Prioritisation of Complex Health Issues – Care Example

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"Prioritisation of Complex Health Issues" is a wonderful example of a paper on care. This assignment addresses the health issues of Evelyn Hansen after she experienced pain in her hands from osteoporosis. Nursing care rankings for the patient’ s health issues with associated tasksa) Nutrition interventionb) Diabetic ketoacidosis: the patient has a fruity smellc) Pain: relieve osteoarthritic pain in handsd) Leg ulcers: Risk of pressure sores to provide skincare and relieve pressuree) Increase rest and sleepf) Visual disturbances: Reduce the possibility of injury through modifying the environment. The priority is based on three levels, including those that are basic (essential to life), secondary (important although less essential to life), and tertiary (those that are less essential to life) (Zulman 2010).

Of the six, the three most important indicated below are based on level of importance: a) Diabetic ketoacidosis: The patient has a fruity smell, showing an increased level of glucose, decrease oral input. It is usually life-threatening. b) Pain management: To relieve pain, particularly osteoarthritic pain in the hands. c) Nutrition intervention: To promote nutrition in order to adjust the patient’ s drink, food, and environment. Since she is on insulin, she may be at risk of hypoglycemia if she cannot be able to eat regularly.

Her blood glucose levels have to be kept even. The remaining health issues are less prioritized since they can be adequately managed by managing the three selected health issues. For instance, pain management will help increase the rest and sleep of the client. It also helps to prevent the risk of pressure sores due to ulcers on the patient’ s lower legs. 2) Critical Health IssuesDiabetic ketoacidosisThe fruity smell and urine signal ketoacidosis.

This shows that the body is getting rid of excess acetone in the body. The health issue is given the highest priority since it is substantially life-threatening and can result in diabetic coma or death (Oakes and Cole 2007). It is also a sign that Evelyn’ s’ condition is not responding to treatment and that her diabetes is not under proper control (McGrath 2013). It is also given priority since it might have led to other health issues such as Evelyn’ s loss of appetite, shortness of breath or change in breathing patterns, and poor visibility.

It may also be an indicator of disrupted insulin treatment. It is also given a priority over pain management for the osteoarthritic as it causes muscle stiffness or aches, which may have aggravated Evelyn’ s pain (Riethof et al 2012; Zolfaghari, Mousavifar and Haghani 2012,). Pain managementThe pain is osteoarthritic pain which the patient feels on her hands. Insufficiently managed pain can trigger adverse health issues as well as affect the patient’ s psychological health outcomes, and that of the husband. When the pain is unrelieved or persistent, it will activate the pituitary-adrenal axis, which would suppress the patient’ s immune system (BON 2001).

This can lead further to poor healing of wounds, specifically the patient’ s eight-week-old ulcers on the lower legs. Additionally, unrelieved pain minimizes the patient’ s mobility, which may aggravate the patient’ s health given that some level of exercise is required to improve her condition. Osteoarthritis is a severely painful condition that affects the tough hyaline articular cartilage at the ends of long bones limiting movement (Fransen et al 2011). Persistent unrelieved pain affects the patient’ s psychological wellbeing resulting in depression.

Since Evelyn has been termed as depressed by the husband, unrelieved pain can cause a sense of hopelessness that can make the patient have chronic depression. The pain can also cause sleep deprivation, as a result, limiting the amount of the patient’ s daytime energy. It will also help manage other health issues the patient currently faces. Pain management is given the highest priority since it has the potential to trigger more health issues (BON 2001). Nutrition interventionPatients with type 2 diabetes face difficulties in controlling the levels of their blood sugar since the body cells fail to absorb sugar from the bloodstream properly, leading to high sugar in the urine.

If not managed, it may trigger poor blood circulation and issues with the kidney. Significant dietary changes can help control such health issues (American Diabetes Association 2013). The dietary changes can help control blood sugar levels to prevent further damage triggered by type 2 diabetes. The patient has failed to comply with her dietary regime. She shows restrictive eating behavior, as the husband says she does not like the hospital food.

Nursing intervention should be focused on ensuring she has rigid dietary control (Yannakoulia 2006). 3) Role of the NurseNurses play a significant role in contributing to the improved health of a patient and her relatives (WHO 1999). Patients expect that nurses will be with them both physically and emotionally throughout the period of their illnesses (Overland and Brooks 2005). In practice, a nurse owes a duty of care Evelyn is obligated to ensure that the patient is taken care of to improve her health conditions, such as through nutrition intervention, pain management, and management of diabetic ketoacidosis.

The nurse should also use the standard of care by ensuring that compliance is given to prescribed patient care standards (Act Health 2004). According to the Australian Nursing and Midwifery Council, a registered nurse must demonstrate competency in providing healthcare that is focused on individuals in compliance with their educational preparation and professional nursing standards, as well as relevant policies and legislations (Burton and Ormrod 2013). Health Professionals Regulations 2004 demands that nursing professionals should adopt standards of practice and a code of ethics.

The Standards of Practice of ACT Allied Health Professionals promote an environment where the actions of a health professional may not be an offense even though it fails to meet professional standards. For instance, it would be a breach of the Health Records Act 1997 when a nurse fails to pass clinical information noted on Evelyn Hanson’ s progress report to the next treating practitioner, although it is not defined in the Health Professionals Regulations Act 2004. In any case, the health profession board may view that such conduct has not in compliance with professional standards (Act Health 2004). The role of a nurse is to provide safe, ethical, safe, and competent nursing care for patients.

Nurses are professionals committed to developing and implementing practice standards through critical application and assessment of relevant knowledge, judgments, skills, and attitudes. For instance, the nutrition intervention, a nurse can play the role of dietician by formulating a treatment plan for Evelyn. The nurse also helps the patient to cope with other stressors resulting from the health issues such as Diabetic ketoacidosis (McGrath 2013; Buscher, Sivertsent and White 2009).

Nursing care consists of the synthesis of the close interaction among the patient, nurse, environment, the patient’ s relations, and health (Act Health 2004). Australian Nursing and Midwifery Council sets out that even as the role of a registered nurse may vary according to the employment arrangement, profile of the nurse’ s general practice, or the structure of the general practice, the nurse has to work collaboratively with others to provide nursing care centered on the client. In working collaboratively with Evelyn and her family, the nurse should educate the patient and the husband on the possible implications of not sticking to the dietary regime (Australian Nursing Federation 2005). According to Standards of Practice for Allied Health Professionals 1.4.2, a health professional has the obligation to explain the nature of the health care suggested, its limitations, consequences, purpose, or reasonable alternatives (Australian Nursing Federation 2005).

This should however be within the scope of the nursing practice. In this case, the nurse should monitor the patient’ s fluid intake and record the gravity of urine. Administration of fluids to the patient should be done as directed by the physician (Riethof 2012). A nurse also plays a pivotal role in the promotion of health, prevention of infections, and maintenance of health through providing evidence-based information and education to the patient and her relatives (Burton and Ormrod 2013).

In this case, a nurse can intervene through the use of pharmacological and non-pharmacological interventions in order to manage osteoarthritis pain that Evelyn experiences on her hands to prevent health issues such as chronic depression from developing (Ness and Hibberts 2012). ConclusionIn summary, the health issues given priority include; Diabetic ketoacidosis, pain management, and nutrition intervention in that order.

This is based on their potential to trigger more health issues.

References

Act Health 2004, Standards of Practice for ACT Allied Health Professionals, viewed 18 Oct 2013, http://health.act.gov.au/c/health?a=dlpubpoldoc&document=863

American Diabetes Association 2013, "Nutrition Recommendations and Interventions for Diabetes: A position statement of the American Diabetes Association,” Diabetes Care, Vol. 30 no. 1, ppS48-S65

Australian Nursing Federation 2005, Competency Standards, John Thrift Publishing, viewed 18 Oct 2013, http://anmf.org.au/documents/reports/compstandards_nursesingp.pdf

Burton, R & Ormrod, G 2013, Becoming a qualifi ed nurse, viewed 18 Oct 2012, http://fds.oup.com/www.oup.com/pdf/13/9780199568437.pdf

Buscher, A, Sivertsent, B & White J 2009, Nurses and Midwives: A force for health, WHO Regional Office for Europe, Copenhagen

BON 2001, Pain Management Nursing Role/Core Competency: A Guide for Nurses, viewed 17 Oct 2013, http://www.mbon.org/practice/pain_management.pdf

Fransen, M, Bridget, L, March, L, Hoy, D, Penserga, E & Brooks, P 2011, "The epidemiology of osteoarthritis in Asia," International Journal of Rheumatic Diseases, Vol.14, pp. 113–121

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McGrath, M 2013, Managing Diabetes: The Nurse Practitioner’s Role, Science of Caring, viewed 18 Oct 2013, http://scienceofcaring.ucsf.edu/acute-and-transitional-care/managing-diabetes-nurse-practitioner%E2%80%99s-role

Ness, L & Hibberts, F 2012, Management of lower bowel dysfunction, including DRE an DRF RCN guidance for nurses, Royal College of Nursing, London

Oakes, E & Cole, L 2007, Diabetic Ketoacidosis DKA, viewed 18 Oct 2013, http://intensivecare.hsnet.nsw.gov.au/five/doc/education_packages/nepean/nepean_guide_DKA_2007.pdf

Overland, J & Belinda, B 2005, Diabetes Nurse Practitioner Guidelines Role and Scope of Practice, Royal Prince Alfred Hospital, Camperdown

Riethof M, Flavin PL, Lindvall B, Michels R, O'Connor P, Redmon P, Retzer K, Roberts J, Smith S, Sperl-Hillen J, 2012, Diagnosis and management of type 2 diabetes mellitus in adults, Institute for Clinical Systems Improvement (ICSI), Bloomington (MN)

WHO 1999, The Role of the Occupational Health Nurse in Workplace Health Management, viewed 18 Oct 2013, http://www.who.int/occupational_health/regions/en/oeheurnursing.pdf

Yannakoulia, M 2006, "Eating Behavior among Type 2 Diabetic Patients: A Poorly Recognized Aspect in a Poorly Controlled Disease," Rev Diabet Stud, Vol. 3 No.1: 11–16.

Zolfaghari, M, Mousavifar, A & Haghani, H 2012, “Mobile phone text messaging and Telephone follow-up in type 2 diabetic patients for 3 months: a comparative study,” Journal of Diabetes & Metabolic Disorders, Vol 11

Zulman, D, Kerr, E, Hofer, T, Heisler, M & Zikmund-Fisher, B 2010, “Patient-Provider Concordance in the Prioritization of Health Conditions Among Hypertensive Diabetes Patients,”J Gen Intern Med Vol. 25 No. 5,pp 408–414.

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