Nursing Care Plan and Holistic Care Assesment

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This is a case study on a male adult from New Zealand who is aged 62 years. He was the only child in his family and he is blessed with two daughters and one son. He is retired and a widow. After several falls at his home, he decided to check into a care facility. This was because he has difficulties attending to his personal care and he too had none to take care of him since his children are adults to leaving by their own. Taking his medication by himself is a challenge also.

He was diagnosed with type two diabetes, high blood pressure, urinary tract infection and diabetic foot ulcers on his big left toe. Currently, he has no allergies and he is put under Metformin 100mg TDS and Metroprolol Cr 47.5mg medication daily. In addition to those medications, he also takes Paracetamol 20ml daily, Nitrofurantoin 100mg which is administered orally a Beta dine ointment PRN which he applies on his toe.

Nursing care plan for high blood pressure must adhere to the therapeutic regimen, prevention of complication and one’s life style modification. The plan includes the risk of decreased cardiac output, acute pain, deficient knowledge, activity intolerance and ineffective coping. The risk factor for the plan is myocardial ischemia, ventricular hypertrophy and increased vascular resistance (Kaufman).

On the other hand, type two diabetes nursing care plan risk for unsuitable blood glucose, powerlessness, the risk for infection, deficient of knowledge, fatigue, the risk of injury and risk for the inefficient therapeutic regime. Nursing management should be put in place for effective to normalize blood glucose. Also, the must use insulin to decrease complication and exercise and a balanced diet should be maintained.

Sam lives in safe clean and comfortable environment harmoniously with staff and neighbors. He speaks and understands English and understands voice tones. His memory is good and very much aware of what is going on around him. With support from staff members and family, he is usually happy and most comfortable. Because of poor vision and sense of hearing, when necessary he wears glasses and a hearing aid gadget. Diabetic foot ulcers on his big left toe cause a lot of pain and because of it, he frequently applies Betadine ointment on his foot. He has difficulties in breathing but no chest pain identified on him. During the night, he has a normal sleeping pattern but uses a pillow to elevate his left foot because he experiences a lot of pain during the night. Because of the type two diabetes, there is a recommended diet for him to help in lowering both his blood sugar level and blood pressure. During the day, he urinates frequently as compared to night and four times a day, he takes antibiotics Nitrofurantoin for UTI (Cárdenas-Valladolid et al.).

In addition to the above, for hygiene and dressing, he needs assistance from some. More so toileting and dressing. Due to frequent fall he experiences, there is a power chair to help him mobilize. Most of the time he is independent, hence he can stretch a hand of help to others in feeding. During his free time, he enjoys reading, writing and thinking about his life and when his children are free, they visit him. Always he loves being happy and he is not afraid of dying. This is demonstrated through his Christian virtue where he says he wants to meet his parents and wife in heaven.