Healthy Individual Presentation By Jeff Hershberger Patient Profile

Healthy Individual Presentation By Jeff Hershberger

Patient Profile, Assessment, and Past History • C. M. • 57 years old • Friend of the family for over 30 years • Vital signs/Other Measurables: 5'4” 175 lbs, BP 160/85, HR 85, R 20, T 98. 2, BMI 30 • C. M. is a Caucasian female that lives alone in a home in North Canton, Ohio. She has no children and was never married. She has worked for our family business for 13 years. Patient is a devout catholic. • Patient denies use of tobacco products, alcohol, and illicit drugs. • Patient denies psychological history with the exception of “day to day stress. ” She has an extensive health history including hypertension, diabetes (type 2), hypercholesterolemia, neuropathy (secondary to her diabetes), chronic migraines, arthritis, and diverticulitis. • She has had bilateral knee replacements (2005), an appendectomy (2006), and a tonsillectomy (unable to recall year).

Assessment, Risk Behaviors, and Personal Health Beliefs • Risk Factors and Behaviors: Chronically ill, borderline obesity, irregular diet, sedentary lifestyle, inappropriate management of financial resources regarding medications, inadequate discipline and organizational skills, hypertension, and hypercholesterolemia (Hill, 2011). • Health Beliefs: C. M. believes that her health is poor because of genetics. She finds it “easier” to manage her symptoms instead of the causative factors. She states “I would rather live happily for 60 years than miserably for 70 years. ” • Based off the patient's health history and risk factors, we agreed to focus on managing her diabetes and improving her health awareness regarding the topic. • Assessment of patient completed on September 16 th 2012 @ 1700

Assessment & Diabetic Questionnaire • When were you diagnosed with diabetes? “ 33 years old. ” • Do you have a family history of diabetes? “No that I am aware of. ” • Have you received any formal education regarding diabetes? “Yes when I was last in the hospital, but that was several years ago. ” • How do you learn best: Hands-on, demonstrations, reading, or listening? “Listening. Though with certain things demonstrations are better. ” • Do you test your sugar at home? “Yes, well, usually. ” • Are you on a diabetic diet? What is that? “I guess not. ” • Do you keep records of your blood sugars and interventions? “No. ” • How often do you exercise each week? “I do not do anything scheduled. I get most of it at work or through housework and grocery shopping. ” • How often do you get ill? “Nothing usually too serious. I get colds quite a bit. ” • Do you take your blood sugar when you are sick? What is a standard result for you? “No, I don’t take them when I am sick. I lose my appetite. Often my

Health Promotion Model & Goal • Pender's Health Promotion Model • Patient's Perceived Strengths/Self-efficacy: Determined, membership to YMCA (through employment), access to vital sign equipment and scale, and supportive friends and co-workers. • Patient's Perceived Weaknesses/Barriers: Price of healthy food, discomfort associated with exercise, unorganized, inadequate diabetic education. Inappropriate allocation of financial resources. • Healthy Behavior Goal: To show a stable yet steady trend in glucose levels towards the acceptable ranges of 70 -150 through diet revision, exercise participation, weight loss, and proper coverage techniques.

Plan of Action & Outcome • Educational Interventions: The co-morbidities associated with mismanaged diabetes, the proper times to check blood sugar and proper administration of insulin, importance of maintaining diabetic management during periods of illness, the importance of weight management, appropriate diabetic diets, obtaining HA 1 C and how it differs from daily checks, and the importance of developing a system to record and track changes in blood sugar to identify trends (Forth & Jude, 2011). • Active Interventions: Assisted patient with enrolling into activity programs at the fitness club that were appropriate for her level of endurance to achieve an ideal BMI of 20 -25, located easy to prepare recipes that are low in sugar and saturated fats, restocked diabetic management supplies, and created a spreadsheet on her computer to track daily diabetic results and management (Nazarko, 2011). • Plan & Outcome: I made a commitment to the patient to review her weight, vital signs, and spreadsheet weekly for 1 month. Additionally, I accompanied C. M. To the fitness club for each of her low-impact classes (first session only) to ensure she was comfortable and understand what to expect. Finally, I assisted my patient with the removal of her unhealthy foods and subsequently replaced them with foods conducive to a proper diabetic diet. At the end of 1 month, her weight was down to 167 lbs and BP reduced to 150/80. I did random weekly blood glucose checks which were as follows: 176, 154, 170, and 148. BMI is still slightly high at 28. 7.

Discussion of Resources • Community Resource #1: North Canton YMCA • Mission and Purposes: To put Christian principles into practice through programs that build spirit, mind, and body for all. • Type of Care, Goals, and Objectives: Youth Development, Healthy Living, and Social Responsibility • Sources of Funding: Monthly fee • Management & Staffing: The staff is organized into functional levels. Each area has instructors present for assistance (exact numbers not available). A child care program is also part of the membership to assist with participation. • Who the Agency is Responsible to: The community

Discussion of Resources • Community Resource #2: North Canton Medical Foundation • Mission and Purposes: To provide charitable, health-related services that improve the quality of life for many people in our community. • Type of Care, Goals, and Objectives: Individual evaluation and development of a persona plan of care to help you meet your learning and lifestyle goals, group education classes to expand your knowledge, follow-up care to modify your plan of care, diabetic support groups, and advanced education on topics such as insulin therapy & carbohydrate counting. • Sources of Funding: Donations (nonprofit organization) • Management and Staffing: Physicians, nurses, and volunteers (exact numbers not available). Facility is set on 96, 000 square feet of land with a newly constructed 250 seat educational auditorium. • Who the Agency is Responsible to: The community

References Forth, R. , & Jude, E. (2011). Diabetes: Complications, preventions, and treatment. British Journal of Healthcare Management, 17(1), 30 -35. Hill, J. (2011). Diabetes monitoring: Risk factors, complications and management. Nurse Prescribing, 9(3), 122 -130. Nazarko, L. (2011, November). Current treatment of type 2 diabetes. Nursing & Residential Care, 13(11), 530 -532. North Canton Medical Foundation website. (2012). http: //www. ncmf. com/ The YMCA website. (2012). http: //www. ymcastark. org/north-canton-communitybuilding-ymca