Treatment, Referrals And Monitoring For Patient With Multiple Conditions

Immediate treatment actions

1. First, we need to check the patient’s vital signs to make sure they are okay. It’s not enough to just get the blood pressure. We also need to figure out respiratory rate and heart rate, as well body temperature and oxygen saturation. The nurse can do this.
2. Because we want to make sure that the patient is getting enough oxygen, we can give him a nasal cannula that gives him 2LPM of oxygen every hour. Because the patient’s chest is tightening, this can make it hard for oxygen to move through their body. The nurse can do this.
3. Medications are also important to help with the pain. Because this is an emergency, we can give the patient nitroglycerin to help with the pain. This will help him if he is having chest pain. This might be a case of myocardial infarction 
4. We can help the patient deal with other symptoms that he or she is having. We also need to look at other things that might have caused the patient’s main complaint. We can talk about the patient’s blood sugar and see if it has anything to do with their health. The more we know about the patient’s health, the better we can help them.
5. Assist the patient in a comfortable and secure setting. Reduce the humidity and heat in the room. Provide a calm setting or anything else that promotes health and reduces the likelihood of discomfort. Patients who are already in pain should be placed in a stress-free atmosphere as this will help them recover immediately.

Immediate treatment actions: In order to do so, we must address the patient’s symptoms as soon as possible. Chest discomfort in this scenario. We can provide pain relief drugs as well as ancillary therapies to help manage the symptoms. Supplementing with nitroglycerin and oxygen is required. This will deal with the issue directly. If this is successful, we will continue to evaluate the patient to see if there are any underlying disorders that are contributing to the patient’s condition. 

Referrals: If the patient is not eased by the current therapy, this can be done. The doctor can order normal laboratory testing to confirm this and further investigate. Imaging modalities can also be requested to look for any linked causes. We refer the patient to another health care professional because we may require more sophisticated skills and expertise to handle the patient properly. 

Longer term actions: The patient had risk factors that exacerbated his condition. This includes being a Type 2 diabetic, eating an unhealthy diet, and smoking cigarettes. We must treat this in order to reduce the likelihood of more serious occurrences, such as stroke. We should counsel the patient to adopt a healthier lifestyle by eating a well-balanced diet rich in vegetables and fruits. Reduce intake of rice, fatty, and salty foods. We must also underline the importance of using oral hypoglycemic medicines to assist control blood sugar levels, as diabetes can lead to a variety of issues. Also, counsel the patient on how he can quit smoking. We can recommend him to a support group that can assist him on his journey. Discuss the downsides of cigarette smoking, and as nurses, we can raise the patient’s fear by informing him of the consequences if he maintains the habit. This, presumably, will assist the patient in changing.

• The presence of type 2 diabetes will undoubtedly have an impact on the patient’s health. Diabetes, as previously stated, causes a slew of complications, including kidney problems, stroke, hypertension, leg ulcers, peripheral diseases, and so on.
• Living alone is also a problem. This will have such an impact on the patient that no one will be able to motivate or remind him of what he should be changing in his behaviors. Involving family members will help with medication adherence.
• The patient works as a farmer. The patient may be unable to comply with medical therapy due to a lack of funds. This could also be the reason why the patient is not eating nutritious foods. It could be that he cannot afford it or that it is not easily accessible.
• Away from the community clinic. This will make it difficult to obtain rapid health treatment if an emergency arises. In his situation, he had to drive an hour to a clinic.
• The patient’s comprehension of the situation. This has a significant impact on the patient’s desire to deal with the problem. If the patient has a distorted view of the disease, he will not be alarmed and will believe that smoking is normal or acceptable even if he has DM.

A treatment regimen that is overly complex or has too many steps. Because the patient has a number of other diseases, he must change many of his habits, which he has grown accustomed to. And it’s a lot. This can have a significant impact on the therapy’s effectiveness.

• Recreation and leisure in general. Yoga. Mindfulness, Bollywood Meditation. Retreats. Mindfulness. Australasia/My First Gym, Robina- this will aid with mindfulness and, eventually, weight loss.
• Quitline- This is a free, confidential service that will give you with information, advice, and assistance targeted to your specific requirements. Using nicotine replacement treatment in conjunction with counseling more than doubles your chances of successfully stopping smoking.

Moranbah Hospital- This hospital primarily provides services that can aid in the development of healthier eating habits. A doctor or a dietician is the best person to ask. They are aware of the misconceptions and truths regarding eating, which spares the patient from the unneeded circumstance of having terrible eating habits.

• Persuade the patient to stop smoking.
• Emphasize the necessity of a proper and healthy diet to the patient.
• Educate the patient or his family why he needs to be placed in a nursing home. 

Referrals

Essentially, these three objectives will aid in proper patient surveillance. This will allow us to provide the patient with the necessary care and health needs. In addition, the patient has dementia and is living alone. He will almost certainly skip appointments and medication consumption that is required. Dementia patients require a support group as well as someone who can care for them. A nursing home is an excellent choice.

• Stop smoking. Support groups in the surrounding area will assist the patient in quitting smoking. However, because the patient is alone, elderly, and suffering from dementia, this can be extremely difficult. It may take some time for him to be persuaded to stop smoking.
• Maintain a healthy and well-balanced diet. Again, because the patient is alone and likely capable of caring for himself, he should be admitted to a nursing home. He requires someone to look after him to ensure that he adheres to the changes and is compliant with medications, if any are prescribed.

Regular check-ups are required. His geriatrician is a qualified professional who can help him with this. The patient will benefit from having a doctor who specializes in elderly care.

• Do you understand the significance of smoking cessation?
• How do you look after yourself?
• What is your opinion of your situation? 

These questions will help us understand the patient’s perception of his status/condition. Their perspective will assist us in identifying any barriers to optimal health.

Dementia patients are in a vulnerable stage of the disease. Many people are facing the condition alone and have many unanswered questions due to limited follow-up after diagnosis and a lack of available services, which can lead to depression and difficulties adjusting to and coping with the condition. Even if we spend hours explaining things to the patient, he still requires support. By placing him in a group of people with dementia, we can encourage him to participate in health-promoting activities. Or in a place that provides a lot of help to their patients. Participants’ self-rated health improved significantly after attending the health promotion course. The course should emphasize health promotion and provide information on how to stay healthy and active while dealing with a chronic illness.

• Physical activity has increased.
• Improvements in lifestyle/a much healthier way of life
• Decreased cigarette use

The first three criteria can be tracked by weighing him to see if there have been any changes. This includes gaining or losing weight. This will reveal whether or not our patient is eating healthily/enough. We keep track of his smoking by asking him how many sticks he smokes per day. We must also record these in the patient’s medical chart in order to properly track his progress.

• Relationships with others that are healthy

This is measured by the number of friends he has made during his time in the nursing home. People in his immediate vicinity may provide feedback. This should be documented as well.

• Health examinations on a regular basis

The patient’s chart will assist us in keeping track of and documenting his progress. Typically, the doctor inquires about the patient’s health. The patient’s medical history and physical examination will aid in the detection of any problems that may arise during the course of his illness.

Related lifecycle stage.	Note three (3) common health issues for lifecycle stage.	Specify one (1) appropriate PHC response / treatment / intervention for each issue.	List one (1) multidisciplinary team member appropriate for each issue and note why they are important.
Infant (0-2 years)	Cold Cough Fever	Cold- Enough fluid intake Cough- Management of underlying disorder Fever- management of underlying disorder	Cold- nurse to ensure fluid administration and monitor the patient Cough- doctor to investigate underlying cause Fever- doctor to diagnose underlying cause
Child (3-12 years)	Obesity Illegal drug use Domestic abuse	Obesity- encourage physical activity and healthy eating Illegal drug use- behavioral based counselling Domestic abuse- child care institutions should take custody of the child	Obesity- nutrionist because diet regulation is key to countering obesity Illegal drug use- psychologist to counsel the child and rehabilitate Domestic abuse- psychologist to counsel the child and ensure psychological well being of the child
Adolescent (13-17 years)	Obesity Illegal drug use Bullying	Obesity- encourage physical activity and healthy eating Illegal drug use- behavioral based counselling Bullying- counselling	Obesity- nutrionist because diet regulation is key to countering obesity Illegal drug use- psychologist to counsel the adolescent who is more vulnerable Bullying- psychologist to counsel themand ensure psychological well being of the adolescent
Adult (22-60)	Mental health problems Back problems Asthma	Mental health problems- diagnosing and treating Back problems- avoid strenuous exercise Asthma- ensuring airway patency	Psychiatrist- they have the right knowledge for the care of the patient Orthopaedic doctor- to investigate for any probable cause and advise accordingly Asthma- nurse to ensure the patient takes the medication accordingly
Older adult (60 and older)	Cardiovascular diseases Alzheimer’s disease Cancer	CVD- encourage healthy diet AD- nursing care to ensure daily needs are met Cancers- palliative care where cure is impossible	Nutrionist- to ensure the patient takes a healthy diet AD- nurse for continuous reminder and administration of any medication Cancer- nurse to closely monitor the patient and ensure the live with dignity

References

Emmady, P. D., & Tadi, P. (2021). Dementia. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557444/ 

Lafortune, C., Huson, K., Santi, S., & Stolee, P. (2015). Community-based primary health care for older adults: a qualitative study of the perceptions of clients, caregivers and health care providers. BMC Geriatrics, 15(1), 57. https://doi.org/10.1186/s12877-015-0052-x 

Lassi, Z. S., Kumar, R., & Bhutta, Z. A. (2016). Community-based care to improve maternal, newborn, and child health. In Disease Control Priorities, Third Edition (Volume 2): Reproductive, Maternal, Newborn, and Child Health (pp. 263–284). The World Bank. https://doi.org/10.1596/978-1-4648-0348-2_ch14 

Ojha, N., & Dhamoon, A. S. (2021). Myocardial Infarction. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537076/ 

Papatheodorou, K., Banach, M., Bekiari, E., Rizzo, M., & Edmonds, M. (2018). Complications of diabetes 2017. Journal of Diabetes Research, 2018, 3086167. https://doi.org/10.1155/2018/3086167 

West, R. (2017). Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychology & Health, 32(8), 1018–1036. https://doi.org/10.1080/08870446.2017.1325890