Prioritization of complex health issues

Assess The  case study of Evelyn where the patient is facing the issue of Diabetes Mellitus. Provide your observations

Introduction

Diabetes has prevailed and is rising in tandem increasing with the growth in population rate. Most diabetics believe that nurses and physicians need to provide them with complete knowledge of the disease. Most even believe that a leading role has to be taken up by nurses in the treatment of diabetes by educating care as existing clinical and trials of observational clinical framework shown to determine the capability of the nurses in providing effective care at low costs (Adrian, 2000).
This assessment is based on the case study of Evelyn where she is facing the issue of Diabetes Mellitus. The assessment is based on the following structure:
 Most important nurse intervention towards the patient along with rationale for the choices
 Most important issues of health identified according to priority and providing the rationale for their order of selection
 Outlining the nurse role in addressing the priority health issues considered in relation to the case for coordinating care
Each of these aspects is studied with regard to regulatory frameworks of nursing and health departmental policies (Bentley, 2001).

Identifying Health Issues

The health issues identified in the case where a major role can be played by the nurse are Diabetes Mellitus for the past 2 years, Leg Ulcers and Depression. Each of these will be tackled differently by the nurse even though each of these may be interlinked.
In accordance to the study conducted by Aboldhasani et al, 2002, most individuals suffering from Diabetes mellitus face other sorts of problems along with the former being the major cause of concern. Most studies also reveal that often patients, family members prompt and indulge in the process of care adopted by nurses as evident in the case of Evelyn as well because they are not aware and do not have the complete knowledge of the disease (Bentley, 2001).
These health issues have been determined keeping in mind the Nursing Diagnoses arranged by Gordon's Health Patterns. The proposed functional pattern of health served as a guide in establishing the nursing intervention in health issues addressed. There are 11 categories in the Health patterns, making possible to collect data in the approach in a systematic and standardized way and enable the nurses to determine the health aspects and functions of human. Under every pattern of health provided by Gordon is a consistent list of NANDA nursing diagnosis arranged within the set up of health patterns. The intention behind this approach is to assist the nurse in implementing the process of nursing (Benner, 2004).
With regard to the choice of these health issues, it is important to address that why these choices are important more than other issues that are also evidently identified in the case of Evelyn.
The health issues identified as important than the other identified issues are Diabetes Mellitus because it has persisted for 10 years and there are various other negative impacts of the disease in Evelyn, leg ulcers because it is an external disease which is evident and can be seen by the nurse especially when the nurse takes a step to intervene in order to fix it, as when the ulcers will slowly eliminate from the body of Evelyn, she will feel that she is getting better and then it is depression because if a person does not feel good then the body can never be healthy and so, Evelyn has to come out of her depression where the nurse can play an important role (Gerry, 2011).

Rational of Prioritization

1. Diabetes Mellitus type 2
2. Leg Ulcers
3. Depression (Field, 2004)
Steps will be taken to deal with the health issues in the intensity to which they persist with Evelyn.
This is because, firstly, it is seen that there is family prompt in whatever Evelyn eats. When Evelyn says that she does not like the hospital food, her husband brings her food from outside. Therefore, the disease seems to persist even though her treatment is consistent and continuous. In order to intervene into the prevention of Diabetes Mellitus Type 2, her food habits would have to be changed by telling her family and Evelyn as well about the complete issues that she has. Enlightenment into the realms of the disease will help not only Evelyn but also her family members especially her husband in understanding the factors that have to be prevented while the treatment is going on. In addition, diabetes Mellitus 2 has persisted in Evelyn's body since the past10 years because of which impact of the disease has been seen with regard to development of other problems such as depression. As the disease is linked to other diseases that follow, therefore, the priority is the treatment of this health issue first in which a nurse has a major role to play (Hoffman, 2003).
Leg ulcers on the other hand, are debilitating and chronic conditions leading towards morbidity especially in older age groups. If the leg ulcers persist, they develop into chronic conditions that establish the exact prevalence of leg ulceration. Most leg ulcers are caused because of hypertension with venous insufficiency but this factor is not limited. Moreover, leg ulcers have a long term sustainable prevention and nurses play an important role in undertaking the management of the same health issue (Sarkar, 2010 ).
However, while treating the leg ulcers, nurses will deal with the following and assessment guidelines for nurses will include the following to be explored:
 Understanding the unique social factors, concerns and experiences of Evelyn
 Understanding the experience of pain (Kiara, 2003)
 Thorough clinical history inclusive of other diseases present
 Assessment of nutrition
 Examining physically
 Investigating relevantly into peripheral vascular assessment, blood pressure, blood glucose levels, weight and urine analysis
In treating the leg ulcers, after the first health issue addressed and investigating on the above mentioned elements, nurse will also be able to determine that where her treatment stands and how successful her intervention is (Adrian, 2000).