(PDF) Patients as Partners in Managing Chronic Disease


Added on  2021-04-24

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(PDF) Patients as Partners in Managing Chronic Disease_1

Introduction Levett-Jones Clinical Reasoning Cycle is a process that reflects the importanceof personalization and prioritization of patient’s needs. This reasoning cycle is used tostructure clinical care by healthcare professionals (Herdman, 2011). This clinical reasoning cycle helps to deliver patient-centered nursing care based on the critical thinking, clinical analysis, clinical reasoning and reflective practice performed by professional healthcare nurse (Alfaro-LeFevre, 2012). This essay is one such patient-centered nursing care structure developed by using Levett-Jones Clinical Reasoning Cycle. The study involves identification of two care priorities and managing care process by a primary health care nurse for the provided case study, which is performed by implementing reasoning cycle steps. Clinical reasoning cycle1. Considering patient situation In the present case study, patient name Peter Mitchell is a middle aged male (52 Years) admitted to the medical ward as per reference from his General Physician. He was facing symptoms of shakiness, increased hunger, high blood glucose, diaphoresis and breathing difficulties while sleeping. As he is a sufferer of type-2 diabetes and obesity, these symptoms highlight high alert of these two conditions. Peter is already overweight, diabetic suffering depression. Peter is a serious smoker from age of 30years, smoking 20 cigarettes per day. Adding on to this situation, Peter suffers other critical situations as well, that involves hypertension; sleep apnoea and gastro oesophageal reflux. Peter is taking proper medication for his health issues but still, he is facing these critical and life-threatening symptoms due to mismanaged lifestyle habits. 2. Collecting cues and information about the case Review current informationAs per case information Mr. Peter on his previous admission to medical ward
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dietician recommended him to lose weight. However, Peter had no interest to make any effort related to his weight resulting in present critical condition. Further, he was also commenced with light exercises by the physiotherapist and was advised to continue them at home. But the increased weight and BMI show his carelessness towards his physical condition.He is 145kgs with BMI 50.2m2 (very high) and height 170cms. His last observed blood pressure is 180/92mmHg (high), respiratory rate 23Bpm (high), heart rate 102bpm (little high) and SpO2 (peripheral capillary oxygen saturation) is 95% (normal). Peter is on current medication involving insulin metformin for diabetes, Lisinopril for hypertension, Nexium for reflux, metoprolol for high blood pressure and Pregabalin (Lyrica) for neuropathic pain in diabetes. Further, Peter is unemployedand struggling to get work reason being his weight issues. He is divorced, living alone, socially isolated, living without any family attention and care. Peter also faces difficulty to perform daily living activities. Gather new informationThe present admission of Mr. Peter Mitchell to the medical ward was due to poorly controlled diabetes, obesity ventilation syndrome and sleep apnoea. Peter was detected with the symptom of high blood glucose level instead of the fact that his medication involves Insulin (34units mane & 28units nocte). Audetat et al. (2013) indicated that if a patient confronts high blood glucose levels despite the fact that insulin is included in medication process indicates mismanagement in medication (insulin) process. According to Selvinet al. (2014) studies improper intake of insulin leading to high blood glucose level also persists symptom of increased hunger. This confirms that high blood glucose level is leading to increased hunger symptom in Peter’s case and he is mismanaging his medication process. Further, shaking and diaphoresis is due to obesity ventilation syndrome. Cunningham, Kramer & Narayan (2014) indicated that obesity ventilation syndrome leads to sleep apnoea identified by difficulty breathing while asleep interrupted sleep and daytime sleepiness. In the present case, Peter is facing cessation of breathing while asleep confirms presence sleep apnoea due to obesity syndrome. Recall knowledgeIn the present case of Mr. Peter Mitchell, three identified critical diseases that are type-2 diabetes, obesity ventilation syndrome and sleep apnoea are either directly
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