Another problem that was identified is the scattered pustule on her face which is commonly called acne. Adult women may present with acne involving lower face and neck is often associated with a premenstrual flare, and they seem to benefit from hormonal therapies (Thiboutot & Zaenglein, 2016). This condition is also present with Ms. Jones of which she claimed that her skin had gotten better when she started taking the birth control pill. Before sending Ms. Jones home, recommend a dermatologist to check her. For home skin care, educate Ms. Jones to wash her face twice a day with gentle synthetic detergent cleanser (i.e., Syndet) as recommended by UptoDate (2016) with her finger but avoiding scrubbing it aggressively and then rinse with warm water. She should be advised not to pick on the lesions as this may exacerbate scarring (Graber, 2016). Health Risks Health risk behavior that was uncovered during the assessment of Ms. Jones was first, she only checked her blood sugar once a day. Being a diabetic, she needs to check her blood sugar before meals and at bedtime. Though she reports that her blood sugar at home is on the average of 90, this is, however, a subjective data unless we can see the actual result on her device. With her also reporting that she increased her physical activity, she also at risk for hypoglycemia. Increased physical exercise lowers the person’s blood sugar (McCulloch, 2016). Healthy Behaviors
PATIENT ANALYSIS AND TEACHING 12 Healthy behavior that was identified during the assessment of Ms. Jones is her improved eating habits and the increase of exercise. Being a diabetic, with prehypertension, and obesity can be controlled by diet and exercise and losing weight. Ms. Jones stated that she eats fewer carbs, avoids sweets, tries to eat whole grain, vegetables, and foods that are low in fats. It is evident by her losing 10 lbs. over the last four months. Overall Plan Ms. Jones overall health condition is good. However, the decreased sensation in both her feet is alarming. She reported that she has been controlling her diabetes and prehypertension with diet, exercise, checking her blood sugar once a day, and taking the medication metformin twice a day. People with diabetes and hypertension are at risk for peripheral arterial disease. Peripheral artery disease (PAD) is a condition that can cause leg pain that gets worse with activity. Patients with PAD often have no complaints. However, if the supply of blood fails to satisfy ongoing metabolic requirements because of arterial narrowing, symptoms will occur, the severity of which depends upon the degree of arterial narrowing, the number of arteries affected, and the activity level of the patients. Risk factor includes black ethnicity, diabetes, hypertension, smoking, hyperlipidemia and a family history of atherosclerosis (Neschis & Golden, 2014). Ms. Jones has at least three of these risk factors, and she is showing symptoms by her decreased sensation in her feet. Healthy people 2020 goals for diabetic patients is to reduce the rate of lower extremity amputation; increase the number of adults with diabetes to have an annual foot examination and increase the number of patients with diabetes to perform self- blood glucose monitoring.
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- Fall '17
- Diabetes, Blood sugar, Diabetes mellitus type 2