TASK 39 Bev Williams

This 68-year old 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.

Relationships                                  Has four children – all adults – all married

Gets on well with husband                  Likes visiting her daughter in the country

Has active social life – visits friends regularly

Medical 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 Plan          No special diet            Tries not to have sugar                        Buys diabetic cordial

Taste food while preparing meals in kitchen  Eats cream cakes at afternoon tea time                      Loves fruit

Unaware of consequences of careless diet      Had trouble Losing weight

Very little exercise walks around the neighbourhood occasionally   Likes a glass of wine with evening meal.

Treatment Plan           Monitor urine – Monitor bleed 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 notes 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,

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