CASE STUDY 2
Running head: CASE STUDY 1
John is a 60-year-old male patient presenting with uncontrolled hypertension, increased intake of water and food, and blurred vision. John was diagnosed with hypertension at the age of 40 years. He was prescribed hydrochlorothiazide to manage hypertension. He was also diagnosed with type II diabetes at the age of 42. He was initiated on metformin and glibenclamide to manage hypertension.
John started to experience palpitations and blurred vision two weeks ago. He also started to experience excessive thirst, hunger, and an urge to urinate. Moreover, he injured his toes while performing some manual work and his wound has not yet healed a week later. He has been admitted before on various occasions for various health issues. At the age of 21, he was diagnosed with gastroesophageal reflux disease. In the same year, he had a BMI of 26.0 and hence was obese.
John is currently on Amlodipine and hydrochlorothiazide for hypertension. His sugar levels are 210mg/dl and he is on insulin injection for diabetes. Moreover, he is taking vitamin B complex tablets having vitamin B1, B6, and B12. He is taking atorvastatin 20 mg OD nocte. John has no known allergies.
John’s father and mother succumbed to hypertension and coronary artery disease. John is the second born amongst four children. He has two brothers and two sisters. One of his brothers has congestive heart failure and his sisters both have hypertension. He is a retired high school teacher and currently works as a volunteer in an orphanage for children with disabilities.
Various findings are evident during the physical examination. Based on his height and weight, John has a BMI of 25.9. His blood pressure is 150/94 mmHg. He experiences palpitations and skin examination indicates lipodystrophy at the injection site. On laboratory investigation, the random blood sugar level is 208 mg/dL. Upon performing the A1C test on John, his A1C is 6.65. he is responsive to the motor and sensory input. Using the Snellen chart, his vision is partially impaired in the right eye.
What roles do lifestyle modification, adherence to medications, and periodic medical checkups play in the prevention of complications associated with hypertension and diabetes?
The first teaching strategy that can benefit John is using videos. Hypertension and diabetes are chronic diseases whose pathologies worsen if proper mitigation measures are not taken (De Boer et al., 2017). For hypertension, the blood pressure levels rise gradually, and the symptoms might go noticed initially. As the disease progresses from mild to moderate and eventually severe hypertension, the symptoms become visible, and several complications can arise. Similarly, for diabetes, the disease progression is determined by lifestyle factors and genetics (De Boer et al., 2017). The common symptoms initially are polyphagia, polydipsia, and polyuria. All these stages of disease progression can be illustrated well through the usage of video clips. The videos will also illustrate the mechanism through which several complications arise. These may involve pictures of patients with diabetic feet, loss of vision, and gangrenous body parts. The clips can also be used to educate John on the required steps and approaches which can be adopted for him to prevent exacerbation of the condition. This may incorporate the inclusion of various diet modifications such as the meals to take and those to avoid.
Another teaching strategy is using robust patient education materials. Many patients such as John do not comprehend the complex medical terms often used by their doctors to describe the various medical conditions and management approaches, they are supposed to use. Usage of several materials aimed at educating the patients is vital in ensuring that the patients comprehend information in a simplified manner. This approach may incorporate charts, written materials, graphics, podcasts, and educational websites. In John’s scenario usage of written materials and pictures to illustrate the impacts that hypertension and diabetes have on the normal human body is vital to help John understand why he is experiencing certain symptoms. There are also many misconceptions and myths about the various chronic diseases that are discussed and dismissed through the various educational materials. Moreover, most of the educational materials and educational platforms have contacts and addresses of the various providers of care who can be reached and queried on the various aspects of disease progression and management (Sharma, 2017). In John’s case, he has been sick for a while, and he has had many medical checkups and visitations hence well informed on diabetes and hypertension. He has received several treatment plans aimed at improving his therapeutic outcome. The educational portals will offer him a platform to as several questions regarding the various complication such as retinopathy which he is likely to develop is his blood glucose levels are not kept within the required limits.
These two strategies are the most appropriate in this case since the patient is suffering from several chronic conditions and is not admitted to the facility. These teaching approaches offer the patient a platform to gather knowledge and query many aspects regarding the diseases even from their residences (Sharma, 2017). These approaches also use evidence-based practices and peer-reviewed articles which are recommended in the management of various conditions.
De Boer, I. H., Bangalore, S., Benetos, A., Davis, A. M., Michos, E. D., Muntner, P., … & Bakris, G. (2017). Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes care, 40(9), 1273-1284.
Sharma, R. K. (2017). Emerging innovative teaching strategies in nursing. JOJ Nurse Health Care, 1(2), 55558.