NURS 3234 Fundamentals case study - week 3.|Fundamentals The Health Care Delivery System

NURS 3234 Fundamentals case study - week 3.|Fundamentals The Health Care Delivery System-Ch. 3 Health, Illness, and Disparities 1. You are a nurse caring for a 42-year-old mechanic who is hospitalized for a gangrenous wound on his foot. His history includes unmanaged diabetes, smoking (20 pack-years), and hypertension. He denies alcohol use. He supports himself with full-time work. Socially, he belongs to a motorcycle club and enjoys riding whenever his work schedule allows. When asked how he would rate his overall health, he reports, “I may not have much money, but I’ve got my health!” (Learning Objectives #2 & #5) a. What pertinent data can you gather based on available patient information? i. He is a non-compliant patient (diabetes, hypertension) that does not understand comorbidities he has. He is in denial about his overall health (reference to last statement). Requires education. ii. There is an alteration in skin integrity due to his gangrenous wound. Calls for concern about infection. b. How would you categorize the patient’s illnesses? i. Work with wound first. ii. Treat his diabetes and educate about maintenance. c. What questions should you ask yourself when caring for this patient? i. Who do you live with? ii. Is he on his feet all day at work? Does he have adequate shoes for work? iii. What is your diet like? iv. How long have you had this wound? What did you do for it? v. What kind of health care coverage do you have? d. Which stage-of-illness behavior avoidance does this patient seem to display? Give the rationale for your choice. i. Stage 1 -- Experiencing symptoms ii. Patient has not assumed the sick role, due to his denial about his overall health. He believes he is not at risk for deteriorating health/illness although he has a gangrenous wound exacerbated by his lack of diabetes management. e. What strategies could you propose to the patient to promote health and prevent illness? i. Educate him on wound care. Make sure he is cleansing the area consistently. Due to his diabetes, he will need to make sure his feet are moist to prevent open sores. Further educate to him about certain shoes he should be wearing for support. ii. Educate him on the importance of diabetes management. Make sure he is eating the right foods and taking the correct dosage of medication prescribed. f. What factors can be useful in predicting a patient’s use of health-related behaviors?