Running head: NURSING CARE PLAN 1

Nursing Care Plan

Rodricka D. Richardson

Delaware Technical Community College

NURSING CARE PLAN 2

Nursing Care Plan

A holistic health assessment was completed on the patient, Mr. Rhodson Azard. This

assessment evaluated the patient’s overall health and well-being, including work status, a

personal health history, family health history and physical assessment. In his personal health

history and physical assessment, it is apparent that Mr. Azard is a very healthy individual with no

current health problems, illnesses or ailments. He maintains a relatively regular exercise schedule

and eats a pretty well-balanced diet. However, he is not without some risk. Mr. Azard does have

a history of diabetes in his family, of which he should be proactive in preventing. Additionally,

he also works in an occupational setting that comes with a particular set of risks to his health. As

a result of these findings, a care plan has been developed to assist him in preventing illness and

maintaining optimal health.

Assessment Findings

Mr. Azard is a 26-year-old black male of Haitian descent and ethnicity. He is 5’10” and

155 pounds with a lean build. He reports no existing health issues. He admits to not seeing his

physician for a yearly physical, noting the most recent one was in 2018. No health issues were

discovered during this visit. As an exercise science degree holder, CNA and nursing student, he

understands the importance of physical activity and maintains a regular and frequently updated

exercise routine, working out 4-5 days a week. Admittedly, he does not do as much cardio in his

workout routine, which he has been working on adding in. His diet is well balanced, eating a

variety of protein, vegetables and fruit, and drinking a gallon of water a day. The amount of

takeout, processed foods and processed sugars Mr. Azard consumes is very limited, though he

admits he can further limit his take-out intake. Practicing good sleep hygeine, he also maintains a

regular bedtime routine most nights and gets about 6-7 hours of sleep a night. During his
NURSING CARE PLAN 3

physical assessment, all findings were found to be within normal limits. Mr. Azard also works a

very physical job as a patient care technician at a hospital. While this also helps him stay active,

this career comes several occupational health risks which will be addressed in his plan of care.

Regarding his family history, due to family dynamics, Mr. Azard is not very familiar with

familial health issues. His mother was able to provide some additional information, noting that

her mother had, and passed due to complications of, type II diabetes mellitus. Two of his

grandparents have passed of causes unknown and the location and status of one is unknown. The

family he is familiar with are all in good health with no known health issues. The only known

living family member with a chronic illness is his mother, who was diagnosed with type II

diabetes mellitus approximately around 2012. She manages her diabetes with exercise, diet and

maintenance of a healthy weight. While Mr. Azard maintains an optimal diet, weight and

exercise routine and is at a lower risk of development diabetes type II, he must still be vigilant

since this illness is prevalent in two prior generations.

Plan of Care

Mr. Azard’s plan of care focuses on prevention since he has no existing health issues.

Though at low risk for development of diabetes, because of his genetic history, he must remain

proactive to prevent becoming high risk. In the United States of America (USA), risk factors for

development of type II diabetes includes being of or African descent, or black, having an

immediate family member with diabetes, hypertension, sedentary lifestyle and being obese

(Gruss, et al., 2019). Mr. Azard meets 2 of the 5 listed risk factors. Genetics and environmental

factors are considered some of the main risk factors for development of this condition and

limiting the risk of development involves controlling modifiable risk factors, such as healthy

diet, weight loss, and regular exercise (Gruss, et al., 2019; Asif, 2014). In the care plan
NURSING CARE PLAN 4

developed for Mr. Azard, prevention includes continuing to work out regularly and continuing to

eat a well-balanced diet with minimal processed foods to maintain a healthy weight and reduce

stress levels. It has also been recommended that Mr. Azard see a physician yearly so that lab

work, such as blood sugar levels and hemoglobin A1C can be monitored. He has received a

referral to United Medical Clinic, a local office in his area that not only provides yearly physical

assessments, but health risk monitoring and management.

As a healthcare worker (HCW) who plans to stay in this field, Mr. Azard is open to

several health risks. Being a healthcare worker can be rewarding, but the work environment is

considered one of the most dangerous as exposure to physical, chemical and biologic harm as

well as stress and burnout is prevalent (Mohanty, et al., 2019; Joseph & Joseph, 2016). Long

hours and shift work that lend to exhaustion and disruptions in circadian rhythm, increasing

workloads and patient acuities that lend to increased stress, exhaustion and job satisfaction, also

play a role in the overall health of HCW’s. The stress that HCW’s experience can manifest as,

lead to or place an individual at higher risk for development of mental health concerns, such as

burnout and depression, along with non-communicable diseases, such as diabetes and

hypertension (Mohanty, et al., 2019; Joseph & Joseph, 2016). Since Mr. Azard is already at an

increased risk, albeit low, of developing diabetes, and since we want to prevent the development

of any other health concerns, it is important for him to maintain a healthy work life balance and

low stress levels to continue to maintain optimum physical and mental well-being. For his plan

of care, the recommendation is to continue to exercise, eat healthy, practice good sleep habits,

but additionally to develop coping and stress relief strategies to help deal with the unique stresses

of healthcare work. Additionally, prevention of exposure to biologic and other materials include

maintaining the necessary levels of precautions when providing care for patients as well as
NURSING CARE PLAN 5

maintaining vaccination status. Mr. Azard states that his job provides regular training of this

practice, however the importance of maintaining proper hand hygiene in these settings has been

stressed. A referral to a counseling service called Delaware Center for Counseling and Wellness

has been made to help Mr. Azard manage stress, learn coping skills, and learn to manage work-

life balance.

Evaluation

Evaluation and re-assessment of the plan of care will occur over time. Initially teach back

method may be utilized to ensure that Mr. Azard fully comprehends the steps he must take in his

plan of care. A teaching and demonstration of proper donning and doffing PPE and hand washing

by Mr. Azard will also ensure that he is properly protecting himself in his workplace. A yearly

meeting with Mr. Azard will be scheduled in which he will bring his most recent lab work,

vaccination history and any changes in health status. He will also be instructed to call prior to our

yearly meet up if there are any significant changes in his health. We will also evaluate if he is

maintaining his exercise routine, healthy diet and adequate sleep and determine if any changes

need to be made to his plan of care. Additionally, we will discuss his stress levels and how well

he is maintaining work-life balance and if his counseling sessions have assisted him with dealing

with work stressors. Also, addressing if the patient has met any financial, cultural, spiritual or

socio-economic barriers to maintaining or utilizing the recommended interventions will be

assessed regularly so that he can be provided with any assistance necessary to help him meet his

optimal health goals.

Developing a holistic plan of care that is detailed for a patient can be challenging. In this

instance, my patient was a healthy young man with manageable risk factors that he was already

managing pretty well on his own. As his nurse, I simply expanded on what he was doing to
NURSING CARE PLAN 6

protect himself and provided additional resources and information. For a patient with a more

complex health status and history, a lot more detail and research would be necessary. An

extensive plan of care may also be overwhelming for a more complex patient to manage which

may require additional assistance. There are many factors, some extrinsic and some intrinsic,

play a role in the maintenance of holistic health. It is important to evaluate as many factors as

possible in order to develop the best plan of care for each individual patient that the leads to their

optimal level of health.

NURSING CARE PLAN 7

References

Asif M. (2014). The prevention and control the type-2 diabetes by changing lifestyle and dietary

pattern. Journal of education and health promotion, 3, 1. https://doi.org/10.4103/2277-

9531.127541

Gruss, S. M., Nhim, K., Gregg, E., Bell, M., Luman, E., & Albright, A. (2019). Public Health

Approaches to Type 2 Diabetes Prevention: the US National Diabetes Prevention

Program and Beyond. Current diabetes reports, 19(9), 78.

https://doi.org/10.1007/s11892-019-1200-z

Joseph, B., & Joseph, M. (2016). The health of the healthcare workers. Indian journal of

occupational and environmental medicine, 20(2), 71–72. https://doi.org/10.4103/0019-

5278.197518

Mohanty, A., Kabi, A., & Mohanty, A. P. (2019). Health problems in healthcare workers: A

review. Journal of family medicine and primary care,  8(8), 2568–2572.

https://doi.org/10.4103/jfmpc.jfmpc_431_19