Read The Assignment Brief And Complete The Instructions

Instructionsread The Assignment Brief And Complete The Instructionst

Read the assignment brief and complete the instructions. This assessment counts towards 50% of your final grade. Total marks available for this assessment: 20 marks. Pass Mark: 50% (10 marks). Assessment Brief: As a new care giver in the community, you were asked to take responsibility for caring for a sixty seven (67) year old male patient, Mr. John Snow, who was recently discharged from Georgetown Public Hospital Co-operation. He was suffering from Diabetes and Hyperlipidaemia for the past seven years but was unable to control same. He recently developed a diabetic foot ulcer and was admitted for management with intravenous medications and insulin to control his condition. After five (5) days of being an inpatient he was discharged with medications for seven days as follows: 1. Clindamycin 300mg po QID 2. Flagyl 500mg po BD 3. Metformin 500mg po TID 4. Daonil 5mg po OD 5. Aspirin 81mg po OD 6. Ramipril 5mg po OD 7. Atorvastatin 10mg po Nocte 8. Vitamin C 1gm po OD 9. BCO 1 tab po OD 10. Diclofenac 50mg PO PRN pain 11. Omeprazole 20mg po OD The patient also requires daily cleaning and dressing of the wound with normal saline and iodine. Mr. Snow is often non-compliant with his treatment regime and normally eats whatever he desires. He is usually a late sleeper and lacks physical activity and exercise. Mr. Snow was warned of his carefree behaviour and if he continues he can actually lose the affected limb. Mr. Snow is living alone with his son visiting twice a month and usually buys his meals as he doesn’t know how to cook. His son can afford to employ a home care provider and is willing to adjust his father’s lifestyle to achieve better health. As the care provider, kindly evaluate the client’s condition and with the support of his family and the instructions of the health care provider, develop a care plan to suit Mr. Snow’s condition and his needs for the seven days. Note the following: His Glucose and blood pressure level reading for the last five days are as follows: Day 1: 365 mg/dl, 130/85 mm/hg Day 2: 395 mg/dl, 128/79 mm/hg Day 3: 289 mg/dl, 139/89 mm/hg Day 4: 343 mg/dl, 145/92 mm/hg Day 5: 271 mg/dl, 140/90 mm/hg Cholesterol: 367 mg/dl. Assessment Criteria: Your Care Plan must include but not limited to the following: A) Background Information and General Overview of the Patient (4 marks) B) The Patient’s Diagnosis (4 marks) C) Goals and Outcomes (4 marks) D) Intervention Strategies (4 marks) E) Evaluation (Short Term & Long Term) (4 marks) End of Assessment.

Paper For Above instruction

The management of chronic conditions such as diabetes mellitus and hyperlipidemia demands a comprehensive understanding of the patient's clinical profile, lifestyle, and behavioral factors influencing disease control. Mr. John Snow, a 67-year-old male recently discharged from Georgetown Public Hospital, exemplifies the complexities faced by community caregivers in fostering effective health management. His case underscores the importance of personalized care planning, medication adherence, lifestyle modification, and ongoing evaluation to prevent complications and improve health outcomes over time.

Background Information and General Overview of the Patient

Mr. John Snow is a 67-year-old male residing alone, with infrequent social interactions, primarily seeing his son bi-monthly. His limited culinary skills compel him to purchase meals, thereby reducing dietary control—a critical factor in managing his chronic conditions. His background indicates a longstanding history of diabetes and hyperlipidemia, both inadequately controlled, leading to a diabetic foot ulcer necessitating hospital admission. His lifestyle habits include irregular sleep patterns, minimal physical activity, and non-compliance with medication and dietary recommendations. These behavioral traits considerably escalate his risk for disease progression, complications, and even limb loss.

His socioeconomic status allows his son to consider hiring a home care provider, highlighting potential access to additional support services. Understanding his social, behavioral, and health status provides the foundation for a tailored care plan aimed at improving medication adherence, encouraging lifestyle modifications, and preventing further foot ulcer deterioration.

The Patient’s Diagnosis

Mr. Snow’s primary diagnoses include poorly controlled Type 2 diabetes mellitus, evidenced by persistent hyperglycemia (blood glucose levels ranging from 271 to 395 mg/dl), and hyperlipidemia, indicated by an elevated cholesterol level of 367 mg/dl. The recent diabetic foot ulcer signifies advanced diabetic complications, likely due to peripheral neuropathy and poor glycemic control. Additionally, his blood pressure readings (ranging from 128/79 to 145/92 mm Hg) suggest hypertension, common in diabetic patients, which requires management to prevent cardiovascular events.

The coexistence of these conditions necessitates an integrated approach addressing glycemic regulation, lipid control, blood pressure stabilization, wound management, and patient education to prevent disease progression.

Goals and Outcomes

Short-term goals focus on stabilizing Mr. Snow’s blood glucose and blood pressure within target ranges, ensuring wound healing, and improving medication adherence. Specific objectives include:

• Achieving blood glucose levels below 180 mg/dl consistently over the next week.
• Maintaining blood pressure within 120/80 to 130/85 mm Hg range to reduce cardiovascular risks.
• Proper wound care with daily dressing and hygiene to promote healing.
• Enhancing understanding of his conditions and medications to foster compliance.

Long-term goals aim at sustainable health improvements, including:

• Achieving better glycemic control (target HbA1c
• Reducing cholesterol levels closer to target (
• Establishing a routine that incorporates balanced diet, physical activity, and medication adherence.
• Preventing future ulcerations and limb loss through ongoing health monitoring and lifestyle adjustments.

Expected outcomes include improved clinical markers, enhanced quality of life, and reduced risk of complications, achieved through collaborative efforts involving Mr. Snow, his family, and healthcare providers.

Intervention Strategies

Effective intervention requires a multifaceted approach:

• Patient Education: Educate Mr. Snow about the importance of medication adherence, dietary regulation, and wound care, emphasizing the consequences of non-compliance. Visual aids and simplified instructions should be used for better understanding.
• Medication Management: Develop a medication schedule aligned with his daily routine, possibly using pill organizers and reminder systems. Regular review of medication effectiveness and side effects is critical.
• Lifestyle Modifications: Encourage gradual incorporation of physical activity, such as short walks, tailored to his capacity. Dietary guidance should focus on balanced meals, reducing high-sugar and high-fat foods, and incorporating nutritious options.
• Wound Care: Daily dressing of the foot ulcer with normal saline and iodine, maintaining hygiene, and ensuring proper dressing techniques. Educate Mr. Snow and his caregiver on signs of infection or complications requiring prompt attention.
• Monitoring and Follow-up: Regular blood glucose and blood pressure assessments to evaluate progress. Encourage recording of readings to identify patterns and inform adjustments.
• Family and Caregiver Involvement: Engage his son and any hired caregiver in education sessions to reinforce care routines and provide emotional support, ensuring consistency and accountability.
• Referral and Collaboration: Coordinate with multidisciplinary teams—diabetologists, podiatrists, nutritionists—for comprehensive management and tailored interventions.

Evaluation (Short Term & Long Term)

Short-term evaluation involves weekly monitoring of blood glucose and blood pressure to assess response to interventions, with adjustments made as necessary. The wound healing process should be evaluated daily, noting signs of infection or deterioration. Medication adherence should be reinforced through reminders and education, and behavioral modifications encouraged.

Long-term evaluation aims to document sustained improvements in clinical parameters—target blood glucose levels, blood pressure, and lipid profile—as well as the healing of the diabetic foot ulcer. Behavioral changes, such as increased physical activity and dietary adherence, must be monitored through patient interviews, self-monitoring logs, and regular clinical assessments. Ongoing support, education, and team collaboration are essential to maintaining gains and preventing relapse or complications.

In conclusion, the care plan for Mr. Snow must be dynamic, patient-centered, and multidisciplinary, focusing on immediate stabilization and long-term health promotion. By fostering better understanding, enhancing adherence, and supporting lifestyle changes, healthcare providers can significantly improve Mr. Snow’s quality of life and reduce his risk of severe complications such as limb amputation.

References

• American Diabetes Association. (2023). Standards of Medical Care in Diabetes—2023. Diabetes Care, 46(Supplement 1), S1–S142.
• Goff, D. C., et al. (2014). 2013 ACC/AHA guideline on the assessment of cardiovascular risk. Journal of the American College of Cardiology, 63(25 Part B), 2935-2959.
• International Diabetes Federation. (2019). IDF Diabetes Atlas, 9th edition.
• Schofield, S., & Gustafsson, C. (2018). Wound management in diabetes. Nursing Standard, 32(24), 49-57.
• Thomas, D. R. (2002). The diabetic foot: An overview. Journal of Diabetes Nursing, 6(4), 124-129.
• World Health Organization. (2020). World report on vision and outcomes of diabetes management. WHO Press.
• Yuan, Z., et al. (2021). Impact of lifestyle modification on glycemic control in type 2 diabetes. Journal of Diabetes Research, 2021, 1-12.
• Wong, J. W., et al. (2017). The effect of patient education on foot ulcer healing: A systematic review. Journal of Wound Care, 26(8), 460-468.
• Mehta, N., & Singer, M. (2019). Managing hyperlipidemia in diabetic patients: Strategies and guidelines. Journal of Lipid Research, 60(3), 421-429.
• Hodgkinson, M., et al. (2020). Patient-centered approaches to diabetes care. Journal of General Internal Medicine, 35(6), 1770-1778.