ASSESSMENT TASK ONE
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 a 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 deeming 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:
Lisinopril 10mg daily (Treatment of the condition of high blood pressure and the various symptoms of hypertension)
Pregabalin (Lyrica) 50mg nocte (Used for the mitigation of problems such as seizure, used for mitigating the symptoms of excessive shaking and sweating/diaphoresis)
Insulin Novomix 30 BD (34units mane & 28units nocte) (Used for the mitigation of the diabetic condition of the reviewed patient)
Metoprolol 50mg BD (Lowering of the overall blood pressure of the patient to acceptable results)
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)
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).
This is a definite priority that needs consideration and acknowledgement since the aspects of healthcare are incomplete without the formulation of a proper plan. The delivery of care in an appropriate and effective manner is thus one of the main priorities of care for consideration in this regard, with the management of the various aspects related to the same being necessary in the long run (Mozaffarian, 2016). One of the main constituent tasks that need effective completion in this regard includes the determination of the main causes and effects of the afflicting conditions in question. For example, the presence of type II diabetes has ensured the need to mitigate the levels of blood glucose and sugar, with a controlled diet also helping in the management of the obese condition that Peter Mitchell is suffering from as well. Since the aforementioned need to be considered and managed to ensure the overall well-being of the patient in question, it is necessary to include them in the overall care plan in a proper manner as well. The main caretakers in this regard (such as the nurses and the attending doctors) need to ensure that the implementation of the aforementioned is ensured in an appropriate manner, with the presence of the same helping increase the chances of success of the overall care plan (Schmittdiel et al. 2015).
The determination of the main symptoms and effects of the afflicting conditions can help in the gain of a relevant magnitude of understanding pertaining to the countermeasures to be taken against their onset, with the details of the tasks pertaining to the said countermeasures needing to be implemented in the developed are plan as well. In the case of Peter Mitchell, the diabetic and obese conditions are some of the most threatening symptoms, with the breathing issues needing to be considered and analysed appropriately as well. As such, the details regarding the main medications and diet restrictions that need to be ensured are among the main considerations in this aspect as well, with the implementation of the same within the developed care plan being absolutely crucial in this regard (Funnell, Bootle & Stuckey, 2015). Indeed, the care plan has to include the details of the correct administration of the medications and the diet/exercise plan (as well as take the social conditions of the patient under consideration, with a developed timetable being helpful in the division of the necessary tasks on a daily basis), in order to truly be successful in managing to provide a proper degree of care for the reviewed patient under consideration (Kavakiotis et al. 2017).
The completion of the aforementioned tasks ensures the fulfillment of one of the main priorities of care, with the proper implementation of the same helping the caretakers in mitigating the effects of the afflicting conditions of the patient in an appropriate and effective manner. Another of the main priorities of care is the ensuring of a proper degree of interprofessional collaborations among the various healthcare professionals (such as the doctors, various kinds of nurses and the attending caretakers of the reviewed patient). The care plan can be properly implemented only in the case of a proper degree of collaboration between the various healthcare professionals, with the presence of an appropriate level of communication and interactions between them being necessary for the fulfillment of the main objectives and aims in this regard (Wafa & Nakhla, 2015).
The nurses and the doctors (as well as the attending caretakers) have to communicate appropriately and in a timely manner to ensure the proper implementation of the care plan and monitor the overall progress of the patient’s recovery in a desirable manner. Thus, the determination and eventual completion of the main objectives related to the given priorities of care can help in initiating a proper degree of care for them reviewed patient (Wafa & Nakhla, 2015).
Clinical Reasoning Cycle
The Clinical Reasoning Cycle is one of the most appropriate tools for the determination of appropriate options for initiating proper strategies and tactics in certain situations. The application of the various steps of the cycle can help in the effective fulfillment of the main aspects and features of the tasks pertaining to the fulfillment of the main care priorities for the reviewed patient as well (Hunter & Arthur, 2016). The main steps of the Clinical Reasoning Cycle (as well as its application on the main priorities of care) include:
The consideration of the overall situation of the patient (understanding the diseases, conditions and ailments afflicting Peter Mitchell)
Collection of the necessary information (through checking the medical history of the reviewed patient)
Processing of the gained information (understanding the magnitude of the symptoms of the conditions)
Identification of the main problems (gain of an understanding the main effects of the afflicting conditions on the part of the professionals and caretakers)
Establishment of the goals (fulfillment of the care priorities such as the development of the care plan and the establishment of relevant communication/interactions between the various healthcare professionals and caretakers)
Conduction of the action (going through with the developed objectives and strategies pertaining to the fulfillment of the main care priority-related objectives)
Evaluation of the main outcomes (comparing the generated results with the previous readings of Mitchell’s symptoms)
The reflection of the overall processes (understanding the main benefits of the implementation of the tasks pertaining to the fulfillment of the main care priorities)
Figure 1: Clinical Reasoning Cycle
(Source: Hunter & Arthur, 2016)Koivisto et al. (2016) agree that the application of the Clinical Reasoning Cycle has been immensely crucial for the completion of the determined priorities of care, with the implementation of the same helping in the stepwise determination and completion of the main steps to be taken in this regard. The implementation of the Clinical Reasoning Cycle further justifies the importance of the chosen priorities of care for a patient such as Peter Mitchell, with the successful completion of the main objectives related to the same leading to proper delivery of caretaking service (and the eventual long-term benefits for the patient in question).
The determination of the main priorities of care is an immensely beneficial task for completion, with a consideration of the same needing to be acknowledged to an appreciable degree by the relevant healthcare professionals and caretakers. The understanding of the main aspects and details of the patient, as well as the fulfillment of the objectives pertaining to the main priorities of care, can help in the effective mitigation of the chronic conditions afflicting patients such as Peter Mitchell. Thus, it is concluded that the determination of the main priorities of care, as well as their proper implementation and justification through the use of tools such as the Clinical Reasoning Cycle, is necessary for initiating an appropriate degree of care for patients such as Peter Mitchell.
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