The first short term goal is reduction of blood pressure to the normal level within 24 hours. Based on the assessment, the patient’s current blood pressure is 162/94 mm Hg. This is above normal blood pressure that has the ability to cause several diseases such as heart disease and eruption of small veins, which could put the life of the patient in an extreme danger. It is in this context that it should be reduced to the normal level using medication within a period of 24 hours.
The second short term goal is to reduce the pain to about two in a scale of 1 to 10. The current pain on the knee that the patient is experiencing does not allow him to perform his daily activities. One of the ways of reducing the pain is using strong pain relievers since the current one does not work for the patient. Similarly, the dose of the current pain relievers can be increased for an increased effect.
Long Term Goals
The first long term goal is to ensure that the patient reduces his weight to prevent being obese and reduce weight-bearing surfaces of the knee joint to relieve pain and disability. One of the best ways and permanently solving the continuous pain on the knee that will enable the patient to manage his daily activities without surgical intervention is weight reduction. Healthy weight reduction shall enable the patient to stop taking pain relieving medication whose compliance is also difficult. Based on the BMI of the patient, it is clearly evidenced that he is overweight hence, any additional weight will lead to obesity, hypertension. Being obese could cause heart diseases. On the same note, regular exercise enables effective circulation of blood hence prevents heart related diseases. The patient should check his food choices and do physical exercise to reduce his weight to about 65kg in a period of six months.
The second long term goal is management of diabetes. Based on the information provided by the client, his close relatives have diabetes, a factor that demonstrates that the patient too is likely to develop the disease if measures are not taken early enough. It is in this context that the patient should correctly choose the food he is taking and avoid those that are likely to cause the disease. Results show that the variations in two previously identified risk genes for type 2 diabetes, THADA and KCNQ1, cause an increased risk of acquiring the disease in the child if they are inherited from the mother.
Recall that you have written the following nursing diagnosis for Mr. Nguyen: Overweight related to inappropriate food choices and serving size, as evidenced by body mass index (BMI) of 28.5
Based on the outcomes you wrote in Chapter 5, Planning Outcomes, identify four possible interventions to address the diagnosis and outcomes. Review the interventions, and identify two that would be most appropriate for Mr. Nguyen given all of the information you have about his health status. Write a nursing order for each of the two interventions you identified above.