Interdisciplinary Care Plan Class Nur 3400 Professor Maikel ✓ Solved

Interdisciplinary Care Plan7class Nur3400professor Maikel Y Porta

Interdisciplinary Care Plan7class Nur3400professor Maikel Y Porta

INTERDISCIPLINARY CARE PLAN 7 Class: NUR3400 Professor: Maikel Y. Portal APRN, FNP-BC Miami Regional University

Abstract Patient care has received much attention in today’s healthcare system. It enhances the treatment plan by involving different health specialists in caring for the patient. Interdisciplinary approach involves elements such as leadership, teamwork, patient-centered practice, and through communications. The care providers ensure effective assessment of the condition thus meeting patient’s desires and needs.

The team pools their knowledge and expertise together towards the recovery of the patients not just the treatment of the disease. Ideally, effective patient outcomes can be achieved through a collaborative approach to the treatment plan. This reduces readmission rates and avoids duplication of duties during the treatment process. The future of health care delivery depends on how effectively the health providers implement the interdisciplinary approach. In this paper, the interdisciplinary care plan will be drafted for McKay Johnson, a patient diagnosed with diabetes and heart disease.

Keywords: interdisciplinary, therapy, diabetes, heart disease.

Background Information

Patient Name:? Age: ? Sex: ? Demographics: ?

Condition: (Diabetes and Heart Disease) or any other PMH Situation: Patient is forgetful and lives alone

Medical History

Johnson was diagnosed with type 2 diabetes in 2013, but he reports he had symptoms one year before the diagnosis. The medical record shows that he had fasting blood glucose records showing values of mg/dl, which categorized his condition as “borderline diabetes.” In 2016, he was diagnosed with heart problem. Johnson has been controlling diabetes until last year when his family physician referred him to our hospital for special treatment of the disease. His wife reports that her husband began to experience abnormal heartbeats, difficulties in breathing, and high blood pressure.

The diagnosis shows that Johnson recorded a pulse of 115 per minute while the systolic blood pressure was 180 mm/Hg. He had bulging neck veins, swelling in the legs, and fluids in the lungs. He had been on glyburide (2.5 g every morning), Gymnema Sylvester, and chromium picolinate to control diabetes. Johnson was also given Angiotensin II receptor blockers and Statins to control heart disease. Johnson’s physical examination results show a BMI of 33.4 kg/m2, Pulse of 85 bpm, fasting glucose of 164 mg/dl, blood pressure of 160/96 mmHg, JVP of 7 cm H2O, and 20 respirations per minute.

He has lung crackles, no retinopathy, swelling legs, non-palpable thyroid, no carotid bruits, and diminishing vibratory sense to the forefoot. He reports regular wheezing and dizziness throughout the day. The lab results presented by the nurse show that Johnson has cholesterol-to-HDL ratio of 4 (normal

Medical Assessment

Based on Johnson’s medical history, physical examination, and lab tests, it is evident he has uncontrollable type 2 diabetes and heart disease. His hemoglobin level (7.5%) is slightly more than the normal indicators (4-7%). He has a BMI of 32.4 kg/m2 and it is way above the BMI of a normal person. When an individual exceeds a BMI of 30, he is termed as obese (Pop-Busui et al., 2017). Johnson has elevated urine microalbumin and blood urea nitrogen. These are the indicators of heart problem and diabetes. Swelling legs, lung crackles, and regular wheezing are also the signs of heart disease.

Care Plan

Johnson presents uncontrollable type 2 diabetes and heart disease, which require a coordinated treatment process from all nurses across the concerned disciplines. The first step of the interdisciplinary team is to select the most pressing health issue and prioritize his medical care in order to formulate an effective treatment plan. The team has to follow the care plan for the two diseases.

Nursing Intervention Rationale

• Assess the signs of hyperglycemia: A patient who uses insulin to treat type 2 diabetes is at risk of developing hyperglycemia. Signs include headache, fatigue, tachycardia, dizziness, and visual changes.
• Assess glucose level before and after meals: The glucose level should be between 140 mmHg and 180 mmHg. Non-intensive care patients should be maintained at less than 140 mmHg (American Diabetes Association, 2019).
• Monitor patient's hemoglobin level: A level of 4-7% indicates good management and progress of the treatment process.
• Monitor blood pressure, apical pulse, and peripheral pulse: Increased blood pressure indicates worsening of disease; low pulse may indicate poor tissue perfusion.
• Avoid taking axillary temperature: Elderly persons have poor peripheral circulation which can yield inaccurate readings.
• Assess feet for temperature, swellings: This helps monitor peripheral perfusion and detect early signs of complications.
• Monitor skin color: Pale skin can suggest decreased tissue perfusion, a concern in heart and diabetes management.
• Assess physical activity: Regular physical activity aids in lowering glucose levels and preventing complications of diabetes and cardiac disease (Naik et al., 2015).
• Administer basal insulin: Proper medication adherence stabilizes glucose and improves tissue perfusion.
• Report BP > 155 mmHg: Hypertension management prevents strokes and retinopathy.
• Monitor urine output and urine albumin: These help assess kidney function and control of diabetes and cardiac condition.
• Encourage active ROM and bedrest with head elevated at 45°: Improves circulation, oxygenation, and reduces dyspnea (American Diabetes Association, 2015).
• Evaluate patient's understanding of conditions and treatments: Promotes adherence and reduces medication errors.
• Administer and monitor medications: Ensures stability of blood glucose, hemoglobin levels, and blood pressure.
• Review diet and nutritional needs: Proper diet maintains glucose levels and blood flow.

Treatment Goals

At the end of treatment, Johnson should have blood glucose levels below 180 mg/dl, BMI less than 30.0 kg/m2, Hemoglobin A1c below 7%, blood urea nitrogen less than 30 mg/dl, and urine microalbumin less than 30 mg/dl. Achievement of these targets indicates successful intervention.

References

• American Diabetes Association. (2015). Cardiovascular disease and risk management. Diabetes Care, 38(Suppl. 1), 49-57.
• American Diabetes Association. (2019). Standards of medical care in diabetes—2019. Diabetes Care, 42(Suppl. 1), 103–123.
• Pop-Busui, R., Boulton, A., Feldman, E., Bril, V., Freeman, R., Malik, R. A., & Ziegler, D. (2017). Diabetic neuropathy: A position statement by the American Diabetes Association. Diabetes Care, 40(1), 136-154.
• Naik, V., Dave, R., Stephens, J. W., & Davies, J. S. (2015). Evidence based prevention of type 2 diabetes: Role of lifestyle intervention as compared to pharmacological agents. International Journal of Diabetes and Clinical Research, 2(6), 49-56.
• Touhy, T., Jett, K., Boscart, V., & McCleary, L. (2018). Ebersole and Hess' gerontological nursing and healthy aging (5th ed.). Elsevier.