Culturally Safe Health Promotion Strategies for Mr. Ernie Boulia Case Study

Running head: MR ERNIE BOULIA CASE STUDY
MR. ERNIE BOULIA CASE STUDY
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MR. ERNIE BOULIA CASE STUDY
Culturally safe health promotion strategies and effective education strategies have the
capability of altering the attitude and behaviors of patients and helping them to adopt healthy
habits. They help in developing the health literacy of the patients making them understand the
significance of their modified behaviors on their health (Dorresteijn et al, 2014). This assignment
will analyze a case study where health professionals would first identify the care properties and
accordingly adopt education strategies for helping the patient to change his attitudes towards
health and develop better quality life at the same time of maintaining cultural competency and
developing therapeutic relationship.
Mr. Boulia is a 47-year-old aboriginal man who is suffering from grade-2 diabetic
neuropathic ulceration. The patient is in need of proper wound management and antibiotics. One
important risk that should be also cared for by the professional is that the patient is at a risk for
developing heart disorders as his family history shows other members being affected by coronary
heart disorders (Van Netten et al., 2016). He is a smoker and consumes a high-risk diet of sugar
and fat that increases the chance of the heart disorders. However, one important thing that also
needs to be stated here is that he has poor medication adherence with respect to insulin self-
administration that results in poor glycemic control. This would result in fatal consequences on
his health. The nursing professionals need to care for the symptoms that have higher chance of
affecting the individuals and therefore, they need to critically analyze the situations, understand
the urgency and then set up care protocols and education regime (Yazdanpanah, Nasiri, &
Adarvishi, 2015).
One of the most important health concerns that have been identified is the caring for the
grade 2 diabetic neuropathic ulceration. Researchers are of the opinion that grade 2 diabetic foot
ulcer is a kind of wound that penetrates to the tendons as well as the capsule. Foot ulcers are

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MR. ERNIE BOULIA CASE STUDY
indeed one of the most common complications of poorly controlled diabetes. This happens
mainly by the breaking of the skin tissues and exposing the underlying layers beneath them.
They are mainly found to be common under the big toes as well as the balls of the feet. Poor
circulation, high blood glucose sugar, nerve damage as well as irritated and wounded feet are
some of the causes of the ulcers in the foot (Armstrong, Boulton, & Bus, 2017). Mainly poor
blood circulation is a form of vascular disorders where the blood cannot flow to the feet
efficiently causing difficulty for the ulcers to heal. Mainly reduced functioning of the nerves due
to the peripheral diabetic neuropathy results in reduction of pain sensation in the foot making to
prone to get damaged without the individuals feeling it. Very strenuous situation might result in
situations where gangrenes can take place in stage 5 leading to amputation. To prevent such
occurrences, this should be considered as acute problem that needs to be cared.
Another potential problem that is also identified is his poor glycemic control. It is found
that he does not adhere to his medications properly and even is not careful about insulin
administration that he was prescribed in the last visits. Therefore, if he does not maintain his
blood glucose level and it remains high, various types of negative outcomes will result. Long
term complications associated with improperly controlled blood glucose level and untreated
hyperglycemia are cardiovascular disorder, nerve damage, kidney damage, and damage to retina,
feet problems, ulcerations, bone joint problems, teeth and gum issues and others (Bus et al.,
2016). The cellular systems of the organs will not receive any energy and might not work
effectively resulting organ disorders as well. Therefore, glycemic control, insulin administration
and other medication should be managed and adhered to effectively.
The first topic that should be addressed is the effective foot care and wound management
by which the patient named Ernie would be able to reduce the chances of deterioration of the

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MR. ERNIE BOULIA CASE STUDY
wound preventing the risks of leg amputation. Researchers are of the opinion that when
individuals have poorly managed diabetes control, they might suffer from foot complications like
infections and ulcers which do not want to heal due to poor circulation. This might result in the
loss of the foot or the leg of the individual even with chances of the life of the patient. Even
chances of occurrence of corns and calluses, development of dry cracked skin as well as nail
disorders might also take place (Skafjeld et al., 2015). Hammertoes and bunions, charcot foot
and poor blood flow might also take place if the patient does not care about his feet effectively.
If untreated, infections might occur and this will make the situation much worse with the passing
days unless gangrenous situations take place. Therefore, the patient should be educated about
how to take care of his feet and management the already made wound effectively. This would
prevent the chances of worsening of the feet conditions and amputations. Better he gets educated
better will be his skill of management. When the patient understands about the complications
that diabetes might result and the ways such complications occur, the adherence of the patient
towards foot care would increase (Monami et al., 2015).
Another topic is poor glycemic control. Poor glycemic control can result in various types
of complications. The patient is also seen to be not adhered to the insulin administration
procedures in a discipline manner and he does not monitor his glucose levels effectively.
Improper glycemic control might results in organ failures affecting his quality of life.
Cardiovascular disorders, kidney disorders, retinal issues, neuropathy, improper metabolic
functioning and many other issues might occur. Therefore, it is very important for the patients to
understand the importance of the effective glycemic control and the different interventions that
the patient needs to manage his glucose levels effectively (Crawford et al., 2015). Therefore, the
professionals should educate the patient about ways to manage the glycemic control through diet,