NSB303 Partnerships in Health: Ruby Pascal Health Promotion Plan

This report presents a health promotion plan for Mrs. Ruby Pascal, a patient with a history of type 2 diabetes and general anxiety disorder, as part of the NSB303 Partnerships in Health and Illness assessment. The plan utilizes the Clinical Reasoning Cycle (CRC) to analyze Ruby's case, encompassing assessment, planning, implementation, and evaluation stages. The assessment stage includes gathering information from handover notes, identifying determinants of health like income, behavior, and social support, and recognizing health concerns such as anxiety, obesity, and chest pain. In the planning stage, prioritized problems are identified, and goals are established to reduce anxiety, manage chest pain, and promote weight loss through dietary changes and increased activity. The implementation phase outlines specific interventions, including establishing a trusting relationship, providing reassurance, formulating an eating plan, and creating an exercise program. Finally, the evaluation stage defines criteria for measuring the achievement of goals, such as a reduction in anxiety attacks, pain levels, and improvements in BMI and eating habits. This comprehensive approach aims to establish a holistic care plan for the patient.

Clinical Reasoning Cycle – Health Promotion Template (Workshop 1). (Modified from Levett-Jones, 2013)
ASSESSMENT
Stage
Response.
Determinants of Health
Initial.
Income and social status are one of the determinants of health. Ruby states that she does not have financial
problems because they have a well-running business. Another determinant of health is personal behavior that
involves eating habits and physical activities. Ruby confirms that she does not eat a healthy diet and does not
exercise regularly. Another determinant of health is social support networks. Ruby is not close to her children
and no close friends and therefore no one offers her support during her husband’s chemotherapy.
Interview, documentation,
observation.
Based on the case study, housing is not a problem for Ruby given that she and her husband are financially
secure because of the business that they own. She is an educated woman and she was even a pharmacy
assistant for twenty years after she completed her studies. Transport is, however, a little challenging because
of the amount of traffic in the city. The health services at her local hospital are satisfactory according to her.
She, however, does not practice healthy eating and rarely takes part in physical activities.
SW
our
text
her

Identify health concerns.
Identify patterns or connections.
Ruby has a history of type 2 diabetes. Her BMI is more than 35 which could be an indication of obesity.
Obesity is believed to increase the risk of type II diabetes. Additionally, obesity is believed to increase the
risk of anxiety disorders, especially in women.

P
l
Stage Response
Identify and prioritize
problems. Number them.
1. Severe anxiety attack
2. Overweight
3. Chest pain
4. Vomiting
5. Nausea
6. Type 2 diabetes
Select top 3 problems and
write goals for each problem.
Severe anxiety attack
The goals should include reducing
levels of anxiety and reducing episodes
of anxiety attacks
Chest Pain
One goal is to reduce Ruby’s chest
pain.
Overweight
Goals should include losing weight while
maintaining a good health. Another goal
is to change eating habits and practice
healthy eating.
Implement Show the actions/interventions
to be taken for the top 3
problems. Number them clearly
so that they correspond.
Establishing a trusting relationship with
the patient is important. A nurse
should also give Ruby reassurance and
educate her that a severe anxiety
attack can be treated. Calmness should
be maintained when addressing the
patient.
The nurse assesses the patient’s
pain after every hour and asks the
patient to report any further
discomfort.
Formulating an eating plan with ruby is
one of the interventions. Additionally the
patient is advised to avoid fad diets. An
exercise program is also important to
increase the patient’s activity levels.

Stage Mrs Ruby Pascal.
Show the criteria (changes in
cues) the you will use to measure
to show if each goal was
achieved.
Goals are achieved when Ruby
does not report several cases of
anxiety attacks within a short time.
To confirm that the goal has
been achieved, Ruby’s pain
should be a value of 3 or less
when measured in a scale of 1-
10.
Goals are achieved when
Ruby’s BMI measures below
30 and when she stops eating
food from the fast food
restaurants.
The assessment process and plan is important in establishing a comprehensive care plan for the patient. This
process has taught me the importance of understanding a patient’s condition and identifying priority problems to
aid in creating a care plan.