Nursing Assignment: Peter Mitchell's Care: Diabetes, Obesity, Apnea

This nursing assignment focuses on the critical role of clinical reasoning in healthcare, specifically in the context of a 52-year-old patient named Peter Mitchell. The assignment identifies and prioritizes two key care priorities: managing morbid obesity and addressing sleep apnea, both of which significantly impact the patient's quality of life and are linked to his type 2 diabetes. The paper details the importance of weight loss through patient education on diet and exercise, emphasizing the benefits of a low-carb diet and regular physical activity. It also highlights the management of sleep apnea through lifestyle modifications, including weight loss, smoking cessation, and adjusting sleep habits. The assignment stresses the need for ongoing evaluation to assess the effectiveness of interventions and the overall improvement in the patient's health, emphasizing the interconnectedness of these conditions and the crucial role of nurses in providing comprehensive patient care. The assignment leverages clinical reasoning to systematically assess, create, and implement the most relevant care for patients.

Running head: NURSING ASSIGNMENT
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Nursing Assignment
Student’s Name
Institutional Affiliation

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Nursing Assignment
The capability to critically think is imperative in the nursing practice. It ensures a
patient’s personal and clinical needs are fulfilled hence the provision of medical care is
appropriate and efficient. Additionally, clinical reasoning will be paramount in identifying and
prioritizing health concerns regarding 52-year-old Peter Mitchell. Two care priorities will be put
forth and critically examined to help the patient lead a better life. A primary health care nurse
will utilize his medical history to be able to provide the relevant care he requires. Type 2
Diabetes is a chronic disease which manifests itself either when the body fails to make an
effective or actual use of the insulin which it produces or when the pancreas fails to produce
sufficient insulin. This paper seeks to identify and prioritize complications and medical concerns
regarding 52-year-old Peter Mitchell. Two care priorities will be acknowledged and extensively
examined by a primary healthcare nurse to help this young patient manage living with this
condition.
Clinical reasoning is an important way of making health decisions. It is largely used by
healthcare professionals when dealing with patients who have chronic illnesses such as Peter
Mitchell. Clinical reasoning, therefore, facilitates systematic problem solving which enables
medical practitioners to better assess, create and implement the most relevant care for patients
(Kassirer, 2010). In the nursing practice, most medical resolutions are complex and rely on many
factors. Consequently, it is necessary for healthcare professionals to depend on a standard
decision-making tool (Simmons, 2010). The utilization of a clinical reasoning cycle enables
creative thinking in formulating clinical management plans for patients.
Morbid obesity is a severe health condition which interferes with the basic physical
functions of the body, for instance, walking or breathing. People who have morbid obesity like

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Peter Mitchell have a higher risk of getting other ailments such as sleep apnea, gastroesophageal
reflux condition, heart disease, cancer, osteoarthritis, gallstones or diabetes (Sturm and Hattori,
2013). Health conditions related to obesity lower life expectancy. Normally, obese individuals
are resistant to insulin that is paramount in regulating blood sugar (D’Hondt, 2011).
Consequently, they end up getting more blood sugar hence resulting to the type 2 diabetes which
is quite chronic.
Weight loss is one of Peter Mitchell’s care priorities. The primary health-care nurse
will aid him loose weight hence controls morbid obesity and subsequently the type 2 diabetes
(Chatterjee, Khunti and Davies, 2017). In addition, this is because these adverse medical
conditions are greatly interfering with his quality of life. Furthermore, he has developed fatigue
hence is unable to work due to his weight. The implementation of this care priority will make
Peter stop feeling socially isolated.
The primary health-care nurse ought to provide Peter with patient education on how to
handle his weight issue. Peter should be encouraged to continue with the high protein and low
energy diet. Additionally, Peter should start eating a low carb diet as it has several advantages. A
low carb diet makes people eat less food and they also have fewer calories (Pontiroli and
Morabito, 2011). Generally, individuals on this diet burn 300 more calories daily when resting.
Another benefit is that it reduces one’s hunger significantly hence makes it easier for a person to
consume less food. Peter can also be enlightened to only eat when he is hungry.
Peter is supposed to cut on meals that have a lot of starches and sugars. Additionally,
this reduces hunger levels hence the consumption of fewer calories. Another advantage is that
reducing starches and sugars also leads to a decline in insulin in the body making the kidneys to
shed additional water and sodium. Furthermore, it leads to a reduction in bloat and excessive

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water weight hence losing weight (Lee, 2012). Peter Mitchell ought to eat vegetables, fat, and
protein frequently. Maintaining such a diet automatically controls the intake of carbs. High
protein consumption boosts metabolism, lessen cravings and moderate the thoughts about food
hence declining the desire for snacks that might cause weight increase.
The primary health-care nurse should help Peter to develop a daily exercise routine to
aid in mitigating morbid obesity. This can be implemented through running, jogging, swimming,
cycling or walking. Continuous exercise assists in burning calories hence preventing body
metabolism from diminishing (Morgan et al, 2010). Most health professionals recommend a
minimum of 150 minutes of moderate aerobic exercise in a week or seventy-five minutes of
intense aerobic activity. Therefore, Peter Mitchell needs approximately 200 minutes in a week of
average physical activity to efficiently lose weight.
Consuming whole unprocessed foods is essential since they are more filling, healthier
and cause less overeating. Studies reveal that drinking water thirty minutes before meals is
fundamental in managing morbid obesity. Eating food slowly makes a person fuller and
stimulates weight-reducing hormones. The consumption of soluble fiber reduces fat precisely in
the belly region (Dann and Guterman, 2010). Having adequate sleep is useful in reducing both
weight and sleep apnea. Moreover, insufficient sleep results in weight gain.
Physical exercise is necessary for people who have type 2diabetes for a number of
reasons. First, physical exercise makes body cells to be insulin sensitive hence reducing glucose
in the blood. Therefore, this lowers sugar levels and significantly provides energy since glucose
is transferred to body cells (Blomberg and Källén, 2010). Consequently, daily exercise helps
achieve this but additional benefit results when the physical activity aids build muscles. It is

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imperative to have daily exercise because the advantage of physical exercise on blood sugar last
for approximately 48 to 72 hours.
The primary health-care nurse should utilize clinical reasoning and conduct an
evaluation to know if Peter’s health conditions are improving. The nurse ought to assess if
Peter’s depression has declined. Typically, obese individuals must deal with frequent depressing
emotional issues such as disapproval from friends and family, failed diets and negative remarks
from people. Moreover, the nurse should investigate if Peter has overcome the feeling of
discrimination by being more comfortable in public places.
Another care priority of Peter care is sleep apnea. Conventionally, the diagnosis of this
condition is usually scary, however, it is a manageable and treatable condition. Sleep apnea is a
complex health disorder that results when an individual’s breathing is interfered with during
sleep. Sometimes the whole body more so the brain is greatly affected as it does not get enough
oxygen. In case it is not properly handled it can cause diverse health issues, for example,
depression, headaches, blood pressure, diabetes, uneven heartbeats and heart failure.
The primary health-care nurse can advise on various things that can help Peter
specifically to moderate the situation. Lifestyle modifications and home remedies will greatly
help. Losing weight is one of the key issues that the patient should consider and implement
effectively. Traditionally, individuals who are overweight have an extra tissue in the throat that
falls frequently over their airway hence blocking air flow into lungs when they are asleep
(Gottlieb, 2010) Any significant weight loss by Peter will largely aid in mitigating sleep apnea.
It is the role of the primary health-care nurse to encourage, advice, or counsel Peter to
reduce or quit completely smoking. Smoking leads to sleep apnea because it increases fluid
retention and inflammation in the upper airway and throat. Another remedy useful is advice on

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reducing the usage of sedatives, sleeping pills, and alcohol, particularly before bedtime.
Likewise, this is because these substances make the throat muscles to relax therefore interfering
with breathing (Redline, 2010). Developing a constant routine of physical exercise is essential.
Daily exercise is important in influencing the duration of sleep, therefore, improving the quality
of sleep. Aerobic training and yoga are effective in strengthening the muscles in Peter’s airways.
Consequently, this improves breathing hence reduces the intensity of sleep apnea.
The primary health-care nurse ought to ensure that Peter steers clear taking heavy meals
and caffeine two hours prior to bedtime. In the same token, he should maintain a regular sleeping
schedule. It is important to note that adapting a steady sleep routine aid in relaxation hence better
sleep (Dann & Guterman, 2010). Sleep apneas occurrences will also decline significantly if Peter
gets plenty sleep every day.
The primary health-care nurse can edify Peter on some diverse bedtime tips which are
vital in evading sleep apnea. The nurse should tell Peter to sleep on his side. Typically, some
individuals only have sleep apnea when they sleep on their back (Cushman et al, 2010). In case
Peter sleeps on his back, it increases the possibility of soft tissues and tongue obstructing his
airway. Furthermore, as Peter sleeps he should prop his head up. Elevating the head of his bed or
his body by using a special pillow is quite important in fighting the disease. Moreover, he ought
to open up his nasal passages more so at night. He can achieve this by using a saline spray, nasal
irrigation, nasal dilator or breathing strips. Alternatively, he can tighten the muscles which make
his mouth closed by chewing gum. Subsequently, singing is imperative as it increases muscle
control, especially in the soft plate and throat hence decreasing sleep apnea and snoring that is
caused by the lax muscles (Tufik et al, 2010). Tongue and throat exercises are also essential in
strengthening his throat and soft plate.

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Evaluation should be done to determine the appropriateness and implementation of the
proposed remedies (Chatterjee, Khunti & Davies, 2017). The nurse should assess if Peter’s
health is improving. Daily moderate aerobic activities, for example, swimming or brisk walking
ought to be analyzed if they are helpful. Furthermore, Peter’s exercise sessions should be
examined if they consume at least ten minutes. This is the easiest way to help Mitchell start
slowly and increase gradually the length of his exercise session.
In conclusion, several factors contribute to the care that patients receive from their
primary health care nurses more so those with chronic situations. Prioritizing patient necessities
is important in improving their health. It is chief to control morbid obesity and sleep apnea
because it makes Peter Mitchell be at a higher risk of developing other conditions, for instance,
heart conditions and blood pressure. Clinical reasoning is an important way of making health
decisions. It is largely used by healthcare professionals when dealing with patients who have
chronic illnesses such as Peter Mitchell. Clinical reasoning, therefore, facilitates systematic
problem solving which enables medical practitioners to better assess, create and implement the
most relevant care for patients. It is, therefore, important to note that the nurses have to critically
think to help patients such as those suffering type 2diabetes to live well with the disease.

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References
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