Student Name
Capella University
NURS-FPX 6610 Introduction to Care Coordination
Prof. Name
Date
Nursing Diagnosis and Care Plan for Mrs. Snyder
Patient Identifier: 6700891
Medical Diagnosis: Poorly controlled anxiety, obesity, hypertension (HTN), diabetes mellitus (DM), and hypercholesterolemia
Ineffective Health Management Related to Diabetes and Lifestyle Choices
Mrs. Snyder is a 56-year-old woman with multiple chronic conditions, including poorly controlled diabetes and hypertension. Her lifestyle choices, particularly the frequent consumption of unhealthy snacks like cookies, contribute to her unstable blood glucose levels. She presented to the emergency department with blood glucose readings ranging from 230 to 389 mg/dL, accompanied by fatigue, lower abdominal discomfort, shortness of breath, and polyuria. These clinical manifestations are compounded by her hypertension and unhealthy dietary habits, creating a complex management scenario.
The primary care objectives are to stabilize her blood glucose and blood pressure within one month and to support sustainable dietary changes and overall wellness within three months (Ramzan et al., 2022). Education and patient empowerment are central to this care plan.
Interventions, Description, and Rationale
| Interventions | Description | Rationale |
|---|---|---|
| Patient education on self-care | Provide guidance on balanced diet, physical activity, and sleep hygiene | Enhances awareness and promotes behavioral changes critical for diabetes control (USC, 2018) |
| Support self-monitoring | Teach her to use glucose meters and maintain food diaries | Encourages accountability and early identification of glucose fluctuations (Carolina, 2019) |
| Training in insulin administration | Demonstrate proper injection techniques | Increases patient confidence and ensures adherence to prescribed insulin regimens (Heart, 2021) |
The effectiveness of these interventions will be measured through regular monitoring of blood glucose logs and blood pressure readings. Adjustments, such as dietary modifications or changes in insulin dosing, will be considered if the current approach does not achieve desired outcomes.
Anxiety Intensified by Family and Caregiving Pressures
Mrs. Snyder experiences significant anxiety exacerbated by her role as the primary caregiver for her ill mother and ongoing conflicts with her son. These stressors have resulted in physiological symptoms, including elevated blood pressure, tachycardia, and inconsistent use of anxiolytic medications. The combination of household and financial responsibilities intensifies her sense of being overwhelmed.
The nursing care goals focus on achieving blood pressure control (130/90 mmHg) and stabilizing heart rate (60–100 bpm) within a month, alongside reducing anxiety symptoms through a structured combination of therapy and medication adherence (Pegg et al., 2022). A holistic approach that addresses both clinical and psychosocial needs is essential.
Interventions, Description, and Rationale
| Interventions | Description | Rationale |
|---|---|---|
| Administer prescribed anxiolytics | Ensure adherence to medication schedules | Helps manage physiological manifestations of anxiety, improving daily functioning (Ströhle et al., 2018) |
| Initiate cognitive behavioral therapy (CBT) | Weekly counseling sessions | CBT effectively reduces anxiety by restructuring maladaptive thought patterns (Pegg et al., 2022) |
| Connect with community support | Referral to faith-based or peer support groups | Emotional and social support reduces isolation and promotes coping strategies (Goodtherapy, 2019) |
Progress will be assessed weekly, monitoring anxiety levels, adherence to medications, and vital signs. The care plan will be adjusted according to the patient’s engagement in therapy and her physiological response to interventions.
Psychosocial Stress Due to Cancer Diagnosis and Caregiver Burden
In addition to chronic health conditions, Mrs. Snyder is confronting a new ovarian cancer diagnosis. Her anxiety is heightened by concerns about chemotherapy, physical symptoms such as abdominal pain and exertional shortness of breath, and ongoing caregiving responsibilities. Oxygen saturation drops during activity, indicating a need for both physical and emotional support.
Short-term care goals include arranging alternative care for her mother within 15 days to reduce her emotional burden. Long-term goals focus on improving oxygenation, physical endurance, and overall well-being over three months. Addressing both psychosocial and physiological needs is vital during this phase.
Interventions, Description, and Rationale
| Interventions | Description | Rationale |
|---|---|---|
| Social work referral | Assist in locating appropriate care for her mother | Reduces caregiver stress, enabling better adherence to cancer treatment (Hoyt, 2022) |
| Frequent pain assessments | Monitor and document discomfort related to cancer treatment | Ensures timely pain management, preventing functional impairment |
| Introduce non-drug therapies | Teach relaxation techniques such as yoga, meditation, and guided imagery | Non-pharmacological methods help alleviate stress and improve physical comfort (Sheikhalipour et al., 2019) |
Effectiveness will be evaluated by tracking changes in pain intensity, oxygen saturation levels, and emotional state. As alternative care for her mother is established, the cancer care plan will evolve to focus more on her holistic recovery and quality of life.
References
Cancer. (2021, October 6). Managing diabetes when you have cancer. Cancer.net. https://www.cancer.net/navigating-cancer-care/when-cancer-not-your-only-health-concern/managing-diabetes-when-you-have-cancer
Carolina, C. M. (2019, October 16). Unlocking the full potential of self-monitoring of blood glucose. USPharmacist. https://www.uspharmacist.com/article/unlocking-the-full-potential-of-selfmonitoring-of-blood-glucose
Goodtherapy. (2019, September 23). Therapy for self-love, therapist for self-love issues. Goodtherapy.org. https://www.goodtherapy.org/learn-about-therapy/issues/self-love
NURS FPX 6610 Assessment 1 Comprehensive Needs Assessment
Heart. (2021, May 6). Living healthy with diabetes. Heart.org. https://www.heart.org/en/health-topics/diabetes/prevention–treatment-of-diabetes/living-healthy-with-diabetes
Hoyt, J. (2022, May 26). Assisted living & senior placement agencies. SeniorLiving.org. https://www.seniorliving.org/placement-agencies/
Pegg, S., Hill, K., Argiros, A., Olatunji, B. O., & Kujawa, A. (2022). Cognitive behavioral therapy for anxiety disorders in youth: Efficacy, moderators, and new advances in predicting outcomes. Current Psychiatry Reports, 24(12). https://doi.org/10.1007/s11920-022-01384-7
Ramzan, B., Harun, S. N., Butt, F. Z., Butt, R. Z., Hashmi, F., Gardezi, S., Hussain, I., & Rasool, M. F. (2022). Impact of diabetes educator on diabetes management: Findings from diabetes educator assisted management study of diabetes. Archives of Pharmacy Practice, 13(2), 43–50. https://doi.org/10.51847/2njmwzsnld
Sheikhalipour, Z., Ghahramanian, A., Fateh, A., Ghiahi, R., & Onyeka, T. C. (2019). Quality of life in women with cancer and its influencing factors. Journal of Caring Sciences, 8(1), 9–15. https://doi.org/10.15171/jcs.2019.002
Ströhle, A., Gensichen, J., & Domschke, K. (2018). The diagnosis and treatment of anxiety disorders. Deutsches Aerzteblatt Online, 115(37). https://doi.org/10.3238/arztebl.2018.0611
USC. (2018, January 9). What does self-care mean for diabetic patients? Nursing.usc.edu. https://nursing.usc.edu/blog/self-care-with-diabetes/