INP 92445: Prioritizing Complex Health Issues in a Patient Case Study

This report provides a comprehensive analysis of the case study involving Evelyn Hansen, a 64-year-old female patient, focusing on the prioritization of her complex health issues. The report identifies five key health issues: diabetes mellitus, depression, obesity, hyperglycemia and dehydration, and a leg ulcer. It then prioritizes three of these issues—diabetes, hyperglycemia and dehydration, and the leg ulcer—based on their immediate impact on the patient's health. The report details the nurse's role in addressing these top three priorities, including assessment, coordination of care, and provision of care, while also relating the discussion to regulatory frameworks of nursing and health department policies. The analysis highlights the importance of proper management and treatment strategies for patients with multiple health conditions.

Prioritization of complex patient health
issues

Table of Contents
Introduction.................................................................................................................................................2
Identification of the five Patient health issues from the case study..............................................................2
Rank the three patient health issues in the order of priority.........................................................................3
Outlining the nurse's role in addressing the top three priority of the patient health issues...........................4
Conclusion...................................................................................................................................................5
References...................................................................................................................................................6
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Introduction
The nurses are seen to be playing an important role for the purpose of carrying out the public
health and the frequent serving of the health processes by carrying out the responsibilities. The
public health nurses are found to be helping in carrying out the health care activities by assisting
the processes for the welfare of the activities. The implementation of the best practices is
indicating the excellent caring skills which can be developed by following the healthcare
guidelines and the clinical processes for treating the patients. According to the case situation of
Evelyn Hansen, the patient was brought into the ambulance that is found to be suffering from
hyperglycemia and dehydration (Al-Rubeaan, 2010). On the continuation of the medication of
the patient, it was found that the patient is consisting of diabetes mellitus type-2 with more than
over 10 years. The analysis is depicted to be carried out in this study on the basis of the
undertaken case situation.
Identification of the five Patient health issues from the case study
According to the case study of the patient Evelyn Hansen, the issues identified in the patient are
depicted to be provided in the following points:-
 Diabetes Mellitus
 Depression
 Obesity
 Hyperglycemia and Dehydration
 Leg Ulcer on right lower leg
The above mentioned five issues are found to be indicating the development of instability in the
patient which is creating a lagging environment. The insulin fusion is being initially carried out
for the purpose of mitigating the issues to some extent. The identified issues are leading to the
development of the complexities in the treatment process for the nurses present in the emergency
department (Galstyan, Shestakova and Sklyanik, 2017). It is indicating the breakdown of the
activities which is impacting the processes and also it is leading to the development of the
protocol failure by which the changes in the processes can be easily made. The overcoming of
the stress is found to be significantly associated with the odd protocols which are leading to the
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establishment of the risk environment for the purpose of carrying out the treatment process
(Haugen and Musser, 2012).
From the above mentioned five health issues of Evelyn Hansen, the three issues are prioritized
which are diabetes mellitus, hyperglycemia and dehydration and leg ulcer on right lower leg.
These three issues are prioritized which are depicted to be provided in the following points as
well as it is depicted to be provided for the welfare of the healthcare of the Evelyn Hansen. The
three selected issues are prioritized which is providing the focus on the analysis (Hazari et al.,
2015). The issues identified can be mitigated by the appropriate treatment processes which will
enable them to focus on carrying out the activities in an appropriate way. It is enabling them to
provide focus on making the improvement in the objectives, as well as the appropriate changes in
the processes, can be easily carried out by defining the regulatory frameworks as identified in
this study. The nurses are depicted to be playing an important role in mitigating these issues and
also the removal of the issues can be easily made by overcoming the processes as identified in
this study. The mitigation of the risks is made by appropriate formation of the regulatory
frameworks (Semenkovich et al., 2015). The reason for not prioritizing the other two issues is
that the patient is not suffering so much during that period of time. For this reason, it was not
prioritized.
Rank the three patient health issues in the order of priority
The ranking of the three health issues of the patient Evelyn Hansen which are selected in the
above section is seen to be provided in the following points according to the rational orders of
ranking.
 Rank 1: Diabetes
 Rank 2: Hyperglycemia and Dehydration
 Rank 3: Leg Ulcer on Right Lower Leg
The rank 1 Diabetes was found in the medical records of the patient Evelyn Hansen and was
undergoing treatment before she was admitted to the emergency. The rank 2 hyperglycemia and
the dehydration were faced by the Evelyn Hansen for which she was admitted to the hospital
(Hunnicutt, 2010). The stabilization process was carried out for the patient in the emergency
room of the hospital as well as it is found to be aiming at providing the development of the issues
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in the patient. As the patient is consisting of diabetes, due to this reason, the leg ulcer on the right
lower leg is becoming critical and also it is impacting the patient health. The impact on the
patient safety is created due to diabetes. For the purpose of controlling the impact, the
intravenous N/Saline of about 1000m/s is provided with the two units of the Novorapid
supplemental insulin (Lorber, 2014). The insulin injections were carried out in the form of the
intravenous ways and also the Novomix 30 BD is implemented in the form of the insulin
injection processes. The patient Evelyn is undergoing through the CNC consult for the wound
which is she is having in her right leg. It is cared for by the cleaning the wound with the help of
N/Saline and the normal water and then it cared with the help of the creep bandages for the
purpose of covering the wound.
Outlining the nurse's role in addressing the top three priority of the patient health issues
The outlining of the nurse's role in addressing the top three priority of the health issue of the
patient Evelyn Hansen are found to be provided in the following points:-
 Rank 1: Diabetes: The outlining of the nurse's role in addressing the diabetes is found to
be carried out by the help of type-1 diabetes as well as the insulin is implemented which
is essential for carrying out the subcutaneous injection process. The several means are
implemented which are including the syringe and the prefilled cartridges. The usual are
of injecting the insulin is found to be in the thighs or in the abdomen (Huri, 2013). The
technique of injecting process is seen to be indicating the usage of the needle at the 90
degrees. Since the patient is found to be suffering from the type-2 diabetes are identified
to be dependent on the initial treatment process as well as the dietary intake is
encouraged as well as the inducing of the weight loss is being made which is leading to
the improvement of the nutrition. The drugs used by the nurses are depicted to be creating
a positive effect on the patient.
 Rank 2: Hyperglycemia and Dehydration: The outcomes of the diabetic patient for having
the hyperglycemia are identified to be illustrating the development of the illness. The
management process which must be carried out by the nurses is indicating the
administration of the 0.15 units/kg rapid-acting of the insulin which will also lead to the
removal of dehydration (Miller, 2011). The process is showing the hourly fingerstick
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blood sugars as well as the laboratory assessments and also it is found to be followed up
by the blood sugar laboratory tests. The potassium chloride identification and the blood
urea nitrogen are carried out by defining the appropriate measurement of the activities
(Senet, 2016).
 Rank 3: Leg Ulcer on Right Lower Leg: The nurses must involve themselves in
following the clinical guidelines for the purpose of carrying out the dressing of the
wounds (Parks, 2009). The implication of the N/Saline for the purpose of washing the
wounds are essential rather than carrying out the wound clearing process with normal
water. Though it is preferable in this case of Evelyn, the dressing must be carried out with
N/saline for the purpose of preventing the spreading or worsening of the wound.
Conclusion
The overall discussion is reflecting the nursing practices with undertaking the case situation of
Evelyn Hansen. The identification of the five patient health issues was made and also was
described as providing the priority to the nurses. The appropriate identification of the process of
ranking the health issues faced by the patient was also explained in this study. It is found to be
reflecting the three priorities for outlining the nursing role for the mitigation of the disease as the
patient Evelyn Hansen is facing. The challenges are depicted to be overcome by illustrating the
appropriate management of the diseases.
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References
Al-Rubeaan, K. (2010). Type 2 diabetes mellitus red zone. International Journal of Diabetes
Mellitus, 2(1), pp.1-2.
Galstyan, G., Shestakova, E. and Sklyanik, I. (2017). Obesity and type 2 diabetes: can we find a
compromised treatment solution?. Diabetes mellitus, 20(4), pp.270-278.
Haugen, D. and Musser, S. (2012). Health care. Farmington Hills, MI: Greenhaven Press.
Hazari, M., Ram Reddy, B., Uzma, N. and Santhosh Kumar, B. (2015). Cognitive impairment in
type 2 diabetes mellitus. International Journal of Diabetes Mellitus, 3(1), pp.19-24.
Hunnicutt, S. (2010). Universal health care. Detroit: Greenhaven Press.
Huri (2013). Management of Severe/Acute Hyperglycemia in Hospitalised Type 2 Diabetes
Mellitus Patients. Journal of Endocrinology and Diabetes Mellitus.
Lorber, D. (2014). Importance of cardiovascular disease risk management in patients with type 2
diabetes mellitus. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, p.169.
Miller, D. (2011). Health care. Detroit, Mich.: Lucent Books.
Parks, P. (2009). Health care. San Diego, CA: ReferencePoint Press.
Semenkovich, K., Brown, M., Svrakic, D. and Lustman, P. (2015). Depression in Type 2
Diabetes Mellitus: Prevalence, Impact, and Treatment. Drugs, 75(6), pp.577-587.
Senet, P. (2016). Compression in hypertensive leg ulcer (Martorell’s ulcer). Veins and
Lymphatics, 5(1).
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