722.673 Nursing With An Inpatient Focus

Patient is of 53 years old with a injured right knee while playing Rugby (Whittaker et al.,2019).
He is supposed to undergo for a knee surgery. 
He face problems to walk, doing simple tasks and also lifting things up. 
He is under anti- inflammatory medication. 
On pre- operative diagnosis, he is diagnosed with Type 2 Diabetes and obesity. 
His surgery has to be postponed and advised to manage his diabetes. 
Further care plan was taken care by General Physician and Diabetes Nurse Specialist.

Source: Gleneagles Hospital

Environment & Context 
Patient belongs from a Tonga. 
Tonga is a South Pacific Island, and neighboring countries are New Zealand and Australia (Tupou & Sullivan, 2021).  
He runs a family business for 10 years. 
He is the only person earning in his family. 
Patient’s family includes: his wife (she is a cleaner), two children (1 son & 1 daughter) and a year old grand- daughter.
Patient History & Diagnosis 
Present complain: Due to severe knee pain, patient cannot do simple tasks and find difficulties in lifting up things. 
Reason for admission: For right meniscus repair surgery (Mani, 2018). 
History of the illness: Injured knee with teared right meniscus. 
Pathophysiological links: Knee swelling and severe right knee pain due to knee injury; under anti- inflammatory medication; diagnosed with Type 2 Diabetes. 
Past health history: Injured knee, Obesity, Inactivity and Pre-diabetes. 
Family/ Socio- cultural determinants: Patient belongs from Tonga; Suffered financial crisis due to Covid. 
Functional health patterns: Patient is not able to walk properly, difficulty in doing simple tasks and lifting things. 
Physical examination: Blood Glucose level – 15 mmol/mol; HbA1c test level- 75 mmol/mol; Height- 166 cm, Weight- 90 kg and BMI- 32.7.
Patient Centered SMART Goal
Nursing Interventions: 
Recommendations for the patient is to maintain healthy balanced diet, avoid junk foods and sugary food due to Diabetes; drink adequate quantity of water (Muimuiheata, 2022). 
Walking and exercising to lose weight; patient must be active. 
Heavy physical work and heavy exercises not recommended due to knee injury; must not lift heavy things as of now. 
Must follow yoga and meditation. 
Counselling of the patient for diet modification and maintaining all the advices as recommended (Butcheret al., 2018). 
Patient is expected to achieve his HbA1c within a healthy range of 50-55mmol/mol and lose weight as soon as possible so that he can plan for his knee repair surgery before it get worsen.

Source: Med India

Patient is from Tongo, a Pacific island. 
Patient had knee injury, required right knee meniscus surgery. 
Patient was diagnosed with Type 2 Diabetes with other health risk factors before surgery. 
Patient is obese and need to lose weight. 
Based on Fonofale model, patient history and diagnosis is being assessed. 
Based on SMART Goal approach, nursing intervention and evaluation to achieve the goal, for the patient can be done (Ogbeiwi, 2021).

Akbar, H., Chow, I., Nuimata, W., Kani, T., Wynn, A., Langan, A. V., & Gallegos, D. (2021, May). Development of a Pasifika Women’s Diabetes Wellness Program: from the perspective of M?ori and Pasifika women living in Queensland. In Queensland Women’s Heath Forum. 


Butcher, H. K., Bulechek, G. M., Dochterman, J. M., & Wagner, C. M. (2018). Nursing interventions classification (NIC)-E-Book. Elsevier Health Sciences. https://books.google.co.in/books?hl=en&lr=&id=L4lIDwAAQBAJ&oi=fnd&pg=PP1&dq=nursing+interventions+for+diabetes+patients&ots=AhkUZFd6Z1&sig=-guiXo4wAPGcv4iNwpb4UmEC8ds&redir_esc=y#v=onepage&q=nursing%20interventions%20for%20diabetes%20patients&f=false 

Mani, M. (Ed.). (2018). Lewis’s Medical-Surgical Nursing, Third South Asia Edition-E-Book: Assessment and Management of Clinical Problems. Elsevier Health Sciences. https://books.google.co.in/books?hl=en&lr=&id=eu1qDwAAQBAJ&oi=fnd&pg=PP1&dq=Lewis%27s+Medical-Surgical+Nursing,+Third+South+Asia+Edition+Assessment+and+Management+of+Clinical+Problems+3rd+Edition+-+August+20,+2018&ots=xNmfUSKYJ-&sig=Z22u39es_dqOdDvUF8Pizgra7co&redir_esc=y#v=onepage&q&f=false

Muimuiheata, S. (2022). Food practices and diabetes management: The lived experience of Tongan people with Type 2 Diabetes Mellitus in New Zealand (Doctoral dissertation, Auckland University of Technology). https://openrepository.aut.ac.nz/handle/10292/14907 

Ogbeiwi, O. (2021). General concepts of goals and goal-setting in healthcare: A narrative review. Journal of Management & Organization, 27(2), 324-341. https://doi.org/10.1017/jmo.2018.11

 Prapaveissis, D., Henry, A., Okiakama, E., Funaki, T., Faeamani, G., Masaga, J., … & Tupai? Firestone, R. (2022). Assessing youth empowerment and co? design to advance Pasifika health: a qualitative research study in New Zealand. Australian and New Zealand Journal of Public Health, 46(1), 56-61. https://doi.org/10.1111/1753-6405.13187 

Tupou, T., & Sullivan-Lee, A. (2021). Tonga. The Contemporary Pacific, 33(1), 252-259. https://doi.org/10.1353/cp.2021.0019  

Whittaker, J. L., Toomey, C. M., Nettel-Aguirre, A., Jaremko, J. L., Doyle-Baker, P. K., Woodhouse, L. J., & Emery, C. A. (2019). Health-related Outcomes after a Youth Sport-related Knee Injury. Medicine and science in sports and exercise, 51(2), 255-263. https://doi.org/10.1249/mss.0000000000001787