Healthy Individual
Presentation
By Jeff Hershberger
Patient Profile, Assessment, and
Past History
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C.M.
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57 years old
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Friend of the family for over 30 years
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Vital signs/Other Measurables: 5'4” 175lbs, BP 160/85, HR 85, R 20, T 98.2,
BMI 30
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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.
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Patient denies use of tobacco products, alcohol, and illicit drugs.
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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.
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She has had bilateral knee replacements (2005), an appendectomy (2006),
and a tonsillectomy (unable to recall year).
Assessment, Risk Behaviors, and
Personal Health Beliefs
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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).
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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.”
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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.
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Assessment of patient completed on September 16th 2012 @ 1700
Assessment & Diabetic
Questionnaire
Diabetic Questionnaire
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When were you diagnosed with diabetes? “33 years old.”
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Do you have a family history of diabetes? “No that I am aware of.”
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Have you received any formal education regarding diabetes? “Yes when I
was last in the hospital, but that was several years ago.”
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How do you learn best: Hands-on, demonstrations, reading, or listening?
“Listening. Though with certain things demonstrations are better.”
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Do you test your sugar at home? “Yes, well, usually.”
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Are you on a diabetic diet? What is that? “I guess not.”
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Do you keep records of your blood sugars and interventions? “No.”
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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.”
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How often do you get ill? “Nothing usually too serious. I get colds quite a bit.”
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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
sugars are above 200.”
Health Promotion Model &
Goal
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Pender's Health Promotion Model
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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.
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Patient's Perceived Weaknesses/Barriers: Price of healthy food, discomfort
associated with exercise, unorganized, inadequate diabetic education.
Inappropriate allocation of financial resources.
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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
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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 HA1C 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).
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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).
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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
167lbs 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
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Community Resource #1: North Canton YMCA
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Mission and Purposes: To put Christian principles into practice through
programs that build spirit, mind, and body for all.
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Type of Care, Goals, and Objectives: Youth Development, Healthy Living,
and Social Responsibility
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Sources of Funding: Monthly fee
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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.
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Who the Agency is Responsible to: The community
Discussion of Resources
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Community Resource #2: North Canton Medical Foundation
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Mission and Purposes: To provide charitable, health-related services that
improve the quality of life for many people in our community.
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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, followup care to modify your plan of care, diabetic support groups, and advanced
education on topics such as insulin therapy & carbohydrate counting.
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Sources of Funding: Donations (nonprofit organization)
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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.
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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-cantoncommunity-building-ymca