Patient-Centered Care Plan: Managing Schizophrenia and Type 2 Diabetes

This report provides a comprehensive overview of a patient care plan developed for Patrick Smith, a 33-year-old male diagnosed with paranoid schizophrenia and type 2 diabetes. The report evaluates the patient's history and pathophysiology, highlighting the complexities of managing both conditions concurrently. It outlines a holistic care plan, emphasizing physical, emotional, and spiritual well-being, and details nursing interventions and treatments, including medication management, lifestyle adjustments, and therapeutic approaches. The report also considers relevant standards, codes of conduct, and legislation, such as the Mental Health Act and the Medical Treatment Planning and Decisions Act, ensuring culturally aware and patient-centered care. Furthermore, it discusses the importance of trauma-informed practice and recovery-oriented approaches, alongside implications for current and future nursing practice and research.

ASSESSMENT 2

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Evaluating patient's history and related pathophysiology process to identify the problems.......3
Comprehensive assessment related to disease.............................................................................4
Explaining Holistic plan of care developed by setting goals.......................................................4
Formulating the nursing interventions and treatments and effectiveness of actions...................4
Considering the relevance of specific standards, code of conduct and relevant legislation........5
Adhering to the cultural awareness and diversity considerations................................................5
Considering the patient centred care and other practices.............................................................6
Considering and explaining the current/future nursing practice and research implications .......6
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................1

INTRODUCTION
The current report will outline about the patient's history and the related pathophysiology
to identify the problems. Further this report will outline the specific tools and holistic plan that
helps to develop the specific goals. Moreover the current report will also put focus on the
interventions and nursing standards in order to maintain the cultural awareness. At last this report
will outline the patient centred care, trauma informed practice, etc. and future nursing practice.
MAIN BODY
Evaluating patient's history and related pathophysiology process to identify the problems
The patient in the current report is facing lots of problems which makes him to suffer a
lot in his life. Patrick Smith is the 33 - year old single male which is facing disability and used to
live in Supported Residential Service (SRS). The patient has diagnosed with the Paranoid
Schizophrenia that is basically treated with the antipsychotic medication from the last five years.
Further Patrick was also diagnosed with the type 2 diabetes from one year. This makes him to
takes lots of medication and by this he has put on his weight which makes him to suffer a lot.
Schizophrenia is defined as the complex disorder that used to involve the dysregulation in
the different pathways in its pathophysiology. This disease used to affect the Dopaminergic,
matriculate and other systems and by having interactions in these this used to caused
pathophysiology of the schizophrenia McCutcheon, Marques and Howes, (2020). This disease
can be defined by recognizing the various features that includes hallucinations, delusions and
thought disorder which makes the person mental disorder. Further it can be considered as one of
the toughest disease which makes the person out of his mind. It also includes some abnormalities
in some aspects that includes thoughts, emotions and cognition. This can be developed by having
the depression or some accidental things that can imbalances the brain of the person Müller,
(2018).
The another disease that is faced by the patient was type 2 diabetes from the last one year.
This type of disease can be very serious and may affect the life of the person. This disease
without having treatment can cause the high level of sugar level in the blood can damage the
parts of the body. These are many complications related to such disease which lifelong affect the
person's life Barron and et.al., (2020). The pathophysiology of the type 2 diabetes is featured by
peripheral insulin resistance, impaired regulation of the glucose production and declining the

blood cells function, etc. The patient must focus on such pathophysiology which helps him to
reduce the level of disease in the body.
Comprehensive assessment related to disease
The patient was facing the schizophrenia from the last five years which is considered as
one of the complex disease as this imbalance the brain of the person. Patrick was taking the
medication related to such disease which makes him to survive without and harm. The
medication he was taking was Olanzapine 20mg and Quetiapine 200 mg BD Fonseca and et.al.,
(2020). These were some medications that he was given in order to get recover.
Another disease he was facing is type 2 diabetes he was not taking the proper medication
as he smokes 30 cigarettes per day which makes him suffer a lot in his life. As the SRS staff was
having the workload which makes them difficult to take proper care of patient and have insulin
for such disease.
This disease is considered at the more priority as if there is increase in the blood level it
will have great impact on the mindset of the person. As type 2 diabetes used to have various side
effects if they are not managed and diagnosed well. This type of disease was having the mental
impact on the Patrick which makes him more ill day by day.
Explaining Holistic plan of care developed by setting goals
The holistic plan refers to such plan that used to provide support to look the person as a
whole not according to its mental health. This support basically consider the physical, emotional
and spiritual well being. The mental health is the priority of the patient as this makes him to so
wrong things and harm himself as well as other Berbudi and et.al., (2020). He must be advised to
do some meditations and physical exercise which makes him calm towards this harmful activities
done by them. The nurse who take care of Patrick must note the symptoms of their diagnosis
and provide him better treatment by developing goals for them. This holistic plan must consider
the person as its whole rather than focusing on its illness and disorders. The nurse must support
the patient and have the best contact with them and seek the best therapist or counsellor in order
to maintain illness and disorders.
As the patient was suffering from type 2 diabetes the nurse who w as taking care of him
must make the holistic plan. This must include the losing weight techniques, eating well and
doing exercise on the daily basis. If the diet is not properly planned so this will imbalances the

blood sugar of the patient. This can be cured by providing the medications for the diabetes and
insulin therapy which was not properly taken by the Patrick.
Formulating the nursing interventions and treatments and effectiveness of actions
There are various interventions that the nurse must be aware of while providing the
treatment to such type of patients. The nurse must make him to do some walk after taking lunch
and dinner that helps him to reduce the weight gain he is suffering from. This will be very
helpful for Patrick to ensure their safety and maintain better life.
The another intervention for the nurse is that they must make them do some meditation
and physical exercise that makes their mind calm and happy Cannon and et.al., (2020). The
meditation is considered as very helpful for the patients who are suffering from any mental and
health disease. Nurse must also provide the proper nutrition which keeps their body healthy. As
the patient was having paranoid schizophrenia which is basically characterized by grandiose
delusional thought content. This used to experience the auditory hallucinations by having lack in
symptoms that is loose associations, incoherence, etc.
This type of diagnostics can be resulted by having the test that can be CT scan or it may
be MRI that made rule out the disorders that can cause psychosis. In order to recover this the
medical management must be managed by the nurses by consulting with the doctors Bakris and
et.al., (2020). They can also help them out with the proper therapy which reduces the depression
and other symptoms. The nurse must also recognize the stage of schizophrenia and establish the
trust and rapport without teasing the patients.
The type 2 diabetes can be cured by taking proper care of the patients and providing them
insulin therapy and proper medications. Metformin is the most common and beneficial medicine
that is used for type 2 diabetes. This helps Patrick to manage the blood sugar at healthy level.
These are some management strategies that the nurse must follow in order to have better
recovery of the patient suffering from diabetics.
Considering the relevance of specific standards, code of conduct and relevant legislation
Mental Health Act (2014): This act was came into effect on July 2014 and this used to
authorize the treatment in certain situations. This used to provide recovery oriented practice and
used to minimize the treatment that are mandatory in order to protect the people that are living
with illness Allison and et.al.,(2021). Nurse who is taking care of patient must be very well
known about such act that helps her to provide better treatment for diabetes.

The Mental Health Nursing Standards by Australian College of Mental Health
Nurse (2013): This is the broad concept that used to care about the clients that are unable with
their mental health. The nurses must support the mental, physical and social health that help the
person to have better recovery. The standards mentioned in such act must be followed by nurses
who are working in SRS.
Medical treatment planning and decisions Act (2016): This act used to establish the
single framework in order to have the better medical treatment decisions for the people. This is
taken by having and decision making capacity that used to ensure the person in order to receive
the medical treatment. This act used to ensure that the Victorians must have the confidence in the
health system which helps them to respect their decisions related to medical treatment of type 2
diabetes. The SRS must follow this act in order to make the better decisions for patient.
Adhering to the cultural awareness and diversity considerations
It is very important for the nurses to maintain the culture awareness and diversity while
treating the patients in SRS. As the nurse in SRS it has to face the people with different and
diverse identities and they used to face social determinants by having lack of education,
imbalances brain and other things. The purpose of nurse should be to maintain equality with the
patients as they are having mental health and other illness as well.
Considering the patient centred care and other practices
Patient centred care: This is about respecting and valuing the individual preferences
that makes the patient feel respected and valuable. It basically used to involve the needs and
respect to make the better decisions related to health. The nurse must follow this practice in order
to help Patrick make them recover related to their disease Wong, Mavondo and Fisher, (2020).
This helps the patient by providing them better care and response and ensures them values
related to clinical decisions. This approach usually need the true partnership with the individuals
and nurses. The patient must take the customized care that make them fulfil the need according
to their internal values and choices.
Recovery oriented: Recovery oriented approach in the mental health refers to the
application by having the set of capabilities that used to support the people in order to recognize
and take the responsibility in order to have recovery and well- being. This is very important
approach for nurse as this helps them to control over their life and maintain the emotional

experience. As Patrick was facing schizophrenia so nurse must follow this approach in order to
recover him faster.
Trauma informed practice: This practice or principle refers to the strength based tool
that is made in order to understand and respond to the impact of trauma. This usually emphasized
on the physical, psychological and emotional safety of the patients. By working as nurse in SRS
it must follow this practice as this used to create opportunities for the survivors in order to
rebuild and have sense of control. There are basically five principles of this practice which are
safety, choice, trustworthiness, collaboration and empowerment. This help the patient to feel
safety while taking medication in SRS that makes them feel valuable and respected.
Considering and explaining the current/future nursing practice and research implications
The nurses must understand the patients which are facing a lot in their life and they are
different from other normal people Lin and et.al., (2020). The practice and research has seen that
the role of nurse is to help the people while they are going from such disease and provide them
better treatment for their better recovery.
CONCLUSION
From the above report it is concluded about the patient's history and the related
pathophysiology to identify the problems. Moreover, this report has evaluated about th specific
tools and holistic plan that helps to develop the specific goals. Furthermore, the report has also
explained about the interventions and nursing standards in order to have the cultural awareness.

REFERENCES
Books and journals
Allison, S. & et.al.,(2021). Emergency department–focused mental health policies for people
with severe mental illness. Australian & New Zealand Journal of Psychiatry. 55(6).
533-535.
Bakris, G. L. & et.al., (2020). Effect of finerenone on chronic kidney disease outcomes in type 2
diabetes. New England Journal of Medicine. 383(23). 2219-2229.
Barron, E. & et.al., (2020). Associations of type 1 and type 2 diabetes with COVID-19-related
mortality in England: a whole-population study. The lancet Diabetes & endocrinology.
8(10). 813-822.
Berbudi, A. & et.al., (2020). Type 2 diabetes and its impact on the immune system. Current
diabetes reviews. 16(5). 442.
Cannon, C. P. & et.al., (2020). Cardiovascular outcomes with ertugliflozin in type 2
diabetes. New England Journal of Medicine. 383(15). 1425-1435.
Fonseca, L. & et.al., (2020). Schizophrenia and COVID-19: risks and
recommendations. Brazilian Journal of Psychiatry. 42. 236-238.
Lin, I. & et.al., (2020). Patient-centred care: the cornerstone for high-value musculoskeletal pain
management. British Journal of Sports Medicine. 54(21) 1240-1242.
McCutcheon, R. A., Marques, T. R., & Howes, O. D. (2020). Schizophrenia—an
overview. JAMA psychiatry. 77(2). 201-210.
Müller, N. (2018). Inflammation in schizophrenia: pathogenetic aspects and therapeutic
considerations. Schizophrenia bulletin. 44(5). 973-982.
Wong, E., Mavondo, F., & Fisher, J. (2020). Patient feedback to improve quality of patient-
centred care in public hospitals: a systematic review of the evidence. BMC health
services research. 20(1). 1-17.
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