Beverley Williams Born 1943
PATIENT
This patient has been in your care for the past 10 years. During the past 8 years Mrs Williams has developed diabetes. It is not well controlled. You are now referring her on to a Public Health Nurse for a health education program.
HISTORY
Type II Non Insulin Dependent Diabetes – onset 8 years ago Prescribed tablets soon after diagnosis
No problems with sugars or infections Has monitored urine with sticks at home Not always well controlled
Does not care about diet regime
High BP for past 5 years – on medication Overweight for past 30 years (BMI 32) Vision OK
Has worn spectacles for past 20 years
Grandmother had Diabetes; died of gangrene of the foot Husband is also Diabetic
DIABETIC HABITS
No special diet
Tries not to have sugar Buys diabetic cordial
Tastes food while preparing meals in kitchen Eats cream cakes at afternoon tea time Loves fruit
Unaware of consequences of careless diet Has trouble losing weight
Very little exercise – walks around the neighbourhood occasionally Likes a glass of wine with evening meal
RELATIONSHIPS
Has four children – all adults – all married Gets on well with husband
Likes visiting her daughter in the country Has active social life – visit friends regularly
TREATMENT PLAN
Monitor urine – monitor blood sugar levels with glucometer Needs to be educated re Diabetes and importance of special diet
Needs to attend formal diabetic education program (daytime classes at Hospital) Increase Daonil from 15 to 20mg per day
Needs vision checked every two to three months
Needs to lose weight – has increased 3.5kg in last 6 months Suggest a suitable exercise program ? Swimming

WRITING TASK
Using the information in the case notes, write a letter of referral to: Ms Michella Mansoura, Public Health Nurse, 125 Canterbury Road, Ringwood, Victoria 3134 Australia. DO NOT use note form – use complete sentences. Expand the relevant notes in the treatment plan requesting that Ms Mansoura take over the management of this patient. Letter should be no more than 25 lines long.

Sample letter by Lifestyle Training Centre

27 June 2022

Dear Ms Mansoura,

Re: Mrs Beverley Williams, aged 79 years.

Thank you for accepting Mrs Williams who needs education and monitoring at your hospital to control her diabetes, diet, and blood sugar levels. She has been in our care for the last 10 years.

Mrs Williams has been under medication for type II Non-Insulin Dependent Diabetes and Hypertension since 8 and 5 years, respectively; which includes Daonil 15 mg. She has family history of diabetes. Though not well regulated, she monitors her urine at home with sticks. She has no infections.

Mrs Williams neither follows any diet regime, nor is she aware of its consequences. She buys diabetic cordial and tries to avoid sugar. However, she loves tasting food, fruits, cream cakes, and a little wine. Therefore, she needs to attend daytime formal diabetic education classes to learn about diabetes and the importance of special diet.

Mrs Williams needs help to lose weight as she does very little exercise.  Her BMI is 32, and she has been overweight for the past 30 years, gaining 3.5kg just in the last 6 months. Therefore, please suggest a suitable exercise program for her such as swimming.

Based on the above information, kindly take over and continue the care. Please increase administration of Daonil by 5mg, and monitor her blood sugar levels with a glucometer. Her vision needs to be checked every two to three months.

If you have any further queries, please do not hesitate to contact me.

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