A nurse is working to admit a 45-year-old male client who speaks a different language than the nurse and was found unresponsive at work. The client was transferred by ambulance to the emergency department and found to be in a coma secondary to severely elevated blood sugar. The client’s health history includes a new diagnosis of diabetes 6 months previously and hypertension. The client is currently awake and alert. As the nurse takes the client’s information through an interpreter, the client indicates he works in a meat processing facility, does not have any sick time allowance, and is concerned about losing his job due to being ill. He indicated that he could not afford to take off work to keep his follow-up appointment with his primary care provider after being diagnosed with diabetes. The client indicates he and his wife both work at the processing plant and often work 12 hours per day, 6 days per week. Because of their work hours, their 15-year-old daughter does most of the cooking for the family. The couple sees the physician only when absolutely necessary. They do see the employee health care nurse at the facility for blood pressure checks each month. Anticipated follow-up will include routine physician visits to check hemoglobin A1c levels and adjust medication to treat diabetes. The provider notes the client would benefit from working with a diabetes educator. Respond to the following questions and provide an evidence-based rationale. LIMIT! 2-3 page response.
(The related steps of the Nursing Process and Clinical Judgment functions are listed after each question below.)
1. Identify relevant information that suggests the client may be experiencing health disparities. (RECOGNIZE CUES/ASSESSMENT)
2. Identify potential illness progression if the client is unable to get follow-up care needed for his diagnosis of diabetes. (ANALYZE CUES/ANALYSIS)
3. Identify needs the client may have at this time related to his health condition? (ANALYZE CUES/ANALYSIS)
4. Prioritize the client’s needs you identified and provide a rationale for your response. (PRIORITIZE HYPOTHESIS/ANALYSIS)
5. Identify strategies the nurse can use to collaborate effectively with the client to meet his care needs? (GENERATE SOLUTIONS/PLANNING)
6. Identify the optimal client outcomes in this scenario. (GENERATE SOLUTIONS/ PLANNING)
7. What additional assessment findings should the nurse collect to address health disparities and support health equity for this client (refer to Lesson 26)? (TAKE ACTIONS/IMPLEMENTATION)
8. How will the nurse determine optimal client outcomes are met? (EVALUATE OUTCOMES/EVALUATION)
