Burden of Overweight and Obesity †Free Samples to Students

Question: Discuss about the Burden of Overweight and Obesity. Answer: Introduction Levett-Jones Clinical Reasoning Cycle is a process that reflects the importance of personalization and prioritization of patients needs. This reasoning cycle is used to structure clinical care by healthcare professionals (Herdman, 2011). This clinical reasoning cycle helps to deliver patient-centered nursing care based on the critical thinking, clinical analysis, clinical reasoning and reflective practice performed by professional healthcare nurse (Alfaro-LeFevre, 2012). This essay is one such patient-centered nursing care structure developed by using Levett-Jones Clinical Reasoning Cycle. The study involves identification of two care priorities and managing care process by a primary health care nurse for the provided case study, which is performed by implementing reasoning cycle steps. In the present case study, patient name Peter Mitchell is a middle aged male (52 Years) admitted to the medical ward as per reference from his General Physician. He was facing symptoms of shakiness, increased hunger, high blood glucose, diaphoresis and breathing difficulties while sleeping. As he is a sufferer of type-2 diabetes and obesity, these symptoms highlight high alert of these two conditions. Peter is already overweight, diabetic suffering depression. Peter is a serious smoker from age of 30years, smoking 20 cigarettes per day. Adding on to this situation, Peter suffers other critical situations as well, that involves hypertension; sleep apnoea and gastro oesophageal reflux. Peter is taking proper medication for his health issues but still, he is facing these critical and life-threatening symptoms due to mismanaged lifestyle habits. Collecting cues and information about the case As per case information Mr. Peter on his previous admission to medical ward dietician recommended him to lose weight. However, Peter had no interest to make any effort related to his weight resulting in present critical condition. Further, he was also commenced with light exercises by the physiotherapist and was advised to continue them at home. But the increased weight and BMI show his carelessness towards his physical condition. He is 145kgs with BMI 50.2m2 (very high) and height 170cms. His last observed blood pressure is 180/92mmHg (high), respiratory rate 23Bpm (high), heart rate 102bpm (little high) and SpO2 (peripheral capillary oxygen saturation) is 95% (normal). Peter is on current medication involving insulin metformin for diabetes, Lisinopril for hypertension, Nexium for reflux, metoprolol for high blood pressure and Pregabalin (Lyrica) for neuropathic pain in diabetes. Further, Peter is unemployed and struggling to get work reason being his weight issues. He is divorced, living alone, socially isolated, living without any family attention and care. Peter also faces difficulty to perform daily living activities. The present admission of Mr. Peter Mitchell to the medical ward was due to poorly controlled diabetes, obesity ventilation syndrome and sleep apnoea. Peter was detected with the symptom of high blood glucose level instead of the fact that his medication involves Insulin (34units mane 28units nocte). Audetat et al. (2013) indicated that if a patient confronts high blood glucose levels despite the fact that insulin is included in medication process indicates mismanagement in medication (insulin) process. According to Selvin et al. (2014) studies improper intake of insulin leading to high blood glucose level also persists symptom of increased hunger. This confirms that high blood glucose level is leading to increased hunger symptom in Peters case and he is mismanaging his medication process. Further, shaking and diaphoresis is due to obesity ventilation syndrome. Cunningham, Kramer Narayan (2014) indicated that obesity ventilation syndrome leads to sleep apnoea identified by difficulty breathing while asleep interrupted sleep and daytime sleepiness. In the present case, Peter is facing cessation of breathing while asleep confirms presence sleep apnoea due to obesity syndrome. In the present case of Mr. Peter Mitchell, three identified critical diseases that are type-2 diabetes, obesity ventilation syndrome and sleep apnoea are either directly or indirectly linked to each other. Olsson et al. (2013) indicated that mismanagement in the lifestyle of diabetic patient leads to deposition of fat in the body that lead to a highly obese body as a major defect. Audetat et al. (2013) studied that if the blood glucose level of diabetic people remains abnormally high this then leads to the stoppage of blood glucose entering body cells. Therefore, the body becomes incapable to convert food to energy leading increased hunger and increase in obesity. Further, American Diabetes Association (2015) paper highlights that high blood sugar leads to deposition in form of fat in the body. Further, Cunningham, Kramer Narayan (2014) studied that deposition of adipose tissue in the state of obesity restrict the normal movement of chest muscles and diaphragm creating difficulty in breathing by respiratory muscles. Hence, obese people find it difficult to breathe creating obesity ventilation syndrome that causes shortness of breathing while asleep which is a major symptom of sleep apnoea. As per present case study data, Mr. Peter Mitchell is a seriously heading towards a critical stage of diabetes and obesity only at middle age period of life. He certainly needs a proper care plan to get a control over this critical health issues basically lifestyle modification because symptoms like shortness of breathe, high BPL level and diaphoresis are really dangerous and abnormal conditions. All the information provided in the case study is relevant and shows some link to understand the critical state of Peters health. However, not much attention is made on the impact of other health issues like hypertension, reflux and depression on the health of Peter considering it as a gap in case information. As per nursing professional knowledge, mental health issue like depression can be considered as a major cause of the lifestyle mismanagement in Mr. Peters life. His careless attitude towards his health (obesity), social isolation, joblessness and unwillingness to improve his health can be considered as outcomes of mental disturbance (depression) (Herdman, 2011). As per the study conducted of case data till now it is clear that nursing care goals should completely be based on managing the lifestyle habits and controlling obesity in case of Peter. This lifestyle management will also involve objective to manage the critical situation of diabetes harnessing his health. The present case of Mr. Peter Mitchell suffering critical obesity and diabetes is a common phenomenon. It is a common disease for which care providers carry a good experience to handle these situations because the control over these issues mainly depends on the lifestyle, eating, activities and mental strength of the patient (Doenges, Moorhouse Murr, 2014). The condition of Mr. Peter Mitchell is really critical as the body weight is 145Kg with BMI above 50. It is tough to manage his obesity issues yet proper goal setting could help to get a control over critical symptoms leading to medical emergencies. Identification problems/issues The two major care priorities in case of Mr. Mitchell are his overweight condition and uncontrolled diabetes type 2. Peter is not even ready to pay any concentration or control his growing complication related to obesity and diabetes (Moorhead et al. 2014). The two care priority issues are obesity and mismanagement of diabetes in Mr. Peters care. The nursing goals are: - Decreasing body weight by 10% within 6months of therapy (1/2 lb/week) Establishing and practising appropriate lifestyle behaviour change for controlling diabetes For the fulfilment of nursing goal regarding weight loss of 10% in 6 months involves certain specific interventions. Yang Zhang (2014) studied some specific nursing actions that provide effective weight loss which is considered best for Peters case as well. Implement rewarding and reinforcing short-term goals for patient followed by negotiations regarding patients aspects of diet that require modifications. Balance the dairy and animal protein intake in the diet as well as provide diet as per measurements. Advise and encourage water intake as well as long-term exercise programs like walking that is best for a diabetic patient (Stellefson, Dipnarine Stopka, 2013). Further, keep a proper monitoring of patient weekly weight changes and modify diet as per requirement. Lastly, educate the patient about healthy eating habits like short meals 5-6times/day, high intake of fibre, regular exercise, relaxation techniques and maximised water intake. As per provider case study data of Peter, the best lifestyle behaviour change in his case involves practices to quit smoking, practising relaxation, social liberation and replacing the unhealthy behaviour with substitutes (Cygan et al. 2014). According to Thom et al. (2013) studies self-rewarding, communication with the patient, motivational counselling and interviewing ate some of the best processes to implement lifestyle changes. Lastly, providing education regarding diabetes and its control can also help Peter to overcome his issues related to depression (Doenges, Moorhouse Murr, 2014). Evaluate Outcomes The evaluation process will involve determining the weight change and achievement of determined weight loss goal by detecting weight after 6 months of therapy. Further, lifestyle behaviour change can be evaluated by determining the control over health issue diabetes and obesity. Lastly, mental status examination (MSE) can be performed to evaluate the mental strength after the nursing process (Kalyani, Corriere Ferrucci, 2014). The clinical reasoning cycle process can be considered as most systematic, manageable and comfortable approach to deal with any clinical scenario in nursing professional practice. As a professional, implementing such process to resolve an issue or case can benefit to gather smart, workable and manageable outcomes. Using clinical reasoning cycle made its easy to deal with this complicated health management case. Conclusion A proper nursing plan to manage the case study patient Mr. Peter Mitchell was developed using clinical reasoning cycle. This involved analysis of patient situation followed by collection and processing information to detect health priority issues. Further, establishing nursing goals and taking actions to achieve these goals handled these health priority issues. Lastly, the process to evaluate care outcomes is also provided in the study to further establish better processes for effective care. References Alfaro-LeFevre, R. (2012).Applying nursing process: the foundation for clinical reasoning. Lippincott Williams Wilkins. American Diabetes Association. (2015). Standards of medical care in diabetes2015 abridged for primary care providers.Clinical diabetes: a publication of the American Diabetes Association,33(2), 97. Audetat, M. C., Laurin, S., Sanche, G., Bque, C., Fon, N. 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