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In: Nursing

John is a 55 year-old Caucasian man with diabetes and asthma. He teaches math at a...

John is a 55 year-old Caucasian man with diabetes and asthma. He teaches math at a local high school in New York City. He was diagnosed with type 2 diabetes on blood tests performed when he applied for life insurance at age 51. At the time, he was obese, weighing 220 pounds at 5 feet, 10 inches height (BMI = 31.6). He stopped smoking at age 46 and he does not consume alcohol.

What other interdisciplinary recommendations would you suggest for J.W.?

Solutions

Expert Solution

Interdisciplinary recommendations include:

Diabetes

Nutritional management

Stress the importance of well balanced diet as a part of diabetes management plan

Explain the impact of carbohydrates on glycemic index and blood glucose level

Physical activity

Discuss the effect of regular exercises on the management of blood glucose , improvement of cardiovascular functon and general health

Medication Adherence

  • Ensure that the patient understand proper use of prescribed medication(e.g: insulin, OAs and noninsulin injectables)
  • Account for a patient's physical limitations or inabilities for self medication. if necessary invovlve the family or care-giver in proper use of medication
  • Discuss all side effects and safety issues regarding medication

Monitoring blood glucose

  • Teach correct technique of blood glucose monitoring
  • Include when blood glucose levels should be checked, how to record them and how to adjust insulin levels if necessary

Risk reduction

  • Ensure that patient understands and appropriately responds to the signs and symptoms of hypoglycemia and hyperglycemia
  • Stress the importance of proper foot care , regular eye examinations and consistent glucose monitoring
  • Inform the patient about the effect of stress on blood glucose

Psychosocial

Advise the patient of resources that are available to facilitate the adjustment and answer questions about living with chronic conditions

Asthma

Medications

Control of symptoms can be acheived by teaching the patient about medications. The drug regimen itsekf can be confusing and complex

Teach patients the importance of monitoring their response to medication. it is easy to undermedicate or overmedicate unless careful monitoring is ongoing

Advise the patient to keep a diary for medication use, wheezing or coughing ,peak flow, the drug's effects and activity level. This informaion will help the health care provider to adjust the medication

Nutrition and exercise

Good nutrition is important . Physical exercise(swimming, walking, stationary cycling) within the patient's limit of tolerance is also beneficial

Sleep that is uniterrupted by asthma symptoms is an important goal. If the patients with asthma , wake up because of symptoms their asthma is not under good control and therapeutic plan must be re-evaluated

Nightingale answered 2 years ago
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