues healthcare professionals
could easily process them to develop healthcare priority for the patient. After
assessing the Peter’s case study, it can be said that, the community nurse should work
along with a dietician, diabetes specialist and with a doctor specialized in respiratory
problems (Atlantis, Fahey & Foster, 2014). As he was facing breathing difficulties, the
community nurse should also collect information about the medicines that Peter was taking.
Along with this, it is the duty of the community nurse to collect information about the blood

2CASE STUDY ON PETER MITCHELL
pressure, blood glucose level, height, weight of Peter. Along with this, in order to assess the
respiratory system of Peter, the nurse should collect information about the nicotine
dependency by using the test for Nicotine dependence (Grant et al., 2014). For assessing
the sleep apnea condition of the patient, the nurses can perform specific tests for it. As the
patient is obese in nature, cardiovascular assessment is required as obesity is related to the
cardiovascular problems.
Processing the collected cues to determine nursing priority for the specific
patient is the next step of the Levett- Jones clinical reasoning cycle and application of
these ensures that healthcare professionals would chose care priorities depending on
the patient concerns and their needs. After collecting cues of Peter’s healthcare
condition, it was seen that his one healthcare complication is connected to another
complication. Peter is suffering from diabetes since 9 years and due to his prolonged
healthcare complication he has lost all his hope from the care process and it has
increased his mental illness, depression and stress. Further he is observed affected
with social illness due to his increased depression and hypertension. As Peter has
symptoms of hypertension the nurse would continue the process of treating diabetes as
diabetes induced insulin resistance can cause aggravation of blood glucose level and also
promote the accumulation of lipid into the endothelial layer of the blood vessels which can
promote the hypertension (Blum et al., 2014). The overweight condition of Peter indicated
that, he had high BMI level than normal and this is also another promoting factor of
cardiovascular disease and diabetes. Therefore, the Fagerström Test will help the
community nurse to understand the present attempts of Peter for smoking cessation as
smoking is one of the key factors of enhancing the risk of hypertension and cardiovascular
disease and it should be looked after in an urgent manner. The diabetes assessment will
allow the community nurses to examine the obesity and diabetes management status of
Peter and in various studies; it is observed that obesity can alter the breathing pattern,
insulin resistance and alteration in sleeping habits (Hakim, Kheirandish-Gozal & Gozal,
2015). A dietary assessment will help the community nurses to fix the dietary pattern of
Peter and it will also help in managing diabetes and cardiovascular disease of Peter.
The community nurse then identify the Peter’s problem that are high level of blood
glucose levels, hypertension, hyperglycaemia, hyperlipidaemia. The high of BMI of Peter will
encourage to start the diagnosis of obesity and this abnormal condition will indicating more
complicated situation of cardiovascular disease and hypertension. Along with this, the
abnormal nursing diagnosis of cardiovascular disease will promote the risks of cardiac
arrhythmia and tachycardia.