Nursing Care Plan: Chronic Illnesses Essay


Added on  2021-04-17

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Running head: NURSINGNursing Name of the student:Name of the University:Author note
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2NURSINGCase Study-Peter MitchellNursing care for chronic illnesses involves influence from multiple factors. In order toensure safe and high quality care the nurse must ensure that the patient needs and the clinicalneeds are met. It can be ensured by the prioritisation of care and it is considered to be the integralpart of the daily nursing practice (Harrison et al., 2017). The essay deals with Peter Mitchellpresented with the uncontrolled diabetes and obesity. The aim of the essay is to manage the chronicillness integrating various principles. Applying the clinical reasoning cycle the main health issues ofPeter will be identified, and two priorities of care will be discussed. According to Levett-Jones,clinical reasoning involves collection of cues, followed by information processing, understanding thehealth problems of the patient, implementing the interventions, evaluating the outcomes andreflecting on learning process (Barker, Linsley & Trueman, 2016). The first step in clinical reasoning process is taking into consideration the patient’ssituation and it involves listing of facts, objects or people (Dalton et al., 2015). Peter Michell, (52years) is presented to medical ward with poorly controlled diabetes. He is troubled with sleepapnoea and obesity ventilation syndrome. For cues and information, the nurse must review thecurrent information from the exiting handover, and asses for collecting new information (Barker,Linsley & Trueman, 2016). On obtaining information from the clinical handover, it was foundthat patient has history of diabetes since 9 years; he has morbid obesity, hypertension, depressionsince three months, apnoea and Gastro oesophageal disease reflux disease. The patient issmoking since last 30 years. Social appears to be poor as he lives alone and his children rarelyvisit him. He is unable to cope up with his weight gain. His diabetes intervention, insulin ledhim to leave job. He is surviving only on government benefits. He avoids socialization owing tohis illness. He appears to be motivated to lose weight and is currently under medication. As per
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3NURSINGthe previous assessment the Peter has HR 102 Bpm, BP 180/92mmHg, RR 23 Bpm, and Sp02 95%,Obesity, blood pressure, hypertension, and diabetes may be interrelated as per knowledgepathophysiology. The vital signs and symptoms demonstrated the risk of heart diseases(Koolhaas et al., 2017). Processing the collected information is important to identify the main heath issue of thepatient. This part of the clinical reasoning involves analysing the data to understand the signs andsymptoms of the patients and relate with the cues to identify the relationships (Barker, Linsley &Trueman, 2016). It will help predict the necessary clinical outcomes in Peter. The patient hasweight 145kgs and height 170cms, that can be calculated to have BMI around 50.2. A BMI of 30or less than 30 is normal and above this range is considered obesity. The patient presentingventilation syndrome and apnoea may be related to obesity. According to Castro-Añón et al.(2015) obesity disturbs the breathing process resulting low blood oxygen level and buildup ofcarbon di-oxide. It may have caused the ventilation syndrome. It affects sleeping process due toepisodes of shallow breathing causing apnoea. People with excess weight have soft tissues inmouth and throat that may cause obstruction of airway during sleep. Smoking also causes apnoeathrough airway obstruction (Kent et al., 2015). It requires immediate intervention to preventfurther deterioration. Patient history of hypertension is due to both obesity and diabetes. Hypertension isknown as high blood pressure. The normal BP should be 120/80 and the patient has 180/92.Increase in fatty tissues in the body with weight gain increases vascular resistance and pressureon arteries. It causes the heart to pump more blood. Obesity is known as the major cause of type2 diabetes. Obesity increases the insulin production to compensate the blood sugar level. Itresults in diabetes. Diabetes causes arthrosclerosis, thereby increasing blood pressure. It is the
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