NUR2102 Chronic Case Across the Lifespan 

Question 1

The primary risk factors that are associated with the health condition of Mr. James Storey include the medical history of hypertension, familial history of cardiovascular diseases, weight gain, stress, and poorly managed diet. Patients with hypertension are at an increased risk of development of diabetes type II (Chamberlain et al., 2019). Further, as in the case of Mr. Storey, possession of both conditions can lead to several health complications that include increased risk of heart attack and stroke and impaired kidney function. Moreover, Mr. James Storey also has a familial history of cardiovascular diseases, making his genetic composition prone to the development of various cardiovascular health problems.

Mr. James has also gained weight in the last year. This weight gain of 12 kgs is extremely harmful as he was already advised to lose 5kgs in the initial course of treatment. Obesity is a major risk factor for diabetes. Obesity can aggravate the health problem associated with diabetes in Mr. James (Llorente Columbié et al., 2016). Another essential risk factor associated with the health condition of the patient is stress. Mr. James expresses that he has been experiencing extreme stress that can worsen his existing health condition, increase the risk of cardiovascular diseases and allied health problems.

Question 2

The primary nursing assessment will require checking of the blood glucose levels in Mr. James. The patient does not check his blood glucose levels at home and, therefore, it is crucial to check the current blood glucose levels to identify the extent of the illness (Teston et al., 2016). Other essential assessment will be to perform a cardiovascular assessment with monitoring of pulse and heart rate. Mr. James is at a high risk of developing cardiovascular health problems due to his current medical condition and also due to his family history of the disease. Therefore, it is crucial to perform a cardiovascular assessment and identify the initial risks, if any. It is also important to perform a neuropathy examination on Mr. James.

Patients with diabetes have a high risk of neuropathological anomalies. Further, Mr. James complains of having bilateral foot pain making this examination critical. Patients with diabetes require extra care towards foot health as excess sugar in the blood can damage the nerves and result in peripheral neuropathy (American Diabetes Association, 2018). Urinalysis should also be performed for the patient. Individuals with diabetes are at a higher risk of developing renal problems and may exhibit complicated symptoms of nephropathy. Urinalysis is, therefore, crucial to determine the overall renal health of the patient.

Question 3

The purpose of health promotion strategies is to encourage a healthy lifestyle and minimize the health risk factors in the chronic conditions in the patients (National Strategic Framework for Chronic Conditions, 2017). It is important to identify the primary risks and provide essential care to the patient through a participatory approach where the patient involvement in the care and treatment leads to overall beneficence of the patient’s health and health promotion. The primary self management priority for Mr. James Storey can be the management of his weight through physical exercise. Mr. Story expresses the will to lose weight and perform physical exercise but also asserts that he lacks motivation for same (American Diabetes Association, 2018).

Therefore, by promoting health and motivating Mr. James Storey to lose weight can help in engaging more in physical exercises. Weight loss and maintaining a healthy BMI will help Mr. Storey minimize his risks of developing cardiovascular complications and also assist in the management of his blood glucose levels (Pande et al., 2018). The patient can be motivated towards weight loss through healthy promotional activities and engaging in a weight loss plan with active participation (Zheng et al., 2018).

Question 4

The SMART goal for the management of the health will include effective management of the blood glucose levels. The healthy blood glucose levels in a patient should be between 72-99mg/dL on fasting and 140mg/dL after 2hours of eating (Isık et al., 2016). Mr. James Storey has poorly managed blood glucose and therefore, effective management of his current health condition will allow for bringing his blood glucose levels to the normal state. The effect of blood glucose management will be visible almost immediately with complete management in 3 weeks, with the application of alternative interventions that will help in the weight loss and diet.

Since Mr. James is also willing to lose weight, management of his blood glucose levels will be possible and realistic through weight management (Pöppl et al., 2017). Management of blood glucose levels is a primary and highest priority. Diabetes in the patient has been poorly managed for some years. The patient also possesses a history of hypertension and is at high risk of development of cardiovascular diseases (Urbina et al., 2019). Therefore, management of the blood glucose levels is the essential priority for Mr. James Storey.

Question 5

Goal setting is essential for the management is important for patients for the overall improvement of their health and management of illness. This helps in the achievement of the desired health outcomes. The goals should be patient centered to ensure that the patients care to ensure maximum beneficence for the patient (Al-Aissa et al., 2017). Having patient-centered goals also helps in engaging the patient towards the care practices and helps in the implementation of the goals and successfully achieving the desired outcomes. Goal setting helps the patients to develop short term and long term goals. Establishment of these goals helps in charting the health strategies and suitable interventions for the optimal care of the patient.

Establishment of these goals also helps in minimizing the risks and promotion of health. The setting of goals also helps in providing patient with adequate education and knowledge about the health condition required for the accomplishment of goals for the beneficence of the health and promotion of recovery (Pöppl et al., 2017).


Al-Aissa, Z., Hadarits, O., Rosta, K., Zoka, A., Rigo Jr, J., Firneisz, G., & Somogyi, A. (2017). A brief of gestational diabetes mellitus, risk factors and current criteria of diagnosis. OrvosiHetilap, 158(8), 283-290.

American Diabetes Association. (2018). Improving care and promoting health in populations: Standards of medical care in diabetes-2018. Diabetes Care, 41(Suppl 1), S7.

Chamberlain, J. J., Rhinehart, A. S., Shaefer Jr, C. F., & Neuman, A. (2016). Diagnosis and management of diabetes: Synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Annals of Internal Medicine, 164(8), 542-552.

Isık, H., Aynıoglu, O., Sahbaz, A., Selimoglu, R., Timur, H., &Harma, M. (2016). Are hypertension and diabetes mellitus risk factors for pelvic organ prolapse?.European Journal of Obstetrics & Gynecology and Reproductive Biology, 197, 59-62.

LlorenteColumbié, Y., Miguel-Soca, P. E., Rivas Vázquez, D., & Borrego Chi, Y. (2016). Risk factors associated to ocurrence of type 2 diabetes mellitus in adults. RevistaCubana de Endocrinología, 27(2), 123-133.

National Strategic Framework for Chronic conditions (2017). National Strategic Framework for Chronic conditions. 

Pande, T., Huddart, S., Xavier, W., Kulavalli, S., Chen, T., Pai, M., &Saravu, K. (2018). Prevalence of diabetes mellitus amongst hospitalized tuberculosis patients at an Indian tertiary care center: A descriptive analysis. Plos One, 13(7).

Pöppl, A. G., de Carvalho, G. L. C., Vivian, I. F., Corbellini, L. G., & González, F. H. D. (2017). Canine diabetes mellitus risk factors: a matched case-control study. Research in Veterinary Science, 114, 469-473.

Teston, E. F., Spigolon, D. N., Maran, E., Santos, A. D. L., Matsuda, L. M., & Marcon, S. S. (2018). Nurses' perspective on health education in Diabetes Mellitus Care. RevistaBrasileira De Enfermagem, 71, 2735-2742.

Urbina, E. M., Isom, S., Bell, R. A., Bowlby, D. A., D'Agostino Jr, R., Daniels, S. R., ... & Reynolds, K. (2019). Burden of cardiovascular risk factors over time and arterial stiffness in youth with type ii diabetes mellitus: The search for diabetes in youth study. Journal of the American Heart Association, 8(13), e010150.

Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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