• Internal Code :
  • Subject Code : 7201NRS
  • University : Griffith University
  • Subject Name : Nursing

Case Study: Mr. Mark


The health care professional are expected to provide the quality of care to the patient to reduce the complication that lead better health status of the indvidual. The person-centred care help to improve the quality of care and it helps to tailor the health care service according to patient condition to improve the health status (Grøndahl et al. 2018). The essay is going to discuss the patient who is the urgent need of care and how to require a transition in the care to improve health status. The report will discuss the critical thinking and problem-solving skills of the nurse to analyze the patient condition in the need. The report will also discuss different care technique that can be used to manage the deteriorated health status of the client.

Situational Awareness and Deterioration

The situational awareness is considered to be the personal perspective that has moulded according to the surrounding and it discusses that situational awareness utilizes the given set of knowledge for decision making regarding the issue. The situational awareness follows three phases which include perception, comprehension and projection to utilize the surrounding scenario to identify the impact on a future outcome. Situational awareness is considered to be one of the key elements in clinical practice that is utilized to interpret the symptoms and sign of patient illness. The first step of the situational awareness help to identify and collection of the essential information from the patient. The next step of the situational awareness included assessment of the gathered information that helps to understand the situation. The last step of the situational awareness is to think ahead from the gathered information to plan the accurate supporting activity (Fischer et al. 2017).

The situation awareness will help to improve the patient assessment that can be used to assist the patient during the care to reduce health related complication. The complex condition of the individual requires urgent attention and there is a need to analyze the patient condition that will help to improve the health status of the individual.

Patient Summary

The case study is about Mr Mark who is a retired 79-year-old man and he administered with the complaint of increased urination and irrelevant unconsciousness that lead to injury because of the fall. The patient vital sign show hypertension and blood glucose level 118-127mg/dl with an increased respiratory rate. His medical history indicates that he is a smoker and had a heart attack 3 months ago that has increased his complication that leads to a sedentary lifestyle.

He complained that his leg wound is facing delayed healing that has increased complication due to pain and he is also facing deteriorated skin condition that is responsible to increase the distress of Mark. The family history of the patient reveals that his father has suffered from type 2 diabetes that directly increased his risk of diabetes. Mark wife was passed away 5 years back that lead to an unhealthy diet of Mark because he started to use microwave food. Mark also complains that he has been having difficulty in vision and that is increasing his impairment to perform the daily activity. The assessment that is utilized to improve understanding toward the patient issue is ABCDE assessment method.

The ABCDE assessment is considered to be one of the systemic approaches that can be used for patient assessment which help to understand the issue with patient condition. the ABCDE assessment helps the nurse to analyse the different body functioning unit that will directly help to identify the issue related to misbalance in the body functioning. The different body functioning that includes in the assessment are airways, breathing, circulation, disability and exposure that directly indicate the discomfort of the patient (Fernández-Méndez et al. 2019). The assessment of the patient revealed that diabetes has increased his complication that increases his disability to perform the daily activity and delayed in wound healing has increased his discomfort.

Situational Factors Related to Deterioration Risk for Mark

The family history of the Mark indicates that his father has also suffered from the type 2 diabetes that directly increased his risk to develop diabetes as heredity is one of the risk factors for the prevalence of diabetes. The diabetes is considered to be the complex disease that occurs due to the combination of multiple factors which include genetic, environmental and lifestyle of the individual. Genetic is considered to play a vital role in the prevalence of diabetes as it directly affects the genetic makeup of the individual. The individual having a family history of diabetes is 5% more expected to develop diabetes when compared to the normal individual because of the genetic makeup. The genetic play a vital role in developing the type 2 diabetes by suppressing the gene that is involved in insulin production which directly increases the complication of the individual (Prasad & Groop, 2015).

The sedentary lifestyle of Mark is also one of the risk factors for diabetes as it directly decreases the metabolism of the individual and leads to misbalance of the different body functioning. The increase sedentary lifestyle is associated with a higher prevalence of the type 2 diabetes that directly causes the discomfort to the patient. The sedentary lifestyle of the individual directly decreases the metabolism of the body and increase the burden over the metabolism process. The sedentary lifestyle not only cause diabetes but it also increases for multiple complications that include hypertension, dyslipidaemia and cardiovascular disease. The increase in physical activity in the daily routine helps the individual to improve the metabolism and improve the health status (Brugnara et al. 2016).

The misbalance diet of the individual is directly responsible to increase the risk for diabetes as it directly affects the nutritional intake of the individual. The proper nutritional intake is also one of the essential factors in maintaining the good health status of the individual but misbalance in the diet directly increase for the disorder. The unhealthy diet directly increases the risk of diabetes as it directly affects the blood glucose level that causes diabetes. The unhealthy diet that increases the risk for diabetes includes high-fat content, high calories, high cholesterol that directly cause the misbalance in the nutrition intake. The increased dietary component directly increases the burden over the body that directly involve in metabolic disorder. The unhealthy diet with a sedentary lifestyle is directly responsible to cause diabetes as the decrease body metabolism and unhealthy diet directly exhaust the functioning unit of the body (Sami, Ansari, Butt & Hamid, 2017).

Cigarette is one of the risk factors for diabetes and medical history of the Mark indicates that he is a smoker that increased his chances to encounter diabetes. According to the Center for Disease Control and Prevention 30-40% of the smokers encounter type2 diabetes in their lifetime. The individual suffering from diabetes smoke directly increase complication in insulin dosing. The article represented by Maddatu, Anderson-Baucum & Evans-Molina (2017) describe that nicotine is one of the important components in the smoking that is directly involved in the increasing rate of diabetes. The nicotine is directly involved in altering the glucose homeostatic that work as an additive in the prevalence of diabetes. The increase in smoking also decreases the function of the beta-cell that is directly involved in insulin production thus increase the risk for diabetes.

Nursing Management Plan

  • One of the methods that can reduce the complication of the Mark include lifestyle intervention that helps to reduce the sedentary lifestyle and improve the social circle of the individual. The lifestyle intervention includes multiple aspects that are to use in the collaborative form to increase the health status of the individual. The first aspect of the intervention includes a healthy diet that includes incorporating a high amount of vegetable, fruits, nuts and whole-grain in the meal to improve the nutritional intake that directly reduces the complication. The second aspect of the intervention includes incorporating exercise in the daily routine to improve physical activity that includes aerobic exercise, yoga and walking. The last aspect of the intervention includes increasing social presence by increasing involvement in the social club that helps the individual to understand the different technique to deal with diabetes (Katula et al. 2017).
  • The next management technique that can be used to improve the lifestyle of the individual is to increase understanding of the individual regarding the self-care technique. The self-care techniques directly decrease the dependency of the individual over other individuals that directly help to improve the quality of life. The self-care technique involved multiple aspects that should be considered in daily routine to improve the lifestyle. The first aspect includes blood glucose monitoring on daily base sand keep record that will help to understand the fluctuation in the reading. The second aspect includes proper medicine routine that can be done by sign the medical alarm system to take medicine at the proper time. The last aspect including a technique to manage the minor fluctuation in the blood glucose level and if the condition is out of control patient has to immediately report the respective doctor to get the accurate assistance (Carpenter et al. 2018).
  • The third intervention will aim to reduce the smoking of the individual as it is related to multiple complications and deteriorating health status of the Mark. The educational intervention will help to reduce smoking as it increases the understanding of the individual regarding health-associated complication due to smoking. The educational intervention will help the individual to understand the effect of the different component over the health status and different strategies that can be used to quit smoking (Reddy, et al. 2015).


The case study is about Mr Mark how 78 year old is and have administered to the hospital with the complaint of irrelevant weight loss and injury due to fall. The medical history of the individual directly indicates the presence of diabetes in his father and he is a smoker. The death of his wife increased the unhealthy diet that leads to a sedentary lifestyle. The different factors that are associated with the deteriorated health status of the individual include smoking, family history of diabetes, sedentary lifestyle and unhealthy diet. The different management techniques that can be used to improve the health status of the Mark include lifestyle intervention that includes incorporating the exercise, healthy diet and socializing in daily routine. Improving self-care technique is also one of the methods to reduce the complication of the individual. The educational intervention is helpful to reduce the smoking that will help to reduce the health-associated complication.


Brugnara, L., Murillo, S., Novials, A., Rojo-Martínez, G., Soriguer, F., Goday, A., Calle-Pascual, A., Castaño, L., Gaztambide, S., Valdés, S., Franch, J., Castell, C., Vendrell, J., Casamitjana, R., Bosch-Comas, A., Bordiú, E., Carmena, R., Catalá, M., Delgado, E., Girbés, J. & Ortega, E. (2016). Low physical activity and its association with diabetes and other cardiovascular risk factors: a nationwide, population-based study. PloS one, 11(8), 1-12. https://doi.org/10.1371/journal.pone.0160959

Carpenter, R., DiChiacchio, T., & Barker, K. (2018). Interventions for self-management of type 2 diabetes: An integrative review. International Journal of Nursing Sciences., 6, 70-91. doi:10.1016/j.ijnss.2018.12.002

Fernández-Méndez, F., Otero-Agra, M., Abelairas-Gómez, C., Sáez-Gallego, N. M., Rodríguez-Núñez, A., & Barcala-Furelos, R. (2019). ABCDE approach to victims by lifeguards: How do they manage a critical patient? A cross sectional simulation study. PloS one, 14(4), 1-12. https://doi.org/10.1371/journal.pone.0212080

Fischer, M. A., Kennedy, K. M., Durning, S., Schijven, M. P., Ker, J., O'Connor, P., Doherty, E., & Kropmans, T. (2017). Situational awareness within objective structured clinical examination stations in undergraduate medical training - a literature search. BMC medical education, 17(1), 262. https://doi.org/10.1186/s12909-017-1105-y

Grøndahl, V. A., Kirchhoff, J. W., Andersen, K. L., Sørby, L. A., Andreassen, H. M., Skaug, E. A., Roos, A. K., Tvete, L. S., & Helgesen, A. K. (2018). Health care quality from the patients' perspective: a comparative study between an old and a new, high-tech hospital. Journal of multidisciplinary healthcare, 11, 591–600. https://doi.org/10.2147/JMDH.S176630

Katula, J. A., Kirk, J. K., Pedley, C. F., Savoca, M. R., Effoe, V. S., Bell, R. A., Bertoni, A. G., & LIFT Diabetes Team (2017). The Lifestyle Intervention for the Treatment of Diabetes study (LIFT Diabetes): Design and baseline characteristics for a randomized translational trial to improve control of cardiovascular disease risk factors. Contemporary clinical trials, 53, 89–99. https://doi.org/10.1016/j.cct.2016.12.005

Maddatu, J., Anderson-Baucum, E., & Evans-Molina, C. (2017). Smoking and the risk of type 2 diabetes. Translational research : the journal of laboratory and clinical medicine, 184, 101–107. https://doi.org/10.1016/j.trsl.2017.02.004

Prasad, R. B., & Groop, L. (2015). Genetics of type 2 diabetes-pitfalls and possibilities. Genes, 6(1), 87–123. https://doi.org/10.3390/genes6010087

Reddy, U. K., Siyo, R. K., Ul Haque, M. A., Basavaraja, H., Acharya, B. L., & Divakar, D. D. (2015). Effectiveness of health education and behavioral intervention for tobacco de-addiction among degree students: A clinical trial. Journal of International Society of Preventive & Community Dentistry, 5(Suppl 2), 93–100. https://doi.org/10.4103/2231-0762.172949

Sami, W., Ansari, T., Butt, N. S., & Hamid, M. (2017). Effect of diet on type 2 diabetes mellitus: A review. International journal of health sciences, 11(2), 65–71.

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