Conference Mobile Communication Healthcare -Myassignmenthelp.Com

Question: Discuss About The Conference Mobile Communication Healthcare? Answer: Introduction: Diabetes is the most common cause of death among elderly patients and other populations alike. Diabetes is also a multi-factorial disease that occurs in people associated with other health issues like obesity, chronic heart diseases, kidney diseases and the leading cause of hospitalizations among geriatric patients. The case study describes a female patient who is 65 years old, having a medical history of diabetes for twenty years. The patient was admitted in the hospital from the emergency department with a case of severe glycemic shock, difficulty in breathing and severe back pain. On diagnosis, the reports showed that the patient has cardiac blockage, is currently obese with hypertension symptoms. The patient was also asses by Beck depression Inventory and showed positive results suggesting she was suffering from clinical depression but did not take any medication prior to this admission. The back pain of the patient was treated with pain medication to minimize the pain score. The report summarizes the care plan set up for the patient with reference to the current condition to treat her glycemic shock, administration of management for the condition and address the heart blockage and depression as well. Patient education is also an important factor for the completion of the care plan and the family of the patient was taught so that the home care can be arranged properly so as to reduce risk of hospital readmission. The family of the patient was also taught to monitor the patient to avoid the risk of falling which might cause severe repercussions, which is commonly observed in geriatric patients. Objective Data Pulse ox: 89% showing low levels Cough: No such detection Sputum: not detected Oxygen: room temperature Respiratory rate: 140/90 mm Hg very high, as seen in hypertensive patients Tachypneic/Hypoventilation (too slow/shallow: Respiratory effort: effort required due to blockage in heart Respiratory rhythm: difficult, erratic and very high due to heart blockage Breath sounds: no wheezing is observed, but breath rate very high Skin: WNL, normal Skin Turgor: Tenting Weight: 90kg/lb, overweight Capillary refill: WNL Apical pulse rhythm: irregularity seen Apical pulse rate: Tachycardia beats noted Heart Sounds: (Arrhythmic sounds noted) caused by hypertension Apical/radial deficit: yes Peripheral pulses: 80mmHg R radical= Doppler, R femoral= yes, R pedal=yes, R post tib=yes; L radical = yes, L femoral= Doppler, L pedal= yes, L post tib= yes. Edema: none such detected in the chest or throat, so no possible pathogenesis is the cause of breathing trouble R Hand/arm= no, R knee to thigh= no, R ankle to knee= non-pitting, R foot/ankle=no; L Hand/arm= no, L knee to thigh= no, L ankle to knee= no, foot/ankle=non pitting, Sacrum=non-pitting. Heart blockage noticed and needs immediate assistance. Deprivation of sleep due to difficulty in breathing Neurological Oriented to : patient Communication : slow but expressive Pupils:round, with a sluggish reaction to light. Glasgow Coma Scale(score range 0-15, Coma=7): Eye opening to: spontaneous=3, verbal command =2, pain=0, no response=1. Verbal responses to: slow and effort, converses=4, disoriented, converses=3, uses inappropriate words=4, incomprehensible sounds=1, no response=1. Motor responses to: verbal command = 5, localized pain=6, flexes and withdraws=3, flexes abnormally (decorticate)=4, extends abnormally (decerebrate)=3, no response = 1. Muscle tone strength Head/ neck: flaccid, Right hand: spastic, L Hand: flaccid, RUE: LUE: flaccid, RLE: flaccid, LLE: flaccid. The muscle on the leg seem to be stressed due to her weight and mild oedema is noticed on the joints due to pressure of weight. Legs: unable to walk properly due to weight gain Depression measurement: scored out of Beck Depression Inventory Erratic mood Low self esteem Sense of failure Lack of self confidence Body image issues Pity on self Old age depression Lack of satisfaction Slow movement Constant sighs Inability to express Demotivated boredom Musculoskeletal Gait: Appearance and no movement Arms: Appearance and movement Legs: Appearance and cannot walk Spine: Appearance and difficulty in moving Location of pain: back pain and soreness in legs Loss of activity: walking is being affected by the pain Description of pain: sharp and located Pain rating on a scale of 0-10: 6 Acceptable level for this client: 5 What makes the pain worse: walking and movement What makes the pain decrease: medication, and sleep. Psychosocial (and other relevant data) patients name: Surinder Kaur gender: Female birth date/age: 65 Marital status: Married Race/ethnicity: Indian languages spoken: English No such mental illness but chronic depression History: diabetes for 20 years and takes daily insulin Obese: 90kg/lb Hypertension Weight gain is the cause of depression Currently no medication is provided for depression Unable to walk due to obesity Suffers from hypertension and back pain Inability to walk Case Study of Client: (Holistic) Among different domains of Nanda approved nursing diagnoses, this assignment will utilize actual diagnosis. The patent in the case study is a 65 year old woman named Surinder Kaur. The patient in the case study had a more or less sedentary lifestyle and stayed in home. The patient had diabetes and had been getting insulin every single day. Still her blood glucose level as per her assessment had been discovered to be extremely high. Hence it can be stated from the assessment that has been carried out for the patient, it has to be mentioned that the patient had been unable to manage her blood glucose levels properly and hence a few other health care concerns have accumulated as well. First and foremost, as an indirect result of her high blood glucose level and her sedentary lifestyle the patient had been gaining weight from the past 5 years and had been obese. Along with that, there is direct link between the cardiac complications and hypertension, and the patient had also been sufferi ng from heart blockages and the hypertension ( Kusnanto, 2017). Surinder also had excessive back pain with a pain score of and had difficulty walking due to peripheral neuropathy, a common complication that is associated with diabetes. According to the assessment data discovered about the patient in the case study, it can be mentioned that all of the different health acre complexities that the patient is suffering from had been a direct or indirect consequence of her poor management of type 2 diabetes and resultant high blood glucose at more than 200 mg/Dl. Hence based in the thorough assessment, the nursing diagnosis for the patient is high blood glucose level with severe risk for uns Extremely high blood glucose levels and severe risk for instability. Assessing the patient for vulnerability to glyceamic shock to the patient so that there is no immediate danger to the patient. Medication administration and facilitating better management of the type 2 diabetes along with educating the patient regarding the diabetes management techniques as well. Encouraging the patient to adopt a healthier life style by starting to eat healthy and maintaining a strict dietary plan with a strict yet attainable physical exercise regimen. Assessment of signs of hyperglycemia so that there is no immediate insulin- glucose level imbalances that the patient is under. Diligently assessing the blood glucose levels of the patient preferably before meal times and at bed time as well ( Franks McCarthy, 2016). Assssing and monitoring the HbA1c-glycosylated hemoglobin levels of the patient as well. Administration of basal and prandial insulin so that tissue perfusion is promoted and helps in reverting the glucose concentration to the normal levels which in turn will slow down the progression of the microvascular disease ( Diab, 2012). Administration of Sulfonylureas like Glucotrol and Diabeta, meglitinides like Prandin, Biguanides like metformin, Phenylalanine derivatives lie starlix, alpha glucose inhibitors like the acarbose and miglitol, thiazolinidiones like actos and avandia and lastly Incretin modifiers like sitagliptin. The medication will decrease insulin resistance, increase insulin production and will delay the absorption of glucose into the blood ( Paschou Leslie, 2013). Monitoring the hypertension of the patient and administer hypertensive drugs as prescribed to the patient which will help in reducing the high blood pressure of the patent and will also work to reducing the risk for strokes. Educating the patient on how to monitor blood glucose on her own using the nursing glucose meters (Modic et al., 2012). Encouraging the patient to develop a healthier lifestyle that includes both dietary changes and active and determined fitness initiative. Engaging in a therapeutic casual conversation with the patient with a cultural liaison assistance to extract information regarding her sedentary lifestyle and diet pattern ( Wexler et al., 2012). Consultation with a dietician for her to help her develop a diet plan that will sit her nutritional requirements along with facilitating eight loss and cholesterol concentration drop. Encouraging the patient to eat less junk food and maintain a protein rich and antioxidant rich diet plan with lesser carbohydrate and fat content ( Juul et al., 2012). Educating the patient with interactive and cognitive therapeutic intervention towards changing her health behaviors towards a promotional health behavior for diabetes control. Enhancing the health literacy of the patient regarding diabetes and the associated co- occurring disorders so that she can work towards managing or preventing it. Lastly, encouraging and helping the patient to begin with mild and least tiresome exercise regimen to help her build her tolerance towards physical exercise. As the patient is accustomed to physical exercise help the patient build towards more tiresome and effective exercise patterns that are targeted at quick weight loss ( Spanakis Chiarugi, 2011). The current case study here focuses upon the Surinder Kaur who is a 65 years old woman and suffering from a number of co-morbid health conditions. She is suffering from hypertension along with back pain; hear blockage and diabetes; depression and weight gain. She had been talking insulin for the past 20 years. In this respect, a care plan could be made for the patient based upon the North American nursing diagnosis association (NANDA). The NANDA diagnosis could be divided into following four types such as actual diagnosis, risks diagnosis, health promotion diagnosis and syndrome diagnosis. In this respect, the actual diagnosis has been taken into consideration where the present health responses shown by the patient are taken into consideration. For the current study, a range of complications depicted by the patient have been taken into consideration. Out of this, blood glucose monitoring have been taken onto consideration for the current study. The patient her had been suffering from type 2 diabetes and had been taking insulin for the past five years. As mentioned by Rosenberg et al. (2014), excessive dose of insulin can often lead to the deposition of body fat. Some of these have been seen to contribute to the worsening of already existent clinical condition in the patient. As the patient has heart blockage the presence of obesity could further worsen the condition. As mentioned by Jindal et al. (2017), obesity has been linked with high blood cholesterol levels. Some of these conditions restricted the life processes of the patient. This further developed depressive thoughts or feelings within the patient. However, one of the most important clinical conditions which were expressed within the patient and needed immediate clinical intervention are monitoring of high levels of blood glucose level. Therefore, the high levels of blood glucose level could lead to fatal consequences where the patient could develop glycaemia shocks. The hyperglycaemia could be associat ed with a range of symptomatic expressions, which could dishevel the normal life of the patients. Some of these are excessive urination, excessive thirst, weight gain, diabetic neuropathy and diabetic retinopathy. As mentioned by Ng, Finnigan, Connellan, Kiernan Coward (2014), high levels of blood glucose can lead to a condition of nerve damage known as diabetic neuropathy. The diabetic neuropathy can have much serious consequences such as development of leg amputations in the patient. The leg amputations can disrupt the normal day to day movement making the patient dependent upon medication and aid. In this stage, additional level of support and care is required for the patient. Hence, the patient looses autonomy over their activities of daily living (ADL) which could further aggaravate the presence and expression of depression in the patient. The high blood glucose level has been associated with the development of retinopathy conditions which can affect the vision in the patient considerably. Therefore, the daily care activities of the patient need to be effectively monitored for the reduction in the clinical manifestations of the patient. Further complications The patient also had hypertension and was suggested regular medications for the control and management of depression. However, the patient hardly followed the medications pattern and doses. This increased the severity of clinical symptoms such as sleep deprivation in the patient. Moreover, the patient could not sleep owing to pain which was also aggravated due to psychological reasons ion the patient. Therefore, in order to control the pain and sleeo deprivation in the patient, the patient was suggested metformin and oxazepam, which could effectively control the rate of depression within the patient. In the lack of effective medication intake by the patient, she could be struck with lethal consequences such as myocardial infarction (MI). Therefore, in order to relieve the overall condition of the patient a holistic care regimen could be developed for the patient (Rossom et al., 2014). Discussion of interventions One of the most important nursing interventions and strategies which could be developed for the patient is implementation of physical exercises. Some of the physical exercises could include light walking, jogging along with light stretching. This could restore the movement and agility patterns in the patient. Additionally, provision of effective medication to the patient could also help in controlling and monitoring the blood glucose level. As mentioned by Zhou et al. (2017), provision of fresh food and supplements to the patient can also be effective in controlling the blood glucose level. The areas which had been highlighted as requiring care management in the above discussion are blood glucose monitoring and reduction in the symptomatic expression of several health co-morbidities. This area of care management was highlighted as the patient had expressed a number of physical abnormalities which impaired the daily life of the patient along with dependence upon insulin. Research and evidences have proved that too much of dependence upon insulin can impair the functioning of the heart and the patient was already suffering from heart blockage (Feigenbaum, 2012). Therefore, the patient had to be provided with a balanced care treatment plan which will help in reducing the daily life grievances of the patient. The focus has to be more upon a holistic care regimen. Additionally, diabetes could also stem unto a number of major health complications such as movement disability, retinopathy and cardiac shock. Therefore, in order to prevent such conditions from the disrupting the life of the patient an effective and balanced car plan is required. Additionally, the patient was also suffering from depressions which affected the rate of recovery of the patient. Hence, providing the patient with a holistic care regimen can help in infusing positive spirit in the life of the patient which could speed the recovery rate (Plat, 2017). Additionally, provision of effective counselling measures along with community based development program can also help in reducing the stress in the life of the patient. The community development program can also motivate Surinder Kaur to lose weight as she was suffering from obesity. Conclusion The above discussion makes it clear that the geriatric patients like Surinder Kaur, need to be closely monitored to avoid rick of glycemic shock. The care plan organized for the patient needs to holistic providing the medication with the respective rationale. Obesity is an indirect effect of diabetes, which needs to be controlled from early signs as weight gain had severe repercussions like cardiac blockage, which is very risky. The patient had also developed depression due to her prolonged illness, which needed to be addressed to help her recover. The glycemic shock was assessed and nutritive as well as pharmaceutical help was provided to her to minimize further risk leading to fatality. The main criteria of the care plan was to control the blood glucose level and control weigh gain to reduce her weight to help her improve her blocked heart condition and improve her ability to walk which she was then facing due to obesity. Obesity and diabetes are correlated with each other and crea te co-morbid conditions in geriatric patients. Cases like this require patient education planning after care plan management, which would help minimize the risk of hospital readmission and falling in these cases. The hypertensive condition clubbed with depression in the patient makes the situation serious and she needs to be well monitored in even home care facilities to minimize the risk of falling. References American Diabetes Association. (2015). Standards of medical care in diabetes2015 abridged for primary care providers. Clinical diabetes: a publication of the American Diabetes Association, 33(2), 97. Bray, G. A., Popkin, B. M. (2014). 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