EBP Guidelines for Health Promotion

System	Findings (normal/abnormal)	Equipment needed	Laboratory findings
Gastrointestinal	Two bowel movements a week; sometimes just once The stool is usually difficult and painful to pass The patient reports feeling nauseous and bloated The stool is dry, hard and appears lumpy Experiences stomachache sometimes	Colonoscope	The patient is experiencing constipation
Respiratory	Shortness of breath Experiences a tight chest that is sometimes painful Experiences difficulties sleeping Frequent and persistent coughing and wheezing	Spirometer	The patient suffers from asthma

Patient Assessment

The table above shows results from the clinical assessment of a patient identified as Mark. Mark is 54 years old Hispanic husband and a father of three children – Sarah, Sofia, and Josep. He is 5’10” in height and weighs 201 lbs. Mark works at the headquarters of a cement company located in Los Angeles. Recently, he was transferred to the company's production site in Wyoming to oversee cement production. Because he has been staying alone and is extremely busy with work, his eating patterns have also changed with most of his meals, including ready-to-eat cereals and wheat products he obtains from a nearby supermarket.

Analysis of Patient Condition

Age-Specific Risk Reduction Screening and Immunization

Mark is 54 years old, which makes him an older adult as per the country's public health standards. People who fall under this category are at a higher risk of developing a diverse range of conditions and illnesses than other populations. Thus, clinical experts such as Shenson, Anderson, Slonim, and Benson (2014) recommend preventive care designed to prevent, forestall, and mitigate illnesses. That being so, Mark needs to undergo numerous tests for detecting underlying conditions that may need medical attention. Due to increased susceptibility to various infections, the patient also needs to undergo a screening procedure for diseases common in this age group.

Screening for diseases in older adults covers many critical diseases. With a height of 5’10” and weight of 201 lbs., Mark has a BMI score of 28.8 kg/m ^2, implying that he is obese. He needs to be tested for blood pressure. Other screening procedures include cholesterol, diabetes, bone density, vision, cancer. Vaccinations for Mark include influenza, shingles, pneumococcal disease, and tetanus-diphtheria. Also, the subscription of aspirin is a critical preventive measure for colorectal cancer and cardiovascular disease. As far as Mark is concerned, preventative care serves three purposes: first, screening for issues that do not yet show noticeable symptoms; second, checking for issues that do not cause symptoms but are often ignored; three, administering vaccines to minimize risks of future illnesses.

Diagnosis of the Abnormal Findings

Mark’s abnormal findings on the assessment of his gastrointestinal system suggest that he is suffering from constipation. All those are signs and symptoms of constipation in its adverse state. There are many diagnoses procedures for constipation, but a more reliable one for the suspected gastrointestinal disease is performing colonoscopy (Wald, 2016). The procedure is used to detect abnormalities in the large intestines and rectum. The procedure involves inserting an instrument known as a colonoscope through the rectum (Wald, 2016). A colonoscope is tube-like flexible equipment that is as thick as an index figure that has an attached video camera and light at the end. The tool offers high-quality pictures that offer a more precise and accurate examination.

Abnormal findings Mark exhibits under respiratory assessment suggests a condition known as asthma. Matsui, Abramson, and Sandel (2016) propose spirometry as the diagnosis procedure for asthma. It is a common lung function test in which a patient blows into a device connected to an instrument called a spirometer. With the instrument, a physician assesses the amount of air one can inhale or exhale, and how fast they can exhale. If the results show a reduced lung function, the physician may subscribe bronchodilator, a medicine that opens up airways. After the medicine performs its function, the doctor will also perform a similar test procedure to detect an improved lung function. The procedure helps come up with a more accurate diagnosis.

Plan for Care

Having ascertained that Mark is suffering from moderate constipation and mild asthma, it is important to devise a care plan. However, before developing a plan, it is important to understand patient-specific causes of the underlying medical conditions. Camilleri et al. (2017) point out that many factors cause constipation. The common causes include dehydration, eating food low in fiber, lack of exercise, and changing one’s routine. Observably, some of the factors mentioned above are responsible for Mark’s condition. There is a significant change in his routine marked by traveling, eating patterns, and busy schedule. Also, Mark consumes the food, which essentially includes processed foods from food stores; he takes less fiber.

From the analysis above, the medical condition is a result of lifestyle changes. That being so, the treatment method, as far as Mark is concerned, is self-care. Camilleri et al. (2017) say that most mild to moderate constipation cases can be managed at home. The intervention involves watching what one eats and making necessary adjustments. Mark should follow these recommendations: one, drink plenty of water, and avoid drinks that cause dehydration such as alcohol and caffeine. Two, add vegetable, whole grains, fruits, and other fiber-rich foods to his diet and eat fewer foods that contain fats. Three, Exercise regularly, that is, reasonable exercise at least twice a week.

The exact cause of asthma remains unknown; however, people develop the condition due to a combination of genetic and environmental factors. Asthma is triggered by exposure to a diver range of triggers. Possible triggers include airborne allergens, respiratory infections, cold air, air pollutants, physical activity, and medication (Matsui, Abramson, & Sandel, 2016). Mark shifted from Los Angeles to Wyoming; the environmental conditions in these two regions differ significantly. Also, he is from working at the headquarters to overseeing the production of cement. It means that he is more exposed to dust and other pollutants in the factory, which may have played a role in his asthma condition.

An intervention for Mark regarding his mild asthma disease is medication coupled with practicing preventive measures. Long-term asthma control medications are the cornerstone of asthma treatment. They keep asthma attacks under control. They include combination inhalers, inhaled corticosteroids, leukotriene modifiers, and theophylline. Considering Mark's work circumstances and environment, prevention measures include wearing personal protective equipment, taking medications, getting vaccinated for pneumonia and influenza, and monitoring breathing. The patient should make sure he is not exposed to harmful substances such as dust and other factories' pollutants. If that seems impossible, he should seek transfer to a safer working environment.

Pharmacological Treatments

Pharmacological treatment is a complex medical intervention that requires a significantly high level of cooperation from a patient’s families and in-depth knowledge of medications, including their benefits and side effects. Kelmendi et al. (2016) highlight pharmacological treatment's main principles: one, reviewing a patient's medical history thoroughly. Two base medication choices on the severity of the medical condition. Three, define the goal of treatment before subscribing medication. Four, evaluate fears and misconceptions linked to the medication before prescribing treatment. With the considering of these principles and the status of Mark’s health condition, the following will constitute his pharmacological treatment:

Inhaled corticosteroids (ICSs) for asthma and calcium polycarbophil for constipation. ICSs are recommended for patients with persistent asthma attacks and have seen a doctor within the past 12 months on an issue related to asthma. However, there are additional criteria for which Mark qualifies for the treatment. It includes patients aged more than 40 years, classified as overweight, and exposed to airborne agents (Christer et al., 2019). Thus, Mark should be under a monitored care plan for ICS medication. Calcium polycarbophil is a fiber supplement that works by absorbing water to help form bulky stools to make bowels going. Mark should ensure he takes the medication consistently with lots of water.

Evidence-Based Practice Strategies

Evidence-based practices (EBP) strategies for older people, such as Mark is concerned with healthy aging. EBP guidelines for health promotion focuses on the advocacy of informed decisions on appropriate health interventions. In other words, the approaches to be adopted under EBP practice are clinically approved to work for the population. The first intervention is building a healthy environment that strengthens individual health. Mark needs a supportive health system and clean surroundings. A healthy support system involves having close family and friends who understand his condition, age, and the degree to which he is vulnerable to diseases. The group will ensure he gets the appropriate care he deserves.

Adopt an exercise routine and a healthy dietary plan. The popular saying that “you are what you eat” is not a cliché saying but a factual nutritional statement. Health status, a significant degree, is determined by what and how one eats and drinks. Thus, Mark needs to work with an experienced nutritionist and a health expert to develop a good diet plan supporting his health. Also, a physical exercise routine designed to the patient's condition and characteristics is needed for healthy aging. Other strategies include having enough rest and sleep and practice yoga and medication.

References

Camilleri, M., Ford, A. C., Mawe, G. M., Dinning, P. G., Rao, S. S., Chey, W. D., ... & Chang, L. (2017). Chronic constipation. Nature Reviews Disease Primers , 3 (1), 1-19.

Christer, J., Accordini, S., Lucia, C., Isa, C., Sebastien, C., Corsico, A. G., ... & Ane, J. (2019). Pharmacological treatment of asthma in a cohort of adults over 20 years: results from the European Community Respiratory Health Survey I, II, and III.

Kelmendi, B., Adams, T. G., Yarnell, S., Southwick, S., Abdallah, C. G., & Krystal, J. H. (2016). PTSD: from neurobiology to pharmacological treatments. European Journal of Psychotraumatology , 7 (1), 31858.

Matsui, E. C., Abramson, S. L., & Sandel, M. T. (2016). Indoor environmental control practices and asthma management. Pediatrics , 138 (5).

Shenson, D., Anderson, L., Slonim, A., & Benson, W. (2014). Vaccinations and preventive screening services for older adults: opportunities and challenges in the USA. Perspectives in Public Health , 132 (4), 165-170.

Wald, A. (2016). Constipation: advances in diagnosis and treatment. Jama , 315 (2), 185-191.