CHE 325 7-1 PMH - assignment for che 325 PDF

Preview

Summary

assignment for che 325...

Description

Patricia Hammock CHE325 7-1 Final Project Southern New Hampshire University Summer 2021

My client Paula is a 58-year-old African American female. She was admitted to a diabetes clinic with uncontrolled diabetes. She was diagnosed with Type II Diabetes Mellitus 18 months ago. Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Following the diagnosis, she was referred to see the diabetes coordinator for education management, in which she failed to follow up. Initially reading about my client, I noticed she was unemployed. She didn’t seem like the one to listen when it came to her health. When her doctor told her to follow up with a specialist about her condition, she did not. Other than her diagnoses there wasn’t too much to go on. There wasn’t anything mentioned about her social or emotional state. After receiving additional information about Ms. Paula, I found out that she was divorced, a volunteer and had relatives living with her. This information helped to piece together her social and emotional state. Although being divorced, she still had people in her life to talk to, people to support and love her. Type II Diabetes (T2D) is a chronic disease. It is characterized by high levels of sugar in the blood. Type II Diabetes is also known as Diabetes Mellitus (adult-onset diabetes), this is because this type is mostly seen in individuals who are in their “middle/late” adulthood. However, anyone young or old can have this type of diabetes. According to the CDC “More than 34 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have Type II Diabetes. Type II Diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it” (CDC, 2019). Symptoms for Type II Diabetes often develop over many years and can go on for a long time without ever being. Some risk factors associated with Type II Diabetes Mellitus includes (but not limited to): 

Weight (mainly being overweight)



Family History



High blood pressure and/or High Cholesterol



Depression

 

Race and Ethnicity (African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander) Not physically active



Are 45 or older

Of the seven listed risk factors I learned that two of them could have contributed to Paula’s health condition, which is Age and Race/Ethnicity. One may say that she may have suffered depression during/after her divorce and being laid off from her job which she had for over 20 years, but it’s not factual information just yet. There’s no proof that she was depressed or had family history or has any other health related issues. With over a million of Americans living with Type II Diabetes (T2D) the importance of education and treatment couldn’t possibly be more significant. The wellbeing and monetary expenses of overseeing, as opposed to improving, the entanglements related with T2D requires a careful look at treatment alternatives that are accessible for it. The national guidelines regarding Type II Diabetes imply that individuals who have been diagnosed should check their blood sugar regularly (at least once a day). According to the CDC, in doing so, the individual can monitor themselves and watch as their numbers go up and/or down. “With this information, you can work with your health care team to make decisions about your best diabetes care plan” (CDC, 2019). Over the years the American Diabetes Association (ADA) recommendations for glycemic control (Glycemic control is a medical term referring to the typical levels of blood sugar (glucose) in a person with diabetes mellitus.) have consistently targeted HbA1c values of less than 7% ² pointing to the vascular benefits of maintaining HbA1c in this range while remaining mindful of

the risks of hypoglycemia. “A hemoglobin A1c (HbA1c) test measures the amount of blood sugar (glucose) attached to hemoglobin” (WebMD, 2020) According to the ADA, Pharmaceutical therapy, Insulin Therapy, Combination Therapy, Basal Insulin and Injectable Therapy are all recommended for treatment options to manage T2D. Metformin is the drug of choice for the treatment of adults diagnosed with T2D because compared to the others it the treatment with the less side effects. It is the most prescribed in the U.S. However, taking a lot of medications to manage T2D can be risky, and may do more harm than good. A good diet and lifestyle changes are also recommended for managing Type II Diabetes. When it comes to my client Paula, the medication may work for her it’s just up to help to take the medication. She must be willing to follow up with her doctors. She must put forth effort to manage her diabetes. With her actively involved with her church and having family living with her they can help to support her through her battle with T2D and help to manage it, by staying on top of her, to stay on top of her health. Paula could also look into support groups or to help her with understanding and managing her condition. The traditional medical approach that was initially recommended for Ms. Paula was to follow up with a diabetes coordinator for education management. This approach was ineffective because my client failed to follow-up with the specialist. Although the recommendation was good for my client, it became ineffective the moment she didn’t set up the follow-up. Without more information it’s hard to determine why there was no follow-up. It could be she didn’t take her health issues serious, or maybe she forgot. The aging population tend to forget things as the age, especially if they aren’t fully understanding of the benefits of taking care of themselves. When thinking about complementary alternative medicines as an approach I have mixed beliefs. I can’t be 100% sure that the CAM would work, or if my client would go through with it,

or if the CAM would cause more harm than good. For instance, if my client considered taking herbal remedies to control her T2D (Type II Diabetes), she has a 50% chance that it would help. If she was having issues with her blood sugar (glucose) being extremely high or extremely low and she figured “I’ll just have some of the herbal remedies”, I don’t think my client would understand that her life was on the line if it didn’t work. She could fall into a coma or stoke or even die. Yes, CAM for diabetes have some advantages one main one being less expensive, they also have drawbacks such as long-term treatment, or not being useful in emergency situations, or even the fact that there is minimal scientific research meaning there is no regulation. “Much of alternative medicine isn’t approved by the U.S. Food and Drug Administration”. Some healthcare professionals wouldn’t even recommend CAM for T2D treatment. According to Dham (2006), “Several CAM practices and herbal remedies are promising for diabetes treatment, but further rigorous study is needed in order to establish safety, efficacy, and mechanism of action”. Majority of healthcare providers like the American Diabetes Associations standard of medical care do not even approve the use of CAM. There are a handful of helpful lifestyle modifications that could be implemented in order to more effectively manager my client’s disease. Eating healthy, exercise, regular check-ups, no smoking/drinking, and managing stress levels are all types of modifications that my client could take to manage her T2D and improve her quality of life. When you have diabetes, what you eat effects the glucose (blood sugar). An individual with diabetes must cut back on things that could cause the blood sugar to rise too high. For instance, carbohydrates turn into sugar, if an individual was to consume too much bread, later on which breaks down into sugar and could cause issues with their levels. It’s critical that one with diabetes monitor what they eat. Staying active or getting active is another big important thing a diabetic much do or start doing. “An

active lifestyle helps you control your diabetes by bringing down your blood sugar. It also lowers your chances of getting heart disease. Plus, it can help you lose extra pounds and ease stress.” (DiLanardo, n.d). I would recommend wellness programs for my client. Diabetic wellness programs are a great fit for Paula. These programs would provide exercises Paula could take part in, while also providing her with support and knowledge on ways to take control and manage her T2D. The purpose of these wellness programs is to better equip the patients with information and answer any questions they may have and helping to maintain or improve physical well-being and quality of life. “Type 2 diabetes is a multi-faceted disease requiring layers of interconnecting treatment strategies, the synthesis of which provides patients with the knowledge and tools they need to properly manage their disease and to prevent disease advancement” (Van Wyckhouse, n.d). In the case of my client, Paula would need to have some type of support system to help her to improve her health. There are studies that show having a good support system have many positive benefits, for instance, higher levels of well-being. It can also combat social isolation which could put her at a higher risk of other illnesses or issues related to her health down the line. My recommendation for Paula would be to reach out to someone for help. Getting people like her daughter or close friend she volunteers with involved with helping her to stay on top of her health. Paula can start small by taking track of the things she normally does within a day. I recommend she marks down the foods/beverages she consumes and the exercise she does within a day. Also keeping track of her glucose before/after meals and when she notices changes in feeling (drained/tired/energized). After a few days of that she can come up with goals to better herself. Monitoring her blood sugar regular can help to prevent her from needing medical attention.

Specific Health Domain*

Paula, 58-year African American female has T2D a Specific health domain would be psychological. Now although emotional health can be a function of our social health, emotional health is the ability to understand ourselves internally and cope with the challenges life can bring.

Recommendations*



  

  

Monitorin g blood sugar (glucose) Regular check-ups Balanced diet Medicatio n (if prescribed ) Exercise Wellness programs Goal setting (large or small)

Resources Required

  

 

Glucose meter Psycholog ical support Knowledg e and training programs Insulin Notepad/J ournal

Order of Implementation

The first thing my client should do is schedule a visit to see a specialist. Then she should continue to follow-up until instructed not to. After seeing the specialist, she should consider working on a balanced diet and exercise.

Desired Outcomes (Improvement Measures)

  

Lower glucose readings Better overall health Lower risk factors for other disease/ill nesses

Justification

With Diabetes being a serious medical condition Paula should take any chances. She should see the specialist before taking any other actions for the simple fact that whatever she may consider doing could cause her more harm. She shouldn’t diet and exercise first because she may cut back on something or implement something in her diet that will set her glucose levels “out of whack”.

CDC (March 20219), Monitoring Your Blood Sugar, Retrieved from: https://www.cdc.gov/diabetes/managing/managing-blood-sugar/bloodglucosemonitoring.html

Dansinger, M. (Medically Reviewed 2020, November 6). HbA1c (Hemoglobin A1c): A1c Chart, Test, Levels, & Normal Range. WebMD. Retrieved from: https://www.webmd.com/diabetes/guide/glycated-hemoglobin-test-hba1c. Dham, S., Shah, V., Hirsch, S., & Banerji, M. (2006). The role of complementary and alternative medicine in diabetes. Current Diabetes Reports, 6(3), 251–258. https://doi.org/10.1007/s11892-006-0042-7

DiLonardo, M. J. (n.d.). 6 lifestyle changes to help control your diabetes. WebMD. Retrieved from: https://www.webmd.com/diabetes/diabetes-lifestyle-tips Van Wychouse, L. (n.d.). Improving workplace wellness for diabetes patients ~ a unique solution. RSS. Retrieved from: https://www.corporatewellnessmagazine.com/article/wellness-for-diabetes-patients...