Discuss about the ADPIE and Gibbs Reflective Framework.
The health history of Sienna indicates that her blood pressure had recently been rising due to her weight gain thus the reason why she chose to lose weight by starting taking the oral antihypertensive Atenolol 50mg as per the prescription of her GP. The weight loss had been going on well until when something happened leading to an increased weight gain. One day while at work she feels unwell and later faints. She is taken by paramedics for treatment into the emergency department and then transferred to the medical ward for analysis. The RN collects the following information BP 118/63, P 72, RR 24, P 36.4 Wt 88.9kg, however, the RN notices that she had started taking the medication, stalled and gained more weight and has recently started taking the medication again which could have triggered fainting.
Risk of proper medication taking: this is characterized by the fact that she had started taking the medication and stalled along the way before starting to take the medication again. This leads to imbalances that make it difficult to lose weight (Yeh, 2016).
Risk of poor nutrition: Sienna seems not to be eating well due to the obsession to lose weight and control the pressure. This could be one of the triggers that made her feel dizzy and faint.
Anxiety related to the need to lose weight: Sienna seems to be suffering from anxiety which is driving her crazy and the need to lose weight. The fact that she had started losing weight and gained the weight again could push her to become anxious.
Put Sienna on a food eating management plan for assisting her control the weight gain. By taking a proper food portion, she can control weight gain and achieve the desired body weight as advices by the GP.
Develop a weight loss plan that will entail measuring herself every week to determine the weight she has lost at the end of the week. This will put her on the right track of weight loss and ensure that she is able to lose the right amount of weight and determine whether she is gaining or losing weight at the end of the week (Domecq, et al., 2015).
Offer proper counselling on the challenges of losing weight and the strategies that she can put in place to address anxiety situations when they arise. Williams, Wood, Collins, & Callister (2015) suggests that counselling can be sued to increase clinical outcomes by giving moral suport to patients. This increases their morale and goodwill in clinical processes.
Teach her on management of the oral antihypertensive Atenolol that can arise for the first few days. Management of the side effects can reduce the risks associated with fainting and improve her response to such situations when she is alone.
Adopt a daily self-monitoring for taking the drug daily to ensure that she does not miss any day.
Maintain a weekly record of weight that she weighs herself.
Maintain a healthy diet through applying the portion of the plate method to control food intake.
Meet with the GP every week to share the challenges and outcomes of weight loss.
Referral to social support groups that are geared towards the weight gain process.
After every visit, Sienna will be assessed to determine the improvements being made in weight loss. In the visits she will be seen by a dietician to analyze her food intake and offer more insights on how to achieve the process. During this visit, the GP will offer psychosocial support and assess the progress made by Sienna in losing weight and controlling weight gain.
According to Greenway (2015) suggests that social support groups have been used to cement therapeutic processes and ensure that patients respond to the intended clinical interventions. By linking Sienna to these groups within the community, she can gain social support by learning from similar patients who were successful in the use of such therapeutic plans in the area of care.
Sienna a worker in a restaurant has witnessed episodes of weight loss and weight gain. She had started taking oral antihypertensive Atenolol daily for losing weight but something disturbed and made her to start gaining more weight again (Fiedorowicz, et al., 2012). After consultation with the GP she was advised to begin the therapy again by taking a single oral pill every day. This led her to start feeling unwell which made her to faint thus being rushed to hospital for emergency care and later admission into the medical ward for further observation. The need to continue taking the oral drug led to the development of weight management plan for developing strategies to achieve the intended therapeutic gains.
Sienna has had weight loss and weight gain episodes which can create anxiety and other emotional disturbances. The fact that she works in a hotel means that she could be undergoing challenges balancing her work and the side effects of the therapy that she is going through. This means that the new therapeutic plan for losing weight has to be done carefully to achieve the intended results and reduce chances of gaining weight again. To achieve this outcome, it means that Sienna has to manage the therapeutic plan well with the assistance of then GP to meet the intended results (Montori, Gandhi, & Guyatt, 2007). The strategies for losing weight will therefore focus on maintaining the drug intake, controlling the food intake and managing anxiety situations to easily manage any side effects that can arise.
The nursing care plan developed will focus on ensuring that Sienna achieves the intended therapeutic results. Having started the weight gain process and failed at one point, it means that Sienna requires a proper management plan to achieve the intended results. The nursing care plan focusses on weekly assessment of the weight loss process to determine whether the objective has been met (Catenacci, Odgen, & Wyatt, 2014). Through measuring her weight every week, the patient is able to assess whether the therapy is working or not. Further, a dietician will be used to guide her in ensuring that she meets the required food portion in every meal.
The role of the nursing care plan developed above is to ensure that the patient achieves the therapeutic objective (Domecq, Prutsky, & Wang, 2012). Through self-assessment, Sienna is able to determine the extent of the therapeutic gains made without the help of a GP. In this process the role of the GP will be to offer moral support and professional guidelines on how the objective can be met.
Conclusion
The fact that a therapeutic management plan has been put in place for Sienna increases the likelihood of achieving the intended clinical outcomes. Through maintaining regular intake of the pills, managing the diet and assessing the weight gain every week, Sienna can achieve the intended therapeutic results of losing weight. Social support groups can be used to give the patient moral support through shared experiences on weight gain.
Future nursing care plans will focus on tailoring the therapeutic process based on the needs of the patient. Patients have different healthcare needs and challenges that can inhibit therapeutic processes or improve the quality of the outcomes. Hall, Hammond, & Rahmandad (2014) suggests that through tailoring patient care plans with their social and psychological characteristics, the health practitioner can achieve the intended healthcare outcomes. In therapeutic plans, patient background plays a role in ensuring shaping the quality of the outcome. Social determinants of health shape the outcome since they determine the response to the interventions being made since the influence the clinical processes of the outcome (Dombrowski, Knittle, Avenell, V., & Sniehotta, 2014). Practitioners have to analyze the patient’s situation and ensure that strategies developed are done through a participatory approach to increase the chances of the process being successful.
References
Catenacci, V. A., Odgen, L., & Wyatt, H. R. (2014). Dietary habits and weight maintenance success in high versus low exercisers in the National Weight Control Registry. Journal of Physical Activity, 11(8), 1540-1548.
Dombrowski, S., Knittle, K., Avenell, A., V., A.-S., & Sniehotta, F. (2014). Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials. Bio-Medical Journal, 348.
Domecq, J. P., Prutsky, G., Leppin, A., Sonbol, B., Altayar, O., Undavalli, C., . . . Mauck, B. K. (2015). Drugs Commonly Associated With Weight Change: A Systematic Review and Meta-analysis. The Journal of Clinical Endocrinology & Metabolism, 100(2), 363–370.
Domecq, J., Prutsky, G., & Wang, Z. (2012). Drugs commonly associated with weight change: umbrella systematic review and meta-analysis. System Review, 1(44).
Fiedorowicz, J., Miller, D., Bishop, J., Calarge, C., Ellingrod, V., & Haynes, W. (2012). Systematic review and meta-analysis of pharmacological interventions for weight gain from antipsychotics and mood stabilizers. Current Psychiatry, 8, 25-36.
Greenway, F. L. (2015). Physiological adaptations to weight loss and factors favouring weight regain. International Journal of Obesity, 39, 1188-1196.
Hall, K. D., Hammond, R. A., & Rahmandad, H. (2014). Dynamic interplay among homeostatic, hedonic, and cognitive feedback circuits regulating body weight. American Journal of Public Health, 104(7), 1169-1175.
Montori, V., Gandhi, G., & Guyatt, G. (2007). Patient-important outcomes in diabetes–time for consensus. Lancet, 370, 1104-1106.
Williams, R., Wood, L., Collins, C., & Callister, R. (2015). Effectiveness of weight loss interventions – is there a difference between men and women: a systematic review. Obesity Reviews, 16, 171-186.
Yeh, J. S. (2016). Obesity and Management of Weight Loss. The New England Journal of Medicine, 375(12), 1187-1189.
Essay Writing Service Features
Our Experience
No matter how complex your assignment is, we can find the right professional for your specific task. Contact Essay is an essay writing company that hires only the smartest minds to help you with your projects. Our expertise allows us to provide students with high-quality academic writing, editing & proofreading services.
Free Features
Free revision policy
$10Free bibliography & reference
$8Free title page
$8Free formatting
$8How Our Essay Writing Service Works
First, you will need to complete an order form. It's not difficult but, in case there is anything you find not to be clear, you may always call us so that we can guide you through it. On the order form, you will need to include some basic information concerning your order: subject, topic, number of pages, etc. We also encourage our clients to upload any relevant information or sources that will help.
Complete the order form
Once we have all the information and instructions that we need, we select the most suitable writer for your assignment. While everything seems to be clear, the writer, who has complete knowledge of the subject, may need clarification from you. It is at that point that you would receive a call or email from us.
Writer’s assignment
As soon as the writer has finished, it will be delivered both to the website and to your email address so that you will not miss it. If your deadline is close at hand, we will place a call to you to make sure that you receive the paper on time.
Completing the order and download