Assignment 3.2: Connecting Developmental Theory Maryville University MSN NURS 600 7W 21/SU1: Theoretical Foundations of Nursing Practice

Dan is a 32-year-old construction worker who typically works early mornings and late nights. He has no time for exercise activities, so he lives a sedentary lifestyle when he is not at work. His wife is a stay-at-home mother, and they have two younger children, a boy who is ten years old and a little girl who is four years old. Dan’s children participate in sports; his boy plays baseball year-round with club seasons, and his little girl dances. Typically, they don’t have time between running the children around from school and extracurricular activities to make meals. Dan will get fast food most days for breakfast. Lunch consists of meals from the gas station like chips and other gas station snacks. Dan’s wife will sometimes have homemade dinners ready, but sometimes she doesn’t have time to cook between the kid’s sports. Dan and his wife hardly see each other; their only alone time is lying in bed and on weekends when Dan doesn’t pick up extra shifts. Dan is overweight, has a history of hyperlipidemia, and hypertension. Dan’s father has type two diabetes uncontrolled as he refuses to eat well and take care of himself. Dan grew up with a busy schedule, and his dad was never around due to work. However, Dan has not seen a provider for more than two years. He states he does not have time. Dan is no longer compliant with his medications and diet to help with his existing cardiovascular disease. Recently he has noticed he has been using the restroom more frequently, constantly feeling thirsty at the end of the day, and feeling fatigued daily after a good night’s rest. He has been brushing these symptoms off as maybe he needed to drink more water throughout the day and get better rest. As months went on, the symptoms persisted. His wife was becoming concerned with Dan’s eating habits and family medical history, so Dan scheduled a visit with his provider to find out what is going on.

In practice, I would expect that Dan has type two diabetes. Since he has not seen a provider in over two years, I would take down a health history to get a good picture of when the symptoms started. He mentions the history of type two diabetes and cardiovascular disease on his father’s side of the family. He also reveals his diet, sedentary lifestyle outside of work, and involvement at home. Vitals showed blood pressure 168/95mmhg, a pulse of 78, respirations of 17, and oxygen saturation at 98% room air. A glucose finger stick performed showed a glucose level of 223mg/dl. I would order blood work to check his a1c, fasting blood glucose, two-hour glucose level, triglycerides, LDL, HDL, liver, and kidney function tests done before I diagnose Dan with type two diabetes. His labs came back to confirm my diagnosis. I will educate him on the disease and the treatment options as it is a new diagnosis with multiple components. A medication regimen will allow for hypertension and hyperlipidemia to be managed. Education and referral to a nutritionist for diet changes and resources will be helpful for his conditions. I will refer him to exercise programs and stress-relieving activities to reduce his stress. Education and demonstration with teach-back method on how to monitor blood glucose and hypertension will be given. Offering stress management skills and ways to decompress to help alleviate the stress he feels daily and getting his family involved in that would be beneficial. As this will be very overwhelming for the patient, a follow-up visit will be made for a month later to see how the patient is dealing with this new diagnosis and will redraw blood work and go from there