Patient Education Plan
You are the nurse organising Trevors care following the first episode of Trevors case study. Using the nursing process, you need to present your assessment data and nursing diagnoses relating to Trevors need for education regarding his lifestyle, illness and treatment. You need to formulate an evidence-based care plan (see Structure and Presentation below) relating to these nursing diagnoses.
Nursing Diagnoses are the problems you find on assessment. They are not medical diagnoses. The medical diagnoses are Trevors Ischaemic Heart Disease (IHD) and Diabetes Mellitus. One example of a nursing diagnoses for Trevor is his breathlessness related to his smoking and obesity. You need to observe his subjective and objective data and analyse what is normal and what is not normal. You only have 900 words (+ 10%) so please DO NOT repeat the scenario and information already given to you unless it is crucial to highlighting a problem.
Remember, the focus of this task is patient education ie. You diagnose his problems (there are several problems including physical, social and psychological) and set goals to improve his health.
Your plan must be appropriately referenced. A minimum of 8 recent evidence-based resources is required for this section of the assignment. APA is the required referencing style for assignments in the School of Health.. Please do not over depend on websites and avoid supporting your points using consumer sites such as Better Health Channel. You must use professional sources as much as possible. Diabetes Australia and the Heart Foundation are acceptable due to their significant research/evidence base.
Kozier and Erbs Fundamentals of Nursing you will find Chapters 11 to 15 very helpful. Help-lines are acceptable as Trevor needs to find information and get support.
& Brown, D. & Edwards, E. (2013) Lewiss Medical-Surgical Nursing 3ed Elsevier, Sydney Chapter 4: Health Promotion and Patient Education
Structure and presentation
1. This assignment should be briefly introduced.
2. You are then required to provide a care plan. The main content of the assignment should be presented in a care plan (grid) format.
3. The columns should be organised as follows: Nursing Diagnoses (based on your assessment findings),
4. Nursing Interventions (what you will plan for Trevor),
5. Goals/Outcomes (what he needs to achieve ie. reduce smoking/stop smoking by what time),
6. Evaluation (what has or hasnt been met)
7. Rationale (evidence).
8. A brief conclusion is also required.
9. A Reference List should be provided as standard.
10. Some points is important should cover (dont copy any of these sentences)
a. Planning for the intervention to reduce the Trevors risk factors associated with ischemic heart disease and diabetes type 2 is needed during the patient education.
b. The fact that Trevor is obese
c. Nutrition education on how to manage type 2 diabetes
d. Smoking is leading to lung cancer disease.
e. Related between the Trevors diet (high levels of sodium and salt) and increasing the blood pressure
f. the education on management of risk factors associated to ischemia heart disease and type 2 diabetes
The case study
Trevor comes to see the doctor
You are on clinical placement in a general practitioner (GP) office, assisting the practice nurse in taking patient histories and conducting general assessments. Trevor Larkins has come for his appointment.
So how are you feeling, Mr Larkins? you ask.
Fine I feel absolutely fine. Im only here because the wife made an appointment.
So what did you want to discuss with the doctor?
Susan thats my wife shes got in in her head that I need a check up. We go for a walk every morning and she says I shouldnt get as breathless as I do. She reckons the doc should give me the once over.
So how far do you and your wife walk each day? you ask Trevor. Is it very far? And do you walk slowly or briskly?
Well, its not power walking, thats for sure. Trevor goes on to tell you that he and Susan walk about 200 metres around the block near their home each day, to the shop where he buys his newspaper and his cigarettes.
And how many cigarettes would you smoke on average each day? you ask.
Only the one pack, Trevor tells you. Ive cut down. Thats another thing Susan keeps on about. So here I am but I dont know what all the fuss is about.
Taking Trevors history
You and the RN begin your assessment by taking Trevors history. This is the information he gives you:
He is a 61 year old man. He was born in Sydney and lived there until he was 50, when he and his wife, Susan, decided to move to this rural town (around 40,000 residents including a large Indigenous population).
He and Susan have four children, aged 23, 25, 27 and 30, who all live in Sydney.
Trevor works as an architect, spending a lot of his work day at his desk. He and Susan like to spend their weekends either relaxing at home or visiting their family.
Trevor doesnt really like physical activity and hasnt played any type of sport since he was a teenager at school. He tells you he is too busy and doesnt see the point.
He tells you he generally doesnt pay much attention to what he is eating. He says he eats whatever Susan cooks for him and when they go out for dinner (about twice each week), he usually orders steak and chips.
He was told by a GP a few years ago to get checked out for type 2 diabetes mellitus, but he has never followed up.
You and the nurse begin a full physical assessment of Trevor. Here is some of the information you collect:
Trevor is 172cm tall and weighs 122kg.
Trevors vital signs are:
Blood Pressure (BP) 143/87mmHg
Heart Rate (HR) 87 beats per minute (at rest, sitting on the examination bed)
Respiratory Rate (RR) 24 breaths per minute (at rest, sitting on the examination bed)
Temperature (Temp) 36.6oC
Oxygen Saturation (SpO2) 94% on room air
Heart sounds are normal: S1 and S2 heard clearly
Lung fields sound diminished, but clear to bases
Blood Glucose Level (BGL) 12.4mmol/L (about 4 hours after his last meal).
The doctors opinion
With this information, the GP suspects Trevor has Ischaemic heart disease (IHD) and decides to send Trevor for a fasting BGL, HbA1C and serum cholesterol tests.
A month later
Trevors test results were as follows:
fasting BGL 9.6mmol/L
serum cholesterol level 9.1mmol/L
Trevor has now been diagnosed with IHD and type 2 diabetes. He is prescribed atorvastatin 20mg oral daily and advised to manage the diabetes via his diet for the time being.