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Health Promotion Paper

April N. Wright

Delaware Technical Community College

NUR 320 Health Assessment

Kate Lind
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Health Promotion Paper

Holistic assessments are both comprehensive and problem focused like the standard

health assessments, but in addition go much deeper into the patient’s health history. There is

much more time spent obtaining a more detailed history during the patient interview and physical

examination including an extensive family history. Through holistic assessments, family history

is so important in determining causative or hereditary factors that may contribute to a patient’s

diagnosis and treatment. The patient, their family and the nurse are included in goal setting. It is

not just the nurse. Together a plan of care is developed and put into action.

Health Problems and Health Promotion and Disease Prevention

My plan of care assignment is focused on a 51-year-old patient, Mr. G.W., I developed a

scenario that makes it easier to reflect my findings. Mr. G.W. has a significant medical history

including a strong family history that looks to contribute to his multiple diagnoses. Mr. G. W.

had his appendix when he was in his early 20’s but other than that was healthy. In his 30’s, he

was diagnosed with Type II Diabetes and due to noncompliance and poor management, he now

has multiple complications that have developed in the last 10 years or so. In my interview, which

also included his wife, we discussed his past and current medical history. Mr. G.W. has Type II

Diabetes Mellitus, Hypertension, Coronary Artery Disease (has had 3 stents inserted for 7

blockages), Vision Difficulties, and Neuropathy. He has had multiple cardiac catheterizations

with stent placements and right shoulder surgery due to frozen shoulder, The surgeries

mentioned above were partially if not due to uncontrolled diabetes resulting in those

complications warranting surgery. His family has a strong history of cardiac issues (maternal)

and diabetes (paternal and maternal). When interviewing Mr. G.W., I learned that his history of

noncompliance was a little deeper than just not wanting to take medications and follow a diet. He
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has a busy work schedule farming as well as some insurance issues with getting his insulin refills

in a timely fashion. He has also become depressed due to many years of checking blood sugars,

dealing with insurance issues, financial burden of out-of-pocket costs of insulin and insulin

pump. Now Mr. G. W. is still dealing with all this as well as new complications from

uncontrolled diabetes. All this needs to be considered when discussing a plan of care or treatment

for the patient. With this holistic assessment, the patient is involved in discussing and putting in

place a plan of care involving the physical, emotional, social, and spiritual well-being of the

patient. All contributing factors are looked at as well. Examples like stress, sleep history, diet,

spiritual practices.

Current Holistic Health Issues/Problems

The main problem I focused on was Type II Diabetes with the complications of

Neuropathy and Coronary Artery Disease. I developed a plan of care for the patient, with the

help of his wife and him. The risks or problems identified were listed and the evidence-based

interventions were included. The American Diabetes Association published an article in the

Summer of 2022 that described how quality outcomes can be improved. “Evidence-based.

interventions can promote early diagnosis of diabetes, prevent, or delay the onset of type 2

diabetes, and improve treatment and outcomes for people with diabetes. Patient education and

outreach materials and practice tools for the patient are included with these interventions “

(Rodriguez, K., Ryan, D., Dickinson, J. K., & Phan, V. , 2022). Mr. G.W. is now in his life

where these interventions hopefully will improve treatment and. Mr. G.W. is now in his life

where these interventions hopefully will improve treatment and outcomes, unfortunately not so

much the prevention part of it.

Evidence-based Interventions and Goals

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The established care plan was one that Mr. G.W. felt was reasonable. It includes some

interventions he was already doing but not complying with it daily or weekly. The interventions

are frequent blood sugar checks, following an ADA diet stricter while monitoring carbs and

fiber, keeping daily diary, joining a tracking plan (weight watchers), joining local gym, wearing

a fit bit or using technology on cell to monitor activity, reporting any signs of concern to doctor

asap along with keeping log of blood sugars or making sure the patient takes his monitor so

doctor can download the information. “Another meta-analysis of 50 high-quality systematic

reviews found three types of quality-improvement interventions that were effective in improving

diabetes care: patient education and support, multidisciplinary teams, and technology-enabled

health care” (Rodriguez, K., Ryan, D., Dickinson, J. K., & Phan, V. ,2022). The hardest thing

said by Mr. G.W. would be to stay compliant. The projected outcome would be at the end of a

three-month period evaluate labs and blood sugar levels and they will show a decrease or better

control due to the interventions and the changes being made. With better control of the blood

sugars and weight, the risks of increased complications are decreased, and overall health and

patient well-being will be improved.

Community Resources/Referrals

As Mr. G.W.’s interview and his care plan were almost complete, Mr. G. W. discussed

concerns regarding resources and if there were any out there to assist his wife and him. On the

last section of his care plan, I explained that there was an area where there was a list of resources

entered complete with names, addresses, and phone numbers, including ones that he already was

involved with. We reviewed them together and added a couple as well. Mr. G.W. expressed how

helpful this was to have them all listed together. A copy of the plan of care was given to Mr.

G.W. and an appt was set up in 3 months so the care plan could be reviewed again. Resources
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included Mr. G. W.’s plan of care are as follows: Primary Care Physician, Dr. John Pearson, an

Endocrinologist, Dr. Desalew, Cardiologist, Dr. Perez, Dietician at Bayhealth and also the

number and location of Planet Fitness for trainer to work with him.

Reflection

As I reflect on this last assignment and this class, I believe that so much can be taken

away from it and used daily in my practice. I plan to give Mr. G.W. a copy of this assignment

and care plan and check in with him to see if he will be able to use it to help improve his way of

thinking and his way of living. As a nurse, we always hope that even the littlest things can help a

patient have a healthier outcome.

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References

Rodriguez, K., Ryan, D., Dickinson, J. K., & Phan, V. (2022). Improving Quality Outcomes: The

Value of Diabetes Care and Education Specialists. Clinical Diabetes, 40(3).

https://doi.org/10.2337/cd21-0089