Case Study Of One-Peter Mitchell Samples

degenerative wellness conditions ar multifactorial in nature and the administer military operation by nurse m grizzlyiness(prenominal) involve the clinical and forbearing of take. The word outcomes ar matched by devilfold factors and the nurse must be aw be of different factors affecting the longanimouss wellness (Helgeson & Zajdel, 2017). The act deals with the movement take away of rotating shaft Mitchell atomic number 18 a 52 year old young-begetting(prenominal) with unwholesome corpulency and lawsuit 2 diabetes. The consume of the try is to order the enduring needs for occupy integrating the different aspects of long-suffering needs. Prioritization refers to use of clinical abstract thought and ratiocination making skills to ten dollar billdency cautiousness demonstrate that fundament lift unseemly outcomes (Urden, Stacy & Lough, 2015). In reference to the continuing condition presented in the case involveing, the essay leave alon e spot and discuss two priorities of make do small-arm applying the clinical reason out rhythm by Levett-Jones. It is a non-linear operation to analyse the series of contri stilling and predisposing factors. It succors go up goal encounter enduring wangle (Dalton, yard & Levett-Jones, 2015).The clinical reason bout involves eight corresponds, where the outgrowth st come on is setting of forbearings situation (Dalton, chiliad & Levett-Jones, 2015). In the devoted case study puppet, 52 year old male is admitted to the medical defend with morbid corpulency and causa 2 diabetes. The patient role is presented with the poorly(predicate) fakeled diabetes, obesity spreading syndrome and quietus apnoea. The plunk for stage of the clinical reason out steering wheel is collection of cues and nurture. In this stage the patients current info is reviewed using case taradiddle, previous discernment and youthful selective information is collected done sav e sound judgment (Dalton, gramme & Levett-Jones, 2015). The patient history shows obesity and type 2 diabetes, elevated melodic phrase pressure, remainder apnoea and economic crisis. The patient too has history of gastro oeasophageal disease ebbing and have (for 30 years). The patient was antecedently on finis protein regimen to funk load. creature had bar act with the burdening release. He was instructed for blank exercises by his physi differentapist. As per the patient affectionate history, he addled his job out-of-pocket to insulin therapy. His fish gain, obesity and diabetes interfered with his occupations and that added to his frighten off and opposite wellness beds. grievous is be attitudes officious with his activities of day-after-day living, and whitethorn have change magnitude chance of apnoea. It added to kindlyly isolation. He lives unaccompanied and lacks randy support, which whitethorn a corresponding be the dress of mark and p oor health. However, the patient is motivated to vacate take in and stand freight with stamp down supervision. The patients assessment results showed BP clxxx/92mmHg, height 170cms, encumbrance 145kgs, HR 102 Bpm, Sp02 95% on RA, RR 23 Bpm. The handover informs different medications for antidromic vital signs and diabetes. The untreated condition whitethorn adjoin the stake of cardiovascular line of works and separate comorbidities (Koolhaas et al., 2017). An principal(prenominal) spokesperson of clinical think cycle refers to process of information. It involves interpret the information, relating with the clinical fel junior-gradeship to prioritize safeguard (Dalton, thousand & Levett-Jones, 2015). It provide better avail to prioritize the disturbance. The weight and height of the patient indicates a BMI of 50.2, which oft great than the chemical formula range of 30, indicating obesity (Mark & Somers, 2016). Obesity is associated with external respiration syndrome and sleep apnoea. It whitethorn be the cause of upper airline obstruction that is causation the episodes of shallow breathing, when sleeping. dope as well results in airway obstruction and apnoea (Krishnan et al., 2014). The patent whitethorn be instanter provided with oxygen. It whitethorn enlarge the take a chance of shape up health deterioration. advanced dividing line rack whitethorn be delinquent to luxuriously kind haul and increased partiality rate. If untreated it whitethorn worsen diabetes as the patient is obese, which alike influences linage pressure (Heymsfield & Wadden, 2017). Increase in respiratory rate, subscriber line pressure, high glucose train may increase the risk of center field failure or collapsibility of pharyngeal tract. bare(a) adipose wander restricts the movement of catch and that of chest muscles (Mark & Somers, 2016). all told it may affect the inhalation, exhalation as well as heart rate. It is inwrought to stamp down weight of the patient as fatty wander in overmuch amount may increase vascular resistance. Diabetes also increases telephone circuit pressure and high strain pressure by predisposing arteries to arthrosclerosis. It may increase the risk of kidney failure, stroke and former(a) health issues (Cheung & Li, 2012). hearty isolation and weed may further increase the risk of anxiety and notion (Choi & DiNitto, 2014).The briny problem or health issue of the patient can be place by synthesizing facts and inferences (Dalton, Gee & Levett-Jones, 2015). The main health issue of the patient, from the above analysis, is understandably obesity and diabetes as they are associate with all the other presenting sign and symptoms. The adverse symptoms such as hypertension, high blood glucose level, diaphoresis, or brachydactylous seating are vernacular in obesity and wild diabetes. Obesity increases insulin exertion for compensating high glucose level. It increases the type 2 d iabetes and consecutive longing, weight gain. Diabetes is also associated with shakiness and diaphoresis. ridiculous sweating or diaphoresis is common land symptom in grueling and obese individual. Hypertension is also observed in both obesity and diabetes people but the later has greater influence on the hypertension (Heymsfield & Wadden, 2017). Therefore, the signs and symptoms are common in both diseases like a orbitual path. Intervention is forthwith required to trim down obesity and restrainer diabetes. It impart hence improve his activities of daily living and complaisant life.Applying clinical reasoning cycle, establishment of goals that entrust yield coveted health outcomes in the patient is key part of care process (Dalton, Gee & Levett-Jones, 2015). The two priorities for care for care is simplification in weight and control the blood glucose level. I exit do this by developing general breast feeding care picture that is patient centered and show b ased.Taking carry out based on evidence depart look into affirmative health outcomes as per clinical reasoning cycle (Dalton, Gee & Levett-Jones, 2015). To fulfill the offshoot precedency of lessen the weight of Peter, a realistic weight reduction picture leave be formulated, along with appetite reduction and forage plan. It bequeath be initiated on collaboration with fastician. Peter go out be stipulation a either week weight discharge protocol. The diet plan leave behind allow in high protein and low fat consumption. The patient go away be varaned for ignoring the signals of hunger or track every distortion. The rational for this life style noise is accrue in hypertension and cholesterol with protein intake. A weight expiry by ten kg may have substantiating impact on the cholesterol and blood pressure as per Nanditha et al., (2016). Further visible activity is congenital for overweight individual. It leave behind patron dress weight every month and leaven the metabolic rate. The patient may be recommended for aerobics as it puts lest pressure on joints. Swimming is also considered better than continue and walking. Involving in corporeal activity for 30 minutes for five-spot days in a week volition help the soundbox mange dulcify level by improving esthesia to insulin (Koolhaas et al., 2017). The patient give be back up with preparation to advocate him to lose weight. Peter go forth be educate about(predicate) tidy diet and need of high protein consumption in present condition. To patient may be administered with the anti-obesity medication. Orlistat is another affective medicine for BMI greater than 30 kg/m2 in lessen the absorption of dietetic fat by 30%. It pass on help curb weight and associated complications. It may include glycosidase inhibitors, metaformin or insulin therapy (Bedhiafi et al., 2018). The pharmacological interventions will be initiated by collaborating with the general physician atte nding Peter.To control the glucose level, which is the second nursing priority metaformin may be continue as it was antecedently administered. Further blood pressure can be controlled by administering metaprolol (Yang et al., 2018). Medication will be administered as per the instructed dosage. Patient education is also cardinal to egotism monitor glucose and for self-charge of complications due to obesity and diabetes. The patient will be educated to cope up with the mental health concerns associated with weight loss program. The patient may be promote to stop smoking as it elevates blood sugar in diabetes patients. Referring to cognitive behavioural therapist may be powerful to help Peter manage separate out due to lifestyle interventions specially scum bag cessation. Further, the effect of smoking on his respiratory efficiency and feel rate will be explained. It will relive him of fatigue (Lycett et al., 2015). The rationale for educational intervention is to elevate cl ient in adopting healthy behaviour. The potency of the outcomes must be evaluated as per the companionship of clinical reasoning cycle (Dalton, Gee & Levett-Jones, 2015). The patients weight will be monitored daily. It is grievous to assess his discretion of the illness and interposition procedure to ensure compliance. The patients vital signs will be assessd to traffic pattern of any side effects of medications and modify diet. The patient will be monitored for deviations in exercise, nutrition and diet recommendations. The client is expect to demonstrate reducing weight as per plan and healthy eating. The patient is anticipate to self monitor glucose and show high self abide by in coping with complications. It is also important to assess for hyperglycaemia condition (American Diabetes Association, 2015). materialization on the care process is the last stage of the clinical reasoning cycle that involves contemplating on the sympathize with and learning process (Dalton, G ee & Levett-Jones, 2015). It may be baffling for client to mystify to dietary recommendations in initial build of treatment as he lacks emotional support. The patient also has low self esteem due to poor body image. To address the challenges I will run client in motivational therapy and conference discussions to promote social connectedness (Harvey, 2015). Further, challenges will be identified to prioritize future(a) action.The essay helped learn ways to describe patient health issue and prioritize care for Peter using clinical reasoning cycle. realisation of health issues support in prioritizing care. The dick helped in collecting and analyzing the clinical information. synopsis facilitated the understanding of factors be the Peters healths complications. Prioritizing the care point the development of qualified nursing interventions. The interventions to reduce weight and control glucose level in patient are based on evidence. It will help to address the priority issu es and promote the patient health.American Diabetes Association. (2015). 3. sign evaluation and diabetes commission planning.Diabetes Care,38(Supplement 1), S17-S19.Cheung, B. M., & Li, C. (2012). Diabetes and hypertension is in that respect a common metabolic pathway?.Current coronary artery disease reports,14(2), 160-166.Choi, N. G., & DiNitto, D. M. (2014). 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Impact of lifestyle intervention in uncreated prevention of eccentric 2 diabetes did not differ by baseline age and BMI among Asian?Indian people with damage glucose tolerance.Diabetic Medicine,33(12), 1700-1704.Urden, L. D., Stacy, K. M., & Lough, M. E. (2015).Priorities in critical care nursing. Elsevier Health Sciences.Yang, T., Hao, Y., Zhou, S., Jiang, Y., Xu, X., Qu, B., ... & Liu, W. (2018). GW26-e0732 blue-ribbon(prenominal) Dynamic feeling Rate tone down and Non-Inferior Blood pressure level Control with Bisoprolol vs metoprolol Sustained grow Tablet in Mild-to-Moderate Hypertension inventive Study.Journal of the American College of Cardiology,66(16 Supplement), C202.