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The understanding of the various factors influencing the care of the patients suffering from an assortment of chronic conditions is an important matter for consideration for the professionals and caretakers in the healthcare sector. The insights pertaining to the prioritization of healthcare are necessary for devising appropriate care strategies that stand high chances of success (Crowe et al. 2015). The determination of the two main aspects of care for a reviewed patient has been attempted in the following sections, with the implementation of the clinical reasoning cycle being ensured within the same as well. The integration of the various principles of managing the aspects of care for patients with different kinds of chronic conditions has been attempted in the following sections. Herein, this study is about the determination of the various aspects and priorities of care, with a specific focus on the details and case study of a particular reviewed patient. 

Observations of the Reviewed Patient

The given case is about Peter Mitchell, who is fifty-two-year-old male suffering from type II diabetes, with accompanying conditions including a severe case of morbid obesity. The patient in question has even been admitted to a medical ward in close proximity to his home with conditions such as obesity ventilation syndrome, sleep apnoea, and a diabetic condition which has been noted to be controlled in a considerably poor manner. Some of the major symptoms displayed by Mitchell in this regard included increased hunger, severe shakiness, high blood glucose levels, diaphoresis, and severe difficulties in breathing properly whilst sleeping. Peter Mitchell’s general physician had even suggested weight loss measures, with the management of the same being beneficial for the mitigation of the obese conditions that the reviewed patient in question has been suffering from since the onset of insulin treatment (for his diabetic condition). The main obstructions in the overall weight reduction processes include the propensity of the patient to deem the necessary exercises as too hard. The recommendations from the physiotherapist nonetheless included light exercises to be continued at home following the period of discharge.

The onset of the weight issues which Peter Mitchell has suffered from over the course of the last few years has also had negative effects on his social life in general. Being embarrassed about his size and overall weight (which stands at 145 kilograms, quite overweight for a person of his height, 170 centimeters), he tends to avoid social interactions on a regular basis. He is also a divorcee, with his sons living in different cities and visiting only on rare occasions. His social isolation and the advent of the various symptoms and issues related to his physical conditions have also induced depression within him, with the diagnosis pertaining to the same being made three months ago. Some of the other observations regarding the patient in question (especially in the immediate time period of discharge) include a Blood Pressure of 180/92 mmHg, a Respiratory Rate of 23 Bpm, a Heart rate of 102 Bpm as well as a blood oxygen saturation level of 95% on RA. The readings compare favorably with the normal readings of the said parameters, with most of the readings being within the normal range.

The main medications which have been prescribed for the patient include:

a) Lisinopril 10mg daily (Treatment of the condition of high blood pressure and the various symptoms of hypertension)

b) Pregabalin (Lyrica) 50mg nocte (Used for the mitigation of problems such as seizure, used for mitigating the symptoms of excessive shaking and sweating/diaphoresis)

c) Insulin Novomix 30 BD (34units mane & 28units nocte) (Used for the mitigation of the diabetic condition of the reviewed patient)        

d) Metoprolol 50mg BD (Lowering of the overall blood pressure of the patient to acceptable results)

e) Nexium 20mg daily (Decrease of the number of overall acids produced within the stomach, used as a means of treatment for the gastro-oesophageal reflux disease)   

f) Metformin 500mg BD (Control of the blood sugar levels and management of a proper diet)

Some of the other main habits that need a proper degree of observation include the propensity of the patient in smoking too much, with the habit being a constant source of indulgence for the last thirty years. The daily intake of smoking cigarettes is also noted to be as high as twenty, with the habit being a particular source of problems for the reviewed patient. The weight is also quite a bit more than the desirable level for a person of his height, with the body mass index (BMI) being much higher than acceptable as well. The determination of the magnitudes of the aforementioned problems is necessary for the mitigation of the issues in a proper manner, with the development of the most effective counter-strategies being ensured in case of the successful completion of the same.

Two Main Priorities of Care

The identification of the main priorities of care is essential for the determination and eventual formulation of the main counter-strategies against the conditions and co-morbid ailments which plague certain patients. Identifying the main priorities of care also ensures the presence of a necessary increase in the chances of success of the caretaking strategies in question, with the nurses and other relevant caretakers needing to ensure that they determine their main objectives and aims in a proper manner (Conklin, Morris & Nolte, 2015). The details of the reviewed case have indeed highlighted the importance of providing a proper degree of care for the said patient, as the onset and eventual worsening of the main symptoms of the afflicting conditions can pose a great degree of danger for his overall well-being in the long run. One of the main priorities, in this case, is the determination of a proper care plan for the purposes of delivering the most appropriate and effective care for the patient in question, with the successful completion of the same leading to the completion of the main objectives pertaining to proper treatment, care and the eventual mitigation of the afflicting chronic ailments and conditions (Runciman, Merry & Walton, 2017).

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