Description NUR2102 Chronic Care Across The Lifespan B
Apply Strategic Priority Area (Promote health and reduce risk) and (Active Engagement) of the National Strategic Framework for Chronic Conditions strategies and identify and describe how you would assess, intervene and evaluate care for the case study “Mr James Storey”. NUR2102 Chronic Care Across The Lifespan B
Step 1: Read the case study of Mr James Storey as provided on page 4 of this task sheet
Step 2: Read the National Strategic Framework for Chronic Conditions via the link provided in the Resources available to complete the task section below.
Focus your reading on Strategic Priority Area 1.1 (Promote health and reduce risk) and Strategic Priority Area 2.1 (Active Engagement).
Step 3: Using the information provided in the case study apply the National Strategic Framework for Chronic Conditions Strategic Priority Areas (1.1 and 2.1) to write short answers (200 words) in paragraph format responding to the following questions:
1. Identify the risk factors for Mr James Storey and clearly explain why these are risk factors for him.
2. Using the best available evidence, identify the nursing assessments that are required to be conducted for Mr James Storey and the rationale for these.
3. Using the best available evidence, discuss the self-management priorities that would be developed in collaboration with Mr James Storey. These should consider health promotion and reducing the risk of complications (Strategic Priority Area 1.1).
4. Utilising the SMART acronym (Specific, Measurable, Achievable, Relevant and Timely) identify and describe one goal that will be set in collaboration with the patient from the self-management priorities identified in Q3. Explain why this goal was selected.
5. Using the best available evidence, explain how goal setting may impact on actively engaging patients in their care (Strategic Priority Area 2.1).
Case Study: Mr James Storey.
Mr James Storey is a retired 66-year-old man with a 5-year history of type 2 diabetes. His pastmedical history includes hypertension and a family history of type 2 diabetes and cardiovascular disease. Although only recently diagnosed, he identifies as having hyperglycaemic symptoms for 2 years prior to diagnosis. At the time of initial diagnosis he was advised to lose weight (at least 5kg) but no further action was taken. James presents to his local General Practitioner (GP) with recent weight gain, suboptimal diabetes control, and bilateral foot pain. He has been wanting to lose weight and increase his exercise for the past 6 months, but states that he lacks motivation.
James takes Metformin 1000mg once per day. He tolerates this medication but admits that he regularly forgets to adhere to his medication schedule. He does not test his blood glucose levels (BGLs) at home. He expresses doubt that this would help him improve his diabetes control as the doctor already knows that his blood sugar level is high. In the past, his wife has encouraged him to treat his diabetes with herbal remedies and weight-loss supplements.
NUR2102 Chronic Care Across The Lifespan B
James recently closed his business due to the increased stress this was causing and states that he now has “nothing to do”. He used to be very active in a variety of community organisations, however, he now finds that he is constantly too tired to keep this up. James lives with his wife of 40 years and has two married children who live overseas. Although both his mother and father had type 2 diabetes, James has limited knowledge regarding diabetes management and states that he does not understand why he has diabetes since he rarely eats sugar.
During the past year James has gained 12kg and, since retiring, he has become less physically active. He has never seen a dietitian and has not been instructed in self-monitoring of blood glucose (SMBG). James’s diet history reveals excessive carbohydrate intake in the form of bread and pasta. He also consumes five to seven pieces of fresh fruit per day at meals and as snacks. He drinks beer daily (approximately 3 standards drinks) and smokes occasionally.
As part of his primary care assessment, James has never had a foot examination or ever received preventive foot care instruction. However, his medical records indicate that he has had no surgeries or hospitalizations, his immunizations are up to date, and, in general, he has been healthy for many years. NUR2102 Chronic Care Across The Lifespan B