NURS FPX 6610 Assessment 1 Comprehensive Needs Assessment

Name

Capella university

NURS-FPX 6610 Introduction to Care Coordination

Prof. Name

Date

Nursing Diagnosis and Care Plan for Mrs. Snyder

Patient Identifier: 6700891
Medical Diagnosis: Poorly controlled anxiety, obesity, hypertension (HTN), diabetes mellitus (DM), and hypercholesterolemia

1. Ineffective Health Management Related to Diabetes and Lifestyle Choices

Mrs. Snyder, a 56-year-old woman, is facing several chronic conditions, most notably uncontrolled diabetes and hypertension. Her lifestyle includes excessive intake of unhealthy snacks such as cookies, contributing to her poor glycemic control. She arrived at the emergency department with a blood glucose level fluctuating between 230 to 389 mg/dL. Accompanying symptoms included fatigue, discomfort in the lower abdomen, breathlessness, and frequent urination. Alongside her elevated blood sugar levels, her hypertension and poor dietary habits further complicate her condition.

The immediate care goals include stabilizing Mrs. Snyder’s blood glucose and blood pressure levels within a month and helping her achieve healthier eating patterns and improved personal wellness within three months (Ramzan et al., 2022). To facilitate these outcomes, the nursing care plan prioritizes education and empowerment.

Interventions	Description	Rationale
Patient education on self-care	Discuss healthy dietary practices, physical activity, and sleep hygiene	Increases awareness and promotes lifestyle changes necessary for diabetes control (USC, 2018)
Support self-monitoring	Teach the use of glucose meters and food diaries	Encourages accountability and early detection of glucose spikes (Carolina, 2019)
Train in insulin administration	Demonstrate proper injection techniques	Enhances confidence and ensures adherence to treatment protocols (Heart, 2021)

To track the effectiveness of this plan, regular evaluations of her glucose logs and blood pressure readings will be conducted. If current strategies fail to show adequate improvement, further dietary adjustments and insulin regimen modifications will be considered.

2. Anxiety Intensified by Family and Caregiving Pressures

Mrs. Snyder also suffers from severe anxiety that stems from her multifaceted domestic responsibilities. She is the sole caregiver for her ill mother and faces ongoing conflicts with her son. This emotional burden has led to symptoms like elevated blood pressure, rapid heart rate, and inconsistent use of her prescribed anxiolytics. Her sense of being overwhelmed is compounded by her responsibility for managing both the household and finances.

The nursing care plan targets achieving blood pressure control at 130/90 mmHg and stabilizing her heart rate to a normal range (60–100 bpm) within a month. Another vital goal is the improvement of her anxiety symptoms through a combination of therapy and medication adherence (Pegg et al., 2022). The approach is both clinical and psychosocial in nature.

Interventions	Description	Rationale
Administer prescribed anxiolytics	Ensure compliance with medication schedule	Medication can alleviate physiological symptoms of anxiety (Ströhle et al., 2018)
Initiate CBT counseling	Weekly therapeutic sessions	CBT is effective in reducing anxiety through restructuring of thought patterns (Pegg et al., 2022)
Connect with community support	Refer to faith-based groups for emotional and spiritual support	Social connections can provide comfort and reduce isolation (Goodtherapy, 2019)

Progress will be monitored on a weekly basis, focusing on anxiety levels, medication adherence, and vital signs. Modifications to the care plan will be made in accordance with the patient’s emotional response and level of engagement in counseling.

3. Psychosocial Stress Due to Cancer Diagnosis and Caregiver Burden

Beyond chronic physical and emotional conditions, Mrs. Snyder is also grappling with a new diagnosis of ovarian cancer. Her distress is amplified by her fear of chemotherapy and the stress of managing her mother’s care. She has expressed concerns about experiencing abdominal pain and shortness of breath during exertion, with oxygen saturation levels that drop during physical activity.

To support her during this critical period, one short-term goal is to arrange alternative care for her mother within 15 days, allowing her to focus solely on her own treatment. A longer-term goal is to improve her oxygen saturation and physical endurance over three months. Addressing both physical and emotional components is key in this phase.

Interventions	Description	Rationale
Social work referral	Help find a care facility for her mother	Reduces emotional burden and improves treatment adherence (Hoyt, 2022)
Frequent pain assessments	Monitor for treatment-related discomfort	Ensures that pain is effectively managed and does not hinder daily function
Introduce non-drug therapies	Teach yoga, meditation, and guided imagery	Non-pharmacological strategies help reduce stress and physical discomfort (Sheikhalipour et al., 2019)

The effectiveness of the interventions will be assessed by observing changes in her pain levels, oxygenation status, and emotional state. As progress is made in relocating her mother, further adjustments to her cancer care plan will be initiated to focus on her holistic well-being.

References

Cancer. (2021, October 6). Managing diabetes when you have cancer. Cancer.net. https://www.cancer.net/navigating-cancer-care/when-cancer-not-your-only-health-concern/managing-diabetes-when-you-have-cancer

Carolina, C. M. (2019, October 16). Unlocking the full potential of self-monitoring of blood glucose. Uspharmacist.com. https://www.uspharmacist.com/article/unlocking-the-full-potential-of-selfmonitoring-of-blood-glucose

NURS FPX 6610 Assessment 1 Comprehensive Needs Assessment

Goodtherapy. (2019, September 23). Therapy for self-love, therapist for self-love issues. Goodtherapy.org. https://www.goodtherapy.org/learn-about-therapy/issues/self-love

Heart. (2021, May 6). Living healthy with diabetes. Heart.org. https://www.heart.org/en/health-topics/diabetes/prevention–treatment-of-diabetes/living-healthy-with-diabetes

Hoyt, J. (2022, May 26). Assisted living & senior placement agencies. SeniorLiving.org. https://www.seniorliving.org/placement-agencies/

Pegg, S., Hill, K., Argiros, A., Olatunji, B. O., & Kujawa, A. (2022). Cognitive behavioral therapy for anxiety disorders in youth: Efficacy, moderators, and new advances in predicting outcomes. Current Psychiatry Reports, 24(12). https://doi.org/10.1007/s11920-022-01384-7

Ramzan, B., Harun, S. N., Butt, F. Z., Butt, R. Z., Hashmi, F., Gardezi, S., Hussain, I., & Rasool, M. F. (2022). Impact of diabetes educator on diabetes management: Findings from diabetes educator assisted management study of diabetes. Archives of Pharmacy Practice, 13(2), 43–50. https://doi.org/10.51847/2njmwzsnld

Sheikhalipour, Z., Ghahramanian, A., Fateh, A., Ghiahi, R., & Onyeka, T. C. (2019). Quality of life in women with cancer and its influencing factors. Journal of Caring Sciences, 8(1), 9–15. https://doi.org/10.15171/jcs.2019.002

NURS FPX 6610 Assessment 1 Comprehensive Needs Assessment

Ströhle, A., Gensichen, J., & Domschke, K. (2018). The diagnosis and treatment of anxiety disorders. Deutsches Aerzteblatt Online, 115(37). https://doi.org/10.3238/arztebl.2018.0611

USC. (2018, January 9). What does self-care mean for diabetic patients? Nursing.usc.edu. https://nursing.usc.edu/blog/self-care-with-diabetes/