Fundamentals case study - week 3.
Ch. 3 Health, Illness, and Disparities
1. You are a nurse caring for a 42-year-old mechanic who is hospitalized for a gangrenous wound on his foot. His history includes unmanaged diabetes, smoking (20 pack-years), and hypertension. He denies alcohol use. He suppo...
Fundamentals case study - week 3.
Ch. 3 Health, Illness, and Disparities
1. You are a nurse caring for a 42-year-old mechanic who is hospitalized for a gangrenous
wound on his foot. His history includes unmanaged diabetes, smoking (20 pack-years),
and hypertension. He denies alcohol use. He supports himself with full-time work.
Socially, he belongs to a motorcycle club and enjoys riding whenever his work schedule
allows. When asked how he would rate his overall health, he reports, “I may not have
much money, but I’ve got my health!” (Learning Objectives #2 & #5)
a. What pertinent data can you gather based on available patient information?
i. He is a non-compliant patient (diabetes, hypertension) that does not
understand comorbidities he has. He is in denial about his overall health
(reference to last statement). Requires education.
ii. There is an alteration in skin integrity due to his gangrenous wound. Calls
for concern about infection.
b. How would you categorize the patient’s illnesses?
i. Work with wound first.
ii. Treat his diabetes and educate about maintenance.
c. What questions should you ask yourself when caring for this patient?
i. Who do you live with?
ii. Is he on his feet all day at work? Does he have adequate shoes for work?
iii. What is your diet like?
iv. How long have you had this wound? What did you do for it?
v. What kind of health care coverage do you have?
d. Which stage-of-illness behavior avoidance does this patient seem to
display? Give the rationale for your choice.
i. Stage 1 -- Experiencing symptoms
ii. Patient has not assumed the sick role, due to his denial about his overall
health. He believes he is not at risk for deteriorating health/illness
although he has a gangrenous wound exacerbated by his lack of diabetes
management.
e. What strategies could you propose to the patient to promote health and
prevent illness?
i. Educate him on wound care. Make sure he is cleansing the area
consistently. Due to his diabetes, he will need to make sure his feet are
moist to prevent open sores. Further educate to him about certain shoes
he should be wearing for support.
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