Type of Assessment to Be Performed on the Patient
The type of assessment that will be undertaken on Mr. L.G is an assessment for modifiable risk factors. This is because the collected data indicates the likelihood that his lifestyle seriously endangers his health considering the fact that he already suffers from diabetes. One of the most considerable risk factors for individuals with diabetes concerns glysemic control. This is especially because diabetes patients face a higher risk for developing cardiovascular disease (CVD), which can reduce their life expectancy by up to 15 years (Mannucci et al., 2013). Mr. L.G has a glucose level of 96. This would be accepted as ideal for his diabetic condition, since it is within the range both for fasting and if only two hours had passed since he took food. Nevertheless, if it is eight hours since he took food, the level is almost approaching the higher limit of 99 and he, thus, needs to be advised on his diet and exercise so as to improve his glysemic control (Mannucci et al., 2013). This way, his risk of developing CVD will be significantly lowered. Regarding the diet, he should precisely be educated on diet patterns and the manner in which he can modify them to suit his particular condition. He currently follows a 1600 calorie diet and this needs to be assessed in terms of such factors as his level of physical activity, weight, age etc. (American Diabetes Association, 2015a). His pulse rate is currently at 118, whereas it should range between 60 and 100 for a resting adult (Laskowski, 2016). This suggests lack of cardiovascular fitness and subsequently, a higher risk for an inefficient heart function (Mannucci et al., 2013). Mr. L.G’s weight should also be assessed against the risk it poses to him in his condition. It usually stands at 165 pounds and, whereas this is neither too high nor too low, he needs to be advised on how he can maintain it at a less risky level. The exercise level of this patient must also be assessed. The American Diabetes Association (2015 b) recommends strength training and aerobic exercise as the two acceptable types of physical activity for diabetics, each for a specified length of time. It is indicated that Mr. L.G goes to the gym three times a week. It is necessary to assess the kind of exercise he takes there, as well as the time span so as to determine whether his physical activity level is at the recommended level. Lastly, it is also critical that Mr. L.G’s blood pressure is regularly estimated. It is at 120/68 at present, which is appropriate, since it is below 120/80.
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The Type of Prevention Level
Assessment of modifiable risk factors as is the case of Mr. L.G can be categorized as primary disease prevention. Its aim is to avert the onset of the disease and it entails application of interventions prior to the occurrence of disease (University of Ottawa, 2015). As mentioned earlier, being a diabetic Mr. L.G faces a greater risk of developing cardiovascular disease. For this reason it is extremely important to adopt measures as to ensure that CVD does not occur. The same applies to hypertension. Although it is a common belief that the only link between diabetes and hypertension is similarity of some causes, some evidence suggests a significant correlation between them (Jovinelly, 2015). In this case of Mr. L.G, there is a need to prevent the onset of hypertension. In general, the intervention would be aimed at preventing the beginning of all health conditions that Mr. L.G is predisposed to, given his diabetic condition and the vital signs that have been recorded.
Another Important Prevention Level
Secondary prevention would also be significant in terms of providing care to Mr. L.G. This concerns disease detection at its very first stages, prior to the surfacing of symptoms, upon which an intervention is made to either stop or delay its progression. Hence, it is assumed that early intervention will effectively slow or reverse the disease (University of Ottawa, 2015). As mentioned before, Mr. L.G’s pulse rate is considerably high taking into account the fact that it has been taken while resting. This is one of the major issues that should be addressed by means of the secondary prevention, so that if the heart is experiencing declining fitness, its performance can be enhanced to prevent occurrence of cardiovascular problems.
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Step-by-Step Approach in Identifying and Resolving Mr. L.G’s Problem
Mr. L.G indicated that he was facing occasional dizziness when waking from sleep in the morning. This feeling can be caused by a number of factors. In this respect, the nurse needs to carefully consider all the data she had gathered about the patient in order to identify the most probable cause. His blood-glucose reading was determined to be 96. It is unknown what time Mr. L.G had spent without eating and consequently, the nurse should learn when his last meal was. Nevertheless, this level appears normal since a range of between 70 and 140mg/dl is considered healthy if it is between 2 hours and 8 hours after eating (Mannucci et al., 2013). It is not likely that hypoglycemia is the cause of the dizziness, although it is common in people with diabetes (NHS, 2015). Dizziness can also be caused by heat exhaustion or dehydration, both of which could emanate from not drinking enough water during exercise (NHS, 2015). Mr. L.G attended the gym three times a week. The nurse should determine whether he could exercise too much and drink too little. Mr. L.G’s dizziness could also be a result of stress or anxiety. These two conditions are common when a person is breathing abnormally quickly at rest (NHS, 2015). This appears to be the most probable cause of the dizziness, since Mr. L.G’s respiratory rate was documented as 18. The normal resting rate for an adult is 12-16 breaths/minute and if Mr. L.G’s rate is increasing up to 18 when rising in the morning, it could cause stress or anxiety thereby leading to dizziness (NHS, 2015). Having identified that the high respiratory rate is causing the dizziness, the next step is to investigate what triggers the faster breathing (hyperventilation). The US National Library of Medicine (2016) documents lung or heart disorder as one of the reasons for hyperventilation. Mr. L.G’s pulse rate has been determined to be beyond the normal range and as a result, he may have a heart problem. To determine whether he indeed suffers from the heart disease, the nurse can perform electrocardiogram, echocardiogram, and cardiac catheterization amongst other relevant tests and examinations. Once the diagnosis has been confirmed, the appropriate treatment should be started immediately (Mayo Foundation for Medical Education and Research, n. d).
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Interventions to Be Included in the Patient’s Plan of Care
Mr. L.G requires proper education on how he should manage his condition, especially if he is diagnosed with heart disease as well. It appears that he has not faced modifiable risk factors, hence, the current heart problem as such. Judging from this, he should receive recommendations about such important aspects as diet, exercise, and unhealthy behaviors such as smoking. Besides this, regular visits to cardiologist concerning his heart condition are extremely important. He could go through the earliest stages of heart disease and it is, thus, critical that an intervention is made immediately to diagnose and address the problem. Modern technology has also enabled individuals with diabetes to monitor their blood glucose level. In addition, another important intervention would teach Mr. L.G. on how he can monitor his blood sugar level, so that he does not suffer serious complications that would worsen his health (American Diabetes Association, n. d).
He may also require the services of a health trainer. If he is determined to overcome both diabetes and heart disease, diet and exercise will be critically important in managing the conditions. His gym instructor may also be enlisted in the plan to ensure that Mr. L.G. engages only in the appropriate exercise type and intensity. In general, Mr. L.G needs a team of professionals who will be readily available to attend in case his condition deteriorates. This will definitely include nurses. For instance, it is paramount that any complications in his heart condition are addressed in a timely manner. When executing the treatment plan, the cardiologist should explain the contribution of the rest of the team to devise the most appropriate intervention (American Diabetes Association, n. d).
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Furthermore, it could be also important to enlist Mr. L.G’s caregiver or a relative who can guide him in sticking to the plan that will be developed. At his age, there is a high risk of forgetting or not being able to adhere to the plan. What is even worse is that if he stays alone (his children became adults), there is a danger of suffering from complications with no one around to help him. This is the case when a caregiver or relative will be an important part of the team that will offer care to Mr. L.G. Most importantly, he needs to develop a positive attitude towards his condition so that he can be able to take care of himself. The healthcare team should guide him in this by enlightening him on important aspects and encouraging him that his condition is manageable (American Diabetes Association, n. d).