MSN FPX 6021 Change Strategy and Implementation KP

According to Reamy in 2018, yearly screenings for elevated lipid in patients with  diabetes is strongly suggested. Such screening should include measuring the blood of total  cholesterol level, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride  levels. An adequate LDL level is lower than 1129 mg per dL (3.41 mmol per L); triglycerides  should be lower than 199 mg per dL (2.31 mmol per L). Individuals with a clinically diagnosis of  cardiovascular vascular disease, LDL levels should be less than 100 mg per dL (2.59 mmol per  L), and triglycerides should be less than 149 mg per dL (1.69 mmol per L). Whether these lab  values should be a goal for all individuals with type 2 diabetes, no matter whether they  developed vascular disease, has been argued. An HDL level of greater than 45 mg per dL is  recommended (1.20 mmol per L). 

The management of hyperlipidemia should begin with a plan to improve glycemic  control, lowering the A1C level, and decreasing their weight to better their Body Mass Index 

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(BMI). Exercising often should be incorporated into the weight-loss regimen, evidence has  shown that if the individual does both, weight loss improves, and weight upkeep is enhanced.  Weight loss will result in a reduction in triglyceride levels and an increase “the good fat” in HDL  levels (Scheen, 2021). Prior to the exercise program being recommended, previous medical  conditions that would upsurge the risks of exercise should be considered, including the presence  of diabetic retinopathy, nerve and podiatry complications. It is sensible to recommend an  exercise tolerance test to rule out any heart problems, predominantly in patients older than 40 years of age. 

Diabetes and Heart Disease  

Heart disease and long-term diabetes often go hand in hand. It is important for the  individual having these problems learn how to protect their heart with minor but effective lifestyle alterations that can also help control and manage diabetes. Heart disease is very  common but very serious. It’s the leading cause of death for both women and in the United  States (Tatum, 2017). If a person diabetes, they are twice as likely to have cardiovascular disease or a cerebral vascular accident (CVA) than someone who does not have diabetes—and at a  younger age. The longer a person diabetes, the likelihood of them having heart disease increases  drastically. The good news is that a person can lower the risk for heart disease and better their heart health by altering certain lifestyle behaviors. These changes will help manage the diabetics  blood sugar and Hemoglobin A1C better too. 

Change Strategies  

At the Diabetes Educational Summit, scientific professionals in education specializing in  diabetes highlighted the importance of using nursing theory to encourage future research and 

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diabetic guidelines to better one’s health. When trying to implement change for a patient with a  prolonged diagnosis of diabetes, one method that has shown to be effective is called the  Transtheoretical Model (TTM). This model is highly effective due to its many applications and stages of readiness for change, especially for nursing and its continuing evolution of practice.  This model has been studied and developed for nearly 4 decades (Tatum, 2017). TTM also  emphasizes on both bettering a person’s enthusiasm in those not ready to change their behavior and improve self-manage circumstances- and providing a change of behavior for people who are  motivated.  

MSN FPX 6021 Change Strategy and Implementation KP

This TTM change strategy will utilize interprofessional considerations and ensure  successful implementation for a diabetic patient because in a nutshell, the TTM assesses patient’s readiness to both fix their diabetic care gaps and education problems, behavioral trends- and act  on new, more positive behaviors. This model occurs across a continuum of a six stage process,  with staff knowing the patients mindset at the beginning have no desire to change and buy into  any changes that are hard to break. If the TTM is correctly done, we can assume that the  behaviors of the patients who needed to change will reach there desired health outcomes on a  long term basis. Our Diabetic patients will need to change eating habits to manage blood sugar,  patients with emphysema will need to quit smoking, and more. Patients may or may not take  action, and the process of change can be a gradual one. 

THE TRANSTHEORETICAL MODEL: HELPING DIABETIC PATIENTS