BeverleyWilliams

BeverleyWilliams      Born1943

PATIENT

This patient has been in your care   for the  

past 10 years.During the past 8years 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.

HISTORY

�  TypeIINonInsulinDependentDiabetes–onset8yearsago

�  Prescribed tablets soon afterdiagnosis

�  No problems with sugars orinfections

�  Has monitored urine with sticks athome

�  Not always wellcontrolled

�  Does not care about dietregime

�  HighBPforpast5years–onmedication

�  Overweight for past 30 years (BMI32)

�  VisionOK

�  Has worn spectacles for past 20years

�  GrandmotherhadDiabetes;diedofgangreneofthefoot

�  Husband is alsoDiabetic

DIABETIC HABITS

�  No specialdiet

�  Tries not to havesugar

�  Buys diabeticcordial

�  Tastes food while preparing meals inkitchen

�  Eats cream cakes at afternoon teatime

�  Lovesfruit

�  Unaware of consequences of carelessdiet

�  Has trouble losingweight

�  Verylittleexercise–walks around the neighbourhood occasionally

�  Likes a glass of wine with eveningmeal

RELATIONSHIPS

�  Hasfourchildren–alladults–allmarried

�  Gets on well withhusband

�  Likes visiting her daughter in thecountry

�  Has active social life – visit friendsregularly

TREATMENT PLAN

�  Monitorurine–monitorbloodsugarlevelswithglucometer

�  NeedstobeeducatedreDiabetesandimportanceofspecialdiet

�  Needs to attend formal diabetic education program (daytime classes at Hospital)

�  Increase Daonil from 15 to 20mg perday

�  Needs vision checked every two to threemonths

�  Needstoloseweight–hasincreased3.5kginlast6months

�  Suggestasuitableexerciseprogram?Swimming

WRITING TASK

Using the information in the case notes, write a letter of referral to: MsMichella Mansoura, Public Health Nurse, 125 Canterbury Road, Ringwood, Victoria 3134 Australia. DO NOT use note form – use complete sentences. Expand the relevant notesinthetreatmentplanrequestingthatMsMansouratakeoverthemanagement of this patient. Letter should be no more than 25 lineslong.

THIS IS A LETTER FOR CORRECTION

 PLEASE  TO CORRECT IT AND WRITE IN 

THE  COMMENT BOX

16 July 2018

Ms Michella Mansoura

Public Health Nurse

125 Canterbury Road

Ringwood

Victoria 3134

Re: Mrs Beverley Williams, 75-year-old

Dear Ms Mansoura,

I am writing to refer Mrs Williams, who has been suffering from Non Insulin Dependent Type 2 Diabetes for last 8 years. She is being sent to your centre for providing health education regarding diet and exercise.

Mrs Williams has been taking medications for diabetes since 2010 and it is poorly managed. She is unaware of the impact of diet in diabetes that results an increased intake of Daonil from 15 to 20 mg. Even though, she does not have any sugar problem and infections; she checks her urine sugar level regularly with strips. Moreover, she has a family history of diabetes.

Recently, her weight is increased up to 3.5 kg. She has an active life but does not exercise regularly. It is worth noting that she is on medications for hypertension too.

It would be highly appreciated, if you could educate her on importance of special diet for diabetic and suggest an ideal exercise pattern like swimming. In addition to that, encourage her to attend formal diabetic day education program and to check her vision once in three months.

If you require any further information, please do not hesitate to contact me.

Yours sincerely,

Charge Nurse.