Community Nursing: Critical Thinking Case Study

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Current Health Needs
Mrs. MH is a 72 year old woman who has a primary diagnosis of Diabetes Mellitus Type II. Her secondary diagnosis and the reason why she was referred to Hackensack home health agency was a non-healing wound on the second toe of her right foot. Upon assessment of the patient, current health needs which were identified pertain to wound care, nutrition, and proper management of Diabetes through compliance with insulin treatment, and knowledge on prevention of hypoglycemic and hyperglycemic episodes. The current plan of care for Mrs. MH and the visit skill relate to wound care and Diabetes self-management.
“Diabetes Mellitus is a chronic multisystem disease related to abnormal insulin production, impaired insulin utilization, or both” (Lewis, Heitkemper, Dirksen, O’Brien, & Bucher, 2007, p. 1253). According to Lewis, Heitkemper, Dirksen, O’Brien, and Bucher (2007) some of the clinical manifestations of Type II Diabetes involve fatigue, recurrent infections, visual changes, and prolonged wound healing. As seen with Mrs. MH prolonged wound healing could become a main concern given that it puts patients at increase risk for infection. The desired goals in the treatment with Mrs. MH is to reduce symptoms of Diabetes, promoting healing and well-being, preventing acute complications of hyperglycemia, and delaying the onset and progression of long-term complications Lewis, Heitkemper, Dirksen, O’Brien, and Bucher (2007).
Standards of Care
The ANA Scope and Standards of Diabetes nursing practice (2003) states that standards of care describe a competent level of practice demonstrated through the nursing process. Starting from adequately collecting patient health data, identifying potential problems with the physical or spiritual being (e.g safety environment, depression), to formulating realistic goals for improving overall health status ( e.g. increasing physical activity), educating the patient of effective diabetes self-management (e.g. insulin



References: AmericanNurses Association, (2003). Scope and Standards of Diabetes Nursing Practice. Maryland: Nurses Books Bellenir, K. (1999). Diabetes Sourcebook. Michigan: Omnigraphics Inc. Lewis, S., Heitkemper, M., Dirksen, S., O’Brien, P., Bucher, L. (2007). Medical Surgical Nursing: Assessment and Management of Clinical Problems. Missouri: Mosby Elsevier. Roy , C. & Andrews, H. (1999). Roy Adaptation Model. Connecticut: Appleton & Lange.

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