NURS FPX 6610 Assessment 2

Include 3–5 pieces of data (subjective, objective, or a combination) that led to a nursing diagnosis.

Write two goal statements for each nursing diagnosis. Goals must be patient- and family-focused, measurable, attainable, reasonable, and time-specific.

List at least three nursing or collaborative interventions; provide the rationale for each goal and outcome.

Explain why each intervention is indicated or therapeutic; cite applicable references that support each intervention.

First Diagnosis:

1. Ineffective Health Maintenance

As a result of the absence of unique knowledge and disrespect for interventions, Mrs. Snyder has a lack of understanding of how to maintain healthy behaviors across the lifespan, including the management of her diabetes. This could lead to issues, elevated blood sugar levels, and other health risks observed by (Castera et al., 2023).

SMART Goal 1: Blood Glucose Management: 

Therefore, it will be the intended course of action of Mrs. Snyder to maintain her blood glucose level within the recommended guidelines. The patient aims to have blood glucose concentrations ranging between 80-130 mg/dL before meals and less than 180 mg/dL after meals. To achieve this, she plans to take her blood glucose level check every day and understand dietary intake, physical activities, and insulin. To realize this aim, Mrs. Snyder plans to visit her medical team after every two weeks.

1. Patient Education: Diabetes education should also include help with scheduled exercise routines and administration of prescribed medicines (Castera et al., 2023).

2. Collaborative Care: 

Ensure that dietitians and diabetes educators develop a type 2 diabetes management approach so that the strategies designed are sustainable (Choi et al., 2022).

3. Monitoring and Follow-up: Bi-weekly check-in calls to reflect on the project progress, as well as to address any concerns (Miler, 2023).

1. Patient Education: Promoting adherence to health maintenance plan: Education (Castera et al., 2023).

2. Collaborative Care:

 Expert integration supports a tailored approach (Choi et al., 2022).

3. Monitoring and Follow-up: Regular monitoring ensures adherence to the plan and also provides a chance to change the plan (Desai et al., 2023).

Outcome Evaluation: Assess Mrs. Snyder through interviews and weekly observations based on the following criteria: The diagnosis will affect the ability of Mrs. Snyder to keep her health in check, especially in terms of managing diabetes. The target blood sugar levels based on ADA criteria are preprandial levels of 80-130mg/dl and postprandial levels of < 180mg/dl.

Two ways to determine Snyder’s results involve measuring the given blood glucose levels and evaluating her adherence to diabetic treatment modalities such as 

• Subjective: Mrs. Snyder says she cannot manage her diabetes and is unaware of the treatment process.

•  Objective: 

The patient in question discontinued anxiolytic medications due to hyperglycemia, which ranges from 230 to 399 mg/dL, obesity, and fatigue.

According to Almalki et al. (2021), Mrs. Snyder ought to be able to attain this goal within three months.

Short-term Goals: 

1. During the first week, Mrs. Snyder will understand how to manage diabetes.

2. To address this nutritional need, Mrs. Snyder began exercising to maintain good health.

 Long-term Goals:

1. In the next three months, Mrs. Snyder’s blood glucose level will maintain the advised range effectively and efficiently.

2. To improve her general health, Mrs. Snyder will follow the diet and physical activities schedule.

exercising proper diet, and the use of medicine.

While it is crucial to visit a patient frequently, it must be done every two weeks to allow for an effective evaluation of their condition. They can track the blood glucose level of Mrs. Snyder throughout such sessions to determine her improvement. This is important to gain qualitative evidence about her understanding of the care plan and compliance with it. These measures enable early recognition of nonadherence and potential outcomes.

• Re-planning:

When objectives are not attained, one should alter the educational approach and involve other assets. Re-planning should focus on such barriers to healthy living and should address them with additional educational techniques or additional resources for support. This may involve changing her diet in some way, exercising more effectively, or receiving more diabetes information.

2. Anxiety Due to Health Issues and Caregiver Stress:

The positive is that this diagnosis accurately painted a picture of Mrs. Snyder’s health, the worry, and the concern that they have. She might develop symptoms such as; 

SMART Goal 2: Anxiety Reduction

She will write diary entries reflecting the changes in her levels of anxiety and meet with clinicians for assessment where she will have to achieve a minimum of 25% reduction in her scores on the Hamilton Anxiety

Second Intervention:

1. Mental Health Counseling: Schedule Mrs. Snyder an appointment with a counselor who is an expert in long-term care (Miler, 2023).

Second Goal Rationale:

1. Mental Health Counseling: Counseling assists in managing stress and anxiety (Choi et al., 2022).

2. Stress-Relief Techniques: Therefore, it can be concluded that anxiety can be significantly alleviated with simple exercises (Desai et al., 2023).

• Outcome Evaluation: This can be done by scheduling therapy sessions as well as incorporating stress busters to know how the subject’s anxiety is progressing. The diagnosis of the condition is the reduced levels of anxiety, this is mostly according to the Hamilton Anxiety Rating Scale (HRS). 

tiredness, agitation, and restlessness, which can also be very harmful to her overall health.

• Subjective: When it comes to her diabetes and how it is going to impact the family, concerns, and anxiety are depicted in Mrs.
• Objective: Heightened degree of apprehension together with feelings of permeation, fractiousness, and fatigue.

Rating Scale in three months. To minimize stress, she’ll join support groups and undergo mental health therapies. Her progress will however be assessed using monthly assessments (Sedini et al., 2022).

Short-term Goals:

1. One week, Mrs. Snyder will be conversing with a person who has a degree in mental health counseling regarding what she is feeling about.

2. Ms. Snyder will practice stress-reducing activities Mrs. Snyder’s stress-reducing exercises will be held.

 – Long-term Goals:

1. In less than 90 days, Mrs. Snyder’s anxiety levels will reduce by 25%.

2. To increase her support base, Mrs. Snyder will be participating in functions that are more of a family nature. 

2. Stress-Relief Techniques: To reduce the incidence of anxiety, implement fundamental actions like breathing exercises (Sabbah, 2022).

3. Support Systems: It is crucial to involve members of the family and the community to establish a strong support foundation (Sabbah, 2023).

3. Support Systems:

 Family and community support is found to increase, thus lessening anxiety and caregiver load (Sedini et al., 2022).

• The HRS is a structured means of quantifying anxiety on a scale that ranges from zero to 56. That is why within the three months of therapy the woman had to achieve the minimal level of anxiety that defines a successful therapy process by reaching a score below 25 points. These outcomes can be measured by the use of sessions for counseling and regular stress-reducing activities to identify how anxious Mrs. Snyder is. It will also help in observing her progress and determining the level of help which she still requires. Interviews with the clinician will provide valuable information on her affective state, and self-report will reveal the degree of success towards stress-management interventions.

Third Diagnosis:

3. Knowledge Gaps in Managing Chronic Diseases

This diagnosis stems from Mrs. Snyder’s lack of understanding about diabetes management and her issues with having high and low blood sugar levels not to mention her failure to adhere to the necessary dietary restrictions and not taking her medications as prescribed. She has already been diagnosed with cancer stage 4 Ovarian cancer therefore; she may have complicated health needs and thus more stress. 

Such a situation may increase the possibility of challenges as well as negative health outcomes (Russell et al., 2023).

  Subjective: Mrs. Snyder’s knowledge deficit affects her ability to follow diets and also manage diabetes while receiving treatment for ovarian cancer including medicine dosages.

●      Objective: Diabetes fluctuations, use of incorrect medicines, and neglect of the diet, all of which are due to long-term consequences of cancer treatments.

   Psychological, Social, and Cultural Factors in Healthcare   For Mrs. Snyder, To further create a conducive environment for better results, the aspects of psycho-sociocultural plans of care include respecting her religious practices, addressing her concerns on ways to deal with anxiety, and including the family on diabetes care to Mrs. Snyder.

SMART Goal 3: Adherence to Diabetes Care Plan

Checklist and food diary forms will be employed in the assessment of compliance with Mrs. Snyder’s diabetic care regime which includes medication, diet, and exercise. This target will be achieved in a month with the support of individualization of the approach and weekly follow-ups to ensure proper adherence.

Short-term Goals:

1.       In the next week, Mrs. Snyder will be able to understand her prescription timings and also how to monitor her blood glucose levels.

2. Mrs. Snyder plans to use a blood glucose monitoring gadget daily, according to her plan.

Long-term Goals:

1.  1. On a detailed plan of over three months, Mrs. Snyder will keep on carrying out blood glucose monitoring as well as follow the diabetes management plan.

2.   2.   On a detailed plan of over three months, Mrs. Snyder will keep on carrying out blood glucose monitoring as well as follow the diabetes management plan.

Third Intervention:

1.     Education and Training: Help with ovarian cancer-related problems by providing personalized recommendations on diabetes self-care and patient education (Rauwerda et al., 2021).

2. Collaborative Support: For meal choice and assistance about diet seek a diabetic educator and a dietitian who has working experience with cancer patients (Russell et al., 2023).

    Monitoring and Follow-up: Considering the intensity of the proposed regimen to correspond to the individual needs of Mrs. Snyder, it is necessary to conduct weekly follow-ups to determine her understanding of the plan and compliance (Velázquez et al., 2023).

Third Goal Rationale:

1.     Education and Training: In addition, there are other challenges related to cancer treatment; therefore, targeted knowledge enhancement may fill existing knowledge gaps and improve the patient’s compliance with the diabetic management plan (Rauwerda et al., 2021).

Co Collaborative Support

Involving diabetes educators and dietitians ensures that 

      cancer patients are given professional guidance that is culturally competent (Russell et al., 2023).

         Monitoring and Follow-up: That means, a more frequent check-in ensures progression and acquires aspects addressing the impacts of cancer treatment (Garg et al., 202

2).

       Outcome Evaluation: Therefore monitor whether or not Mrs. Snyder is following her diabetic care plan during weekly assessment with considering the effects of cancer therapy. The main consequences of this diagnosis are concerned with the question of Mrs. Snyder’s ability to understand and manage her diabetes. This can be looked at via weekly check-ups since if you take her, you get a chance to check the level of medication, food, and exercise understanding. Two indicators that were used to assess adherence were the extent to which patients followed the suggested treatment regimen, as well as the frequency of blood glucose measurement. A few features of the case show that during the evaluation, there were additional 

        factors because of her medical condition: she was diagnosed with stage 4 ovarian cancer. This may make it hard for her to follow instructions given to her on diabetes treatment hence it will be crucial to examine her frequently to ensure that she is not having any gaps in her knowledge.

         Re-planning: If objectives are not fulfilled change the education programs, conduct follow-ups more often, or communicate with other specialists to overcome the specific problems connected with stage 4 ovarian cancer.