Nursing: Self-Management of Diabetes and Health Promotion for J.P

NURSING
NURSING
Name of the Student
Name of University
Author’s note

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Part 1
The primary healthcare needs for J.P include self-care for diabetes. According to the case
study, J.P’s current hemoglobin A1c level is 9.5 while his blood glucose fasting range is 135 to
142 mg/dl. He is also under the medication of Metformin. Thus his case history highlight that he
is under the diabetic stage. According to Choi et al. (2013) fasting blood sugar level greater than
126 mg/dL indicates diabetic state. Shrivastava, Shrivastava and Ramasamy (2013) are of the
opinion that effective self-management of diabetes helps in effective control of the blood sugar
level while improving the overall quality of life by promoting healthy lifestyle habits. The self-
management of diabetes for J.P will include weekly monitoring of the blood glucose level by the
use of glucometer, timely medication adherence, regular practice of mild to moderate physical
activity, maintaining proper diet diabetic plan, cessation of smoking along with periodic follow
up with the physicians in order to identify or for the early detection of the complications
associated with diabetes like diabetic retinopathy or diabetic foot ulcer or other renal
complications. Powers et al. (2017) stated that self-management of diabetes is an ongoing
process and can be accomplished in a successful manner only under the training and disease
awareness education provided by the nursing professionals. Thus J.P needs to educated about the
diabetes prognosis before indulging in disease self-management.
The secondary care healthcare needs include effective financial management of J.P so
that he can comprehensively cover his expenses in the domain of medication management, food
or diet and other basic amenities of life (Strawbridge et al. 2015). The case study highlights that
he is under the Medicare and Medicaid coverage and also receives social security as
supplementary income. However, unlike Medicaid, Medicare insurance can only be availed

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under proper submissions of the premiums and effective financial management and planning for
J.P is important to sustain healthy life-style. Medicare also offers self-management training
benefits for diabetes (Strawbridge et al. 2015). Cessation of smoking will help to reduce his
expenses further (J.P at present smokes two packets of cigarettes per day).
Part 2
The health beliefs are defined as personal belief of individuals about the effective
treatment of the disease. For examples, some individuals, mostly the aboriginals rely on
traditional medicines (herbs and shrubs) as the main source of medication for the disease
management (Oliver, 2013). While other people belief that apart from relying on the medication,
bringing change in the life style can be prove to be effective for faster health recovery. The case
study however fails to highlight any specific healthy belief of J.P. However, the case study
shows that J.P is chain smoker for the past 30 years. According to Pan et al. (2015) long-term
addiction towards tobacco smoking increases the predisposition of developing type 2 diabetes
mellitus (T2DM). () stated that smoking is a modifiable risk factors for the development of
T2DM during the later stages of life and the conditions become detrimental for patients who
have family history of heart disease. Moreover, the case study also reveals that J.P is over-weight
and has high BMI. All these cumulates that J.P healthcare belief does not give importance to
healthy style towards maintenance of healthy living even when there is a disease complication
(J.P is suffering from T2DM for the past 2 years). Wang et al. (2013) are of the opinion that
awareness and education in disease management helps to bring change in healthcare beliefs.

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Part 3
According to the American Diabetes Association (ADA) (2018), patients’ with T2DM
must have their HBA1C level less than 7. Mr. Jones’ HBAIC is 9.5. Thus the goal for the
effective management of the blood sugar level will be to reduction of HBA1C within the
permissible limit by 9 months. According to the ADA (2017) effective management of the blood
sugar level and HBA1C can be done with the help of non-pharmacological interventions. Non-
pharmacological interventions like diet, physical exercise and behavioral change is helpful in
reducing BMI and body weight by >5% thereby promoting reduction in the blood glucose level
(ADA, 2018). The diet plan that will be suitable for J.P will be low on carbohydrate and
saturated fat and high lean protein diet (ADA, 2018). Limited intake of saturated fat will help to
regulate the blood cholesterol level of J.P further.
However, J.P states that he prefers to consume rice with every meal only eats two times
per day due to his busy work schedule. However, in order to reduce the dietary calorie intake the
consumption of carbohydrate needs to be reduced. Thus J.P’s diet plan will include small meals
of carbohydrate (one cup of rice, two times a day). In order to manage his appetite, the diet plan
will be enriched with fresh fruits and vegetables and chicken soup. Since J.P is a busy person
consumption of full course meal at least three times a day might be difficult in that case his diet
plan will include consumption of dry fruits, fresh fruits and cream cracker biscuit (as healthy
snacks) within an interval of 3 to 4 hours (3 times) and 3 full course meals. All these raw food
products recommended as snacks for J.P are easy to carry and eat and thus having less chance to
create problem in busy schedule of J.P (Munshi et al., 2016).