A risk is a common occurrence in our daily lives. The nature of risk makes its total eradication impossible. Marvin Rausand contends that risk assessment consists of two stages namely; risk analysis and risk evaluation. Analysis of risk includes all activities that identify threats, hazardous events, and frequency of these events and establish the risk picture whereas the evaluation of risk comprises of acceptance of risk, its significance and realizing all potential parties to be affected by the hazardous event (Rausand, 2013). Risk assessment aids in handling the threat through risk control which completes the whole risk management process. Three aspects are evaluated to collect information about risk factors that may incline a patient towards chronic illness. These factors include a patient's health history, physical examination and diagnostic tests. The risk factors are divided into three, namely: personal characteristics, physiological parameters and states either in the past or in the present that increase the likelihood of a patient developing a particular disease.
Description of the patient
The patient under assessment is a male of Spanish descent aged 62 years. He is a construction worker who works eight hours daily for six days a week. His educational level is basic. He lives with his wife whom they have been married for 35 years. His wife works in a restaurant. They have two children, but they live separately. He lives in a Spanish community in a two-bedroom apartment. On his relaxing day, he spends his day with his friends enjoying a few beers. He rarely visits the primary care unless her wife insists and the last time he went for a checkup was seven months ago. He rarely visits the hospital because he lacks health insurance.
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This visit is a follow-up appointment after he was discharged from the emergency department seven days ago with chest pain. Cardiac catheterization tests indicate that his coronary arteries are normal apart from the right coronary artery that is 40% blocked. The medical personnel placed him on beta-blocker metoprolol 12.5mg once a day. His chest pains have subsided to the level he can return to work. Other tests indicate that he has type 2 diabetes, high blood pressure, GERD, borderline kidney disease and his bun and creatine level are elevated. He takes Glucophage 500mg twice a day to manage his diabetes, but he misses his dose occasionally. He rarely checks his blood sugar unless he feels unwell. His blood sugar level this morning is 356. Other medications include Norvasc 10mg and Pepcid 20mg for his high blood pressure and GERD respectively.
Identifying risk factors
Risk factors constitute three aspects: personal characteristics, psychological parameters and the present state of the patient. The individual characteristics comprise the patient's health behaviors. Personal health behaviors evaluate the lifestyle of the patient. In our case, our patient does not smoke but drinks alcohol. He is a social drinker who only drinks on his free days. When the patient's family history is examined, no one in the family is diabetic or has high blood pressure. According to JoAnn Grif Alspach, a contributor to Critical Care Nurse (CCN) for more than 30years, family history serves as a means of evaluating a patient’s combination of genes and an indicator of the risk of the patient. This instrument is the most accepted tool for solving multifaceted interaction between genes and the environment to assess an individual’s disease risk. (Alspach, 2011).Family history shows the likelihood of a patient to suffer from a disease especially if a particular disease runs in their family.
According to diagnostic tests done at the laboratory, the patient has a BMI of 34.87. His body temperature was normal. The patient’s average pulse rate was 115. His blood pressure levels stood at 123/80-145/90. These levels are higher than the normal pressure range. Catheterization tests indicate that his RCA is 40% blocked. Creatinine tests reveal that his serum creatinine range stood at 1.6mg/dL. BUN levels stood at 2.4. The patient has type 2 diabetes, high blood pressure, GERD and borderline kidney disease.
Diagnostic tests and Health promotion interventions
Intervention refers to any activity that is commenced to improve the health of a patient. It is done either by prevention, therapeutic and reduction of severity of an existing disease. Various strategies are applied according to the condition. They comprise of vaccines, civic education, harm deterrence, and change of behaviors (Smith et al, 2015). There are two broad categories of intervention, namely: preventive and therapeutic interventions. Preventive interventions range from vaccines, nourishing interferences, nurturing and newborn interferences, change of behavior, environmental alterations and use of drugs for prevention of disease. On the other hand, therapeutic interventions range from treatment of infectious diseases, medical and radioactivity treatment, diagnostics to guide psychoanalysis and control of chronic ailments (Psychology Today, 2019). Our patient shall utilize both interventions both preventive and therapeutic. To intervene in the patient`s diabetes, we shall employ nourishing interferences. The patient's diet shall have a reduction in salt and fat. We shall overcome the caloric intake of the patient to reduce the weight of the patient. According to Kazuko et al, a study has indicated the association of hypertension and diabetes type 2 to a patient’s weight. Obesity leads to both hypertension and diabetes and escalates the risk for development of cardiovascular and renal impediments (Masuo, Michael, & Gavin, 2011). Therapeutic interferences shall involve control of chronic ailments, which will entail behavioral change such as abstinence from alcohol and daily use of pharmaceuticals.
Discussion of management of barriers
Several barriers exist that hinder the patient from managing their conditions. The first barrier is the neighborhood and built an environment of the patient. The patient spends his rest days with his friends who are alcoholics. The patient works in stressing environment, which increases the stress on the body. Secondly, the patient lacks health insurance making it difficult for him to keep up with his checkups and appointments. This barrier shall be tackled by registration of the patient to the universal healthcare to grant the patient health insurance.
References
Alspach, J. G. (2011). The Importance of Family Health History: Your Patients’ and Your Own. Critical Care Nurse, 31 (1), 10-15.
Masuo, K., M. L., & G. W. (2011). Hypertension and Diabetes in Obesity. International Journal of Hypertension, 2011 , 1-2.
Psychology Today. (2019). Therapeutic Intervention . Retrieved from Psychology Today: https://www.psychologytoday.com/us/therapy-types/therapeutic-intervention
Rausand, M. (2013). Risk Assessment: Theory, Methods, and Applications. New Jersey: John Wiley & Sons.
Smith, P. G., R. H., & D. A. (2015). Field Trials of Health Interventions: A Toolbox. 3rd edition. Oxford: Oxford University Press.
