The three priority teaching needs for G.T. are weight management through natural methods, regular monitoring of her blood glucose levels at regular intervals and lifestyle modifications in compliance with the medications. The patient is experiencing lack of appetite and weight loss. As she is weak, she is also experiencing lack of energy and is also skipping meals. As she has a medical history of uncontrolled diabetes mellitus type 2, regular monitoring of blood glucose levels are important at home. She is unaware of her health condition, so she needs to be taught about how to control her chronic disease condition. Moreover, she should also be taught about importance of medications use that would help her to check on her physical factors that is leading to deterioration of her body (Inzucchi et al., 2015).
The evidence-based outcome is that through the natural remedies, she would be able to gain weight through proper intake of balanced diet and proper nutrients. By preparing traditional foods and home-made methods, the patient would be able to gain energy and prepare food for her and continue with gardening and church work. Through the continuous monitoring of her blood glucose levels at regular intervals at home, she would be able to control her diabetes mellitus type 2 and its related complications. By adopting lifestyle modifications like physical activity and intake of home-made food that would help to control her diabetic condition are the positive health outcomes for G.T. Moreover, through the natural, herbal medications, she would be able to control her chronic diabetic condition (Lind et al., 2017).
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Teachings
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Nursing interventions
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Rationale
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Weight management
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1. Noting of weight, body mass index, waist circumference.
2. Patient knowledge about nutrition and need for supplements (Butcher et al., 2013).
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1.Estimation and documentation of exact weight would help to determine the health outcomes.
2. It helps to develop teaching plan according to the patient’s current state.
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Control of blood glucose levels
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1. Assist G.T. in the identification of the eating patterns that needs modification.
2. Educating the patient about importance of meal plan and medications (American Diabetes Association, 2014).
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1. This forms the basis for the individualized dietary instruction.
2. It would help to maintain the sable blood glucose levels through the use of herbal medicines.
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Lifestyle modifications
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1. Cognitive-behavioral strategies for behavior change that addresses the social and cultural context of the patient.
2. Education on lifestyle modification, exercise and physical activity, follow-up and dietary changes (Model, 2015).
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1. This would help to determine the level of commitment for making dietary changes and delivery strategies.
2.This would help to control her chronic diseased condition of diabetes mellitus type 2, hyperlipidemia, hypertension and gout.
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Meal plan
Breakfast- Glass of low-fat milk, piece of fruit like orange, whole grain toast (1 slice)/ cold cereal
Lunch- Soup, sandwich made of 2 slices of whole grain bread, lean meat, fish, or chicken, tomato slices, low-fat plain yogurt, grapes/ brown rice/ whole-wheat Pita bread/ skimmed milk
Snacks- For afternoon snacks, she can have apple or a small banana.
Dinner- 1 large potato, vegetable, green salad, low-fat milk, 1 medium pear, lean meat, fish or chicken (Wien, Oda & Sabaté, 2014).
Grocery list
Low-fat milk, whole grain bread, fruits like oranges, banana, apple, pear, grapes, guava, lean meat or chicken or fish, brown rice, potato, yogurt, vegetable soup, cereals.
References
American Diabetes Association. (2014). Standards of medical care in diabetes—2014. Diabetes care, 37(Supplement 1), S14-S80.
Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. (2013). Nursing interventions classification (NIC). Elsevier Health Sciences.
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), 140-149.
Lind, M., Polonsky, W., Hirsch, I. B., Heise, T., Bolinder, J., Dahlqvist, S., ... & Ahlén, E. (2017). Continuous glucose monitoring vs conventional therapy for Glycemic Control in adults with type 1 diabetes treated with multiple daily insulin Injections: The GOLD Randomized Clinical Trial. Jama, 317(4), 379-387.
Model, C. C. (2015). Standards of medical care in diabetes—2015 abridged for primary care providers. Diabetes care, 38(1), S1-S94.
Wien, M., Oda, K., & Sabaté, J. (2014). A randomized controlled trial to evaluate the effect of incorporating peanuts into an American Diabetes Association meal plan on the nutrient profile of the total diet and cardiometabolic parameters of adults with type 2 diabetes. Nutrition journal, 13(1), 10.
