Patient_Education_Plan_Diabetes

Patient Education Plan Bertha Quimiro Nur/427 Health and Chronic Disease Management Aimee Canepa Describe the Patient The patient is a 43- year- old female, widowed in 2003, and has two grown children. She was living a sedentary life for the last three years, as of the present time she is in her last year of nursing school and has been very busy. When she was younger in her late teens, she used to go out and party about three times per week with friends. During that time she was a social drinker and cigarette smoker, so she drank and smoked only when she went out. She was sexually active and had multiple partners; she also had a miscarriage at 13weeks gestation. In her late 20s she married and was trying to conceive another child but was having heavy painful irregular periods, she had about two periods per year. She retired at age 38 because of problems with carpal tunnel syndrome, her job was a sedentary job that required her to type the entire day. During this time she also gained a superior amount of weight and experienced a great deal of stress. Regarding her family background the patient currently lives with her 25- year- old daughter, 18- year- old son, and seven- year- old granddaughter that she helps raise. Her husband passed away because of a heart condition. Her mother is 69, in poor health and living and her father left when she was only two. She has one younger sister 42 who is in fair health, and one younger brother 41 who is also in fair health. The patient was diagnosed at age 38 with hypertension, diabetes, anemia, hypo-thyroid, and uterine fibroids. Her mother had breast cancer and had to have a mastectomy, she also had heavy painful bleeding and uterine fibroids that required her to have a hysterectomy. The patient’s 96- year-old grandmother is living, and has thyroid cancer and hypertension. Her sister and brother both have hypertension, and her younger sister has Lupus. Because her father left when she was young his medical information is unknown. The patient is a high school graduate and has received an Associate’s degree in General Technology and is currently working on her Associate degree in Nursing. She is a visual learner and is very fond of reading and can comprehend information better in writing. When assessing her needs, the patient has a medical background, she is aware of the disease and knows what to expect for future outcomes but will still need further information, also explanations about her options on what she can expect in the future. She must also be informed on different types of surgery, pain medication, diagnostic procedures (pelvic ultrasound), and alternative therapy options to help with the pain and discomfort. She will need to take iron supplements for her anemia, for her thyroid she currently takes hormone medication and will probably need to take more if she decides to have surgery. An Introduction to the Disease Process Fibroid tumors are found in the uterus and are almost all benign (noncancerous), round, and depend on hormone estrogen to grow. This usually affects women in their 30s of childbearing age and will shrink during menopause. Fibroids can be either small in size or grow to be enormously large, and there is usually more than one. Common symptoms of uterine fibroids include abnormal uterine bleeding, increased menstrual cramping, infertility, miscarriage, bladder pressure, rectal pressure, pain with intercourse, pelvic, and abdominal pain (Fibroid Tumors/Denver gynecology, 2009). Age and Developmental Issues If the patient chooses to have surgery she will need to think of surgical risks and psychological effects including depression or loss of sexual pleasure so she will probably need to have information on support groups. If the ovaries are removed she will have a higher risk for osteoporosis and heart disease. After a hysterectomy she will no longer be able to bear children and no longer menstruate (National Uterine Fibroids Foundation, 2010). She will also experience the effects of menopause so she will need menopausal information. Impact on Quality of Life The patient is likely experience some type of side effect in the future, whether she will have to take medication and experience side effects, or if she chooses to shrink the fibroids or have them removed she may run the risk of growing more, if she is planning to have more children or if it will affect her possibility of becoming pregnant or being able to hold the pregnancy “Treatment depends on the individual’s age and the desire for childbearing” (Human Diseases, 2007, p.314). She might experience bladder urgency and pressure and have to take antibiotics if she develops any urine infections. She currently takes iron for the anemia, which she may become constipated and have uncomfortable bowel movements, because the patient is a widow, if she decides to re-marry she might experience painful intercourse that can cause a problem for her marriage. If the patient decides to do nothing, she will have to continue to have noninvasive and invasive procedures to verify any changes. The patient might have a hard time dealing with the outcome of any decision that she will make, and it could be possible that she will regret her choice and cause her to become depressed. The Educational Needs of the Patient, and Plan on How They Can Be Met This patient needs education on many alternatives available to her for her uterine fibroids and whether she will need to have treatment or not because fibroids seldom require any treatment. She will be able to list several treatment plans and their affects. She will be able to decide whether she will require surgery or if it can be treated with medication, noninvasive procedures, or whether she can use alternative therapies. Another educational need that the patient needs to recognize is if the symptoms that she is experiencing are due to the uterine fibroids or another medical problem. “As many as 3 out of 4 women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms” (Uterine Fibroids-Mayo-clinic, 2011). To identify symptoms the patient will gather and read information, and will do the necessary test and exams to confirm the diagnosis. The patient will also need education on her hypo-thyroid so that she keeps her thyroid hormones level, which will make energy, regulate body temperature, and assist organs in the body to function. The patient will do this by taking the proper dose of medication, take regular blood test for thyroid level, and have follow- up visits with her provider. Another educational need for this patient is information and awareness to her diabetes so that she can manage her illness, and so that she will know signs and symptoms of high or low blood sugar and what she should do. In doing so the patient will know how to check her sugar levels and properly medicate herself if needed. The patient will also follow a diabetic diet and exercise program. She will follow up with her provider and take the proper blood test to check on her sugar levels. The patient will also know basic information on how to treat hypoglycemia or hyperglycemia. Because this patient also suffers from hypertension, she will need information on how to maintain a normal blood pressure. Also the patient should gather more information on whether or not high blood pressure is associated with uterine fibroids, because both of these conditions have to do with smooth muscle. To make sure her blood pressure the patient will have to know how to check her blood pressure and know what normal ranges are. She will have to follow a low sodium diet and exercise program. She will look up information and speak to her physician in regard to hypertension affecting her fibroids. She will also continue to take the proper medication and dose to maintain a normal blood pressure. Summary Although uterine fibroids are not considered to be a serious condition, looking at the overall picture for this patient, concern in necessary. This patient has many serious other medical conditions and has many risk factors for uterine fibroids. This patient is at a child bearing age, and because she is widowed she may want to marry or have children in the future. This decision can have an increased chance of infertility, miscarriage which, she has already experienced before. Due to her hypothyroid problem, regulation of her hormones will be very important so that she can maintain normal body function. Obesity also plays a great role in uterine fibroids for this patient because fibroids are more common in heavy women and the patient, sister, brother, and her mother are obese. Her weight will also affect her diabetes so she must maintain a normal blood sugar level by having a proper diet and exercise regimen. The patient also has a family history of uterine fibroids from her mother who ended up having a hysterectomy, and so this might have to become one of the patient’s options in the future. Even though it is not proven but many studies have shown that hypertension can be a factor in the production of uterine fibroids because it affects smooth muscle “smooth muscle cells also make up the uterine wall” (Fertility Neighborhood.com). This patient must be compliant with all her medical conditions and must follow treatments. The severity of her medical conditions can cause great consequences if she does not follow proper medical treatment. If this patient is planning to use some type of alternative medication or therapy she must gather vital information and speak to her physician first. Due to the medical problems that this patient is experiencing, she will benefit from a Uterine Fibroid support group, that she can easily find online if she wants to be more discrete or she can have the option of a more personal level and attend sessions in person. Sometime talking to other people with the same condition can be a great help in looking and hearing about different options or different outcomes. References Advanced Women's Health Institute. (2009). Fibroid Tumors/Denver Gynecology. Retrieved from http://www.advancedgyn.com/services-care/uterine-fibroids Fertility Neighborhood. (2009). High Blood Pressure may Predict Fibroids. Retrieved from http://www.fertilityneighborhood.com Mayo-clinic.(2011).UterineFibroids.Retrieved from http://mayo-clinic.com/health/uterinefibroids National Uterine Fibroids Foundation. (2010). Health treatment. Retrieved from http://www.nuff.org/healthtreatment.htrr Neighbors, M and Tannehill-Jones, R.(2006). Human Diseases (2nded.). Clifton Park, NY: Delmar Cengage Learning.