Nursing | T2DM disease and RLT Model

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
According to the Australian Government Department of Health (2019), chronic diseases are
the leading cause of disability on Australia. It is a disease condition that lasts for a lifetime. Some of
the common chronic disease includes cancer, diabetes, asthma and cardio-vascular disease. Type 2
Diabetes is common in Australia and is responsible for high level of mortality and morbidity
(Diabetes Australia, 2019). Following paper is based on the analysis of the health condition of the
patient who is suffering from T2DM. The analysis of the health priority will be with the use of the
Roper Logan Tierney (RLT) model and based on his interview excerpts.
Background
In this assignment, the name of the interviewee will be demoted as Ms. X. The reason
behind this is as per the Data Protection Act (2018), disclosing the personal identity of the
participants of a research is strictly prohibited. The same was also mentioned in the informed
consent that the patient signed before the initiation of the interview (Legislation.gov.uk., 2018). Ms
X is a 32-year old married female. She has one daughter and is from Srilankan background. She has
moved to Sydney 15 years ago. Her parents lives nearly by and frequently visits her. She has two
younger brothers. Ms X completed her schooling (high school) in the year 2008 and has done
graduation if accounting. In the year 2017, she started working for insurance calling centre in Sydney
CBD. Her office was 40 minutes train ride and she has a desk job (sitting in front of the computer).Ms
X conducts exercise once or twice per week and has bad to moderate eating habits. She loves to eat
South Indian food. She has never smoked cigarette nor have sipped alcohol. She has her own car and
enjoys watching movies and spending time with his daughter and parents. Her BMI is 30. MS X was
diagnosed with T2DM 8 years ago and at present has weak left eyes (needs of wear spectacles). She
has undergone appendix surgery 7 years ago. T2DM is a metabolic disorder that is characterised by
increase in the blood glucose level (BGL). High BGL mainly occurs due to insulin resistance or
impaired insulin secretion of beta cells of the Islet of Langerhans. Insulin is the hormone that is
responsible for the uptake of glucose from the blood. Insulin resistance make insulin incapable to
bind with the insulin receptors and thus causing high level of glucose in blood (Zaccardi et al., 2016).
Sedentary lifestyles and improper diet are the two main reasons behind the development and
increased severity of T2DM (Gupta et al., 2020). South Indian food preference of Ms X indicates that
she has high intake of carbohydrate. Bad to moderate food habit of Ms X might cause high
consumption of carbohydrate in comparison to the calorific requirement, leading to T2DM along
with increased BMI. Ms X BMI is high. Ms X office life is sedentary and sedentary lifestyle further

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increase the vulnerability to T2DM. High blood glucose for a prolong period of time increase the
micro and macro vascular complications of diabetes and thus might be a reason why her left eye is
weak. Diabetic retinopathy is one of the microvascular complications of diabetes (Stidsen et al.,
2018). Emerson et al. (2017) stated that other symptoms of T2DM include nonketotic syndrome
along with the development of fatigue, poor healing of wound, blurred vision, vaginal infections
along with the development of irritability (Stidsen et al., 2018). This might be a reason why Ms X
reported that she was experiencing fatigue with frequent mood swings for the past few weeks. At
present Ms X is on anti-diabetic medication.
Discussion
The patient Ms. X economic conditions are stable but her professional life is restricting her
from conducting rigorous physical activity at least 5 times a week. Her doctor has also advised her to
rest the intake of carbohydrate rich food and has recommended to stop using care while going to
nearby places which are within walking limits. The restrictions imposed by T2DM over the life of Ms
X have decreased her overall mental health and well-being. Ms X has also suffering from body image
issues after gaining weight and refuses to socialize. De Groot, Golden and Wagner (2016) stated that
development of the T2DM generate a demanding set of bio psychological challenges both for the
patients and their family members. Individuals who are suffering from T2DM for a prolong period of
time develops severe psychological complications like depression, anxiety and eating disorders. The
conditions are more severe among females as their depression rates are severe owing to body image
issues. The irritable nature of Ms X is preventing her from spending quality time with her daughter
and thus resulting in poor emotional well-being of her daughter.
The Roper Logan Tierney (RLT) model of nursing deals with assessment, diagnosis, planning,
interventions and evaluation. It serves as a guide for the nursing professionals to conduct holist
assessment of the patient and thus helping to generate care plan (Holland & Jenkins, 2019). The
factors that are inhibiting Ms X to execute activities of daily living include unmanaged weight and
fatigue (biological) along with the development of depression (psychological). Ms X is refusing to
take part in the social activities due to depression and thus hampering her socio-cultural life. Ms X
has also described that her office colleagues make fun of her as she is on restricted diet plan and is
over-weight. She also curses herself saying that she has never tougher cigarette and alcohol yet she
as developed T2DM. Shifting to Sydney has also created a cultural gap in her life as she miss her life
back in Srilanka and thus reducing the mental health status further. Trikkalinou, Papazafiropoulou
and Melidonis (2017) stated that primary goal for diabetes early diagnosis and treatment is
improved quality of life (QoL). QoL includes cognitive, psychological, social and mental health

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component and physical health component. Thus it would be the duty of the nursing professional to
access all aspect of QoL while designing the care plan.
Care Priorities and goal setting:
Nursing Care Priority 1
Improvement in the mental health status
The mental health status is poor in case of Ms. X. She refuses to take part in social activity
and also refuse to spend quality time with her daughter. She is also suffering from issues with body
image. Thus it would be duty of the nursing professional to educate Ms. X about the importance of
the social life, depression and diabetes management and encourage her to take part in the social
activity. Robinson et al. (2018) stated that improvement in the mental health status help in proper
management of the hyperglycaemic level or high BGL. Increase in the level of the social participation
will be done by motivating and education Ms. X towards importance of social activities. The use of
the effective communication skills will used as the primary tool for the promotion of the health
education as proposed by National Safety and Quality Health Service Standards for partnering with
the consumers. Use of effective communication skills will help to understand the reason behind the
sudden repulsion in social activity and thereby helping to design parson-centred care plan.
Moreover, education about the importance of the social participation will help to increase patients’
participation in the care plan and improvement in the disease self-management skills (Wiebe,
Helgeson & Berg, 2016).
Nursing Care Priority 2
Encouraging the promotion of physical activity
Ms X conducts physical activity only once or twice of week. However, taking her diabetes
condition into consideration, her sedentary life and her BMI, she must be advised to conduct
physical activity at least 5 times a week. This can be conducted under the presence of the trained
physical exercise trainer. The physical activity must be trained in such a way that it must not create a
barrier in her professional life and at same time might increase her motivation to promote active
participation. Sigal et al. (2018) stated that framing of the physical exercise must be done with a
person –centred approach depending on the age, gender and BMI. Decrease in the BMI will help in
calorie burning and thus helping to reduce additional fat from the body and thereby helping to
promote weight loss. Decrease in weight of Ms X will help to reduce high BGL and thereby helping to
reduce severity of diabetes. Presence of music and his younger siblings will keep her stay motivate in

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physical activity sessions (Colberg et al. 2016). Diet must be regulated strictly along with physical
exercise (Sigal et al., 2018).
Conclusion
Thus from the above discussion, it can be concluded that two T2DM is hampering her mental
health condition and thus preventing her to take part in the social activities. She is also becoming
over-weight and thus suffering from depression due to body image issues. The nursing care plan for
Ms X based on the RLT model will include increase in the participation in the social activity by
promoting health education and mental health counselling. Second nursing care plan will include
promotion of physical activity fifth times a week in order to reduce escalating body weight and thus
helping to reduce high BGL and thus helping to reduce severity of diabetes.

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