Carole Lunde is a 44–year–older woman of mixed Native American and European descent and a new mother. She has recently been diagnosed with diabetes, which she was first diagnosed with at 30 weeks of pregnancy. After being told by her OB/GYN that gestational diabetes should clear up after childbirth, She is concerned that she has not recovered due to continued elevated blood glucose (BG). Carole’s BG has been over 200 postprandial and 150-200 fasting.
After Carole was diagnosed with gestational diabetes, her doctor suggested she begin Insulin to reduce her BG. After consulting with tribal leaders that Insulin was not a good thing due to being created with animal hormones, she declined treatment. Carole refused therapy after it was revealed to her Insulin was a synthetic hormone because she did not want to become dependent on it. Carole reports that her daughter Kassandra was born big but healthy despite elevated blood glucose during pregnancy.
Currently, Carole lives off of the reservation with her ten-week-old daughter post-c-section. She independently cares for her daughter, does freelance work, and has no other financial assistance or support. During the initial postpartum period, Carole’s mother helped her care for her illness and newborn. Her mother has since returned to the reservation. Between caring for her daughter and working, her health is the least important in her life; however, she worries about her daughter developing Diabetes II. Even though Carole has not cared for herself, she is open and receptive to learning more about diabetes to lower Kassandra’s risk of contracting it.
Value and relevance of the evidence
Carole’s cultural beliefs, diabetes knowledge limitations, and psychosocial variables are roadblocks to effective health outcomes, which is why the data offered in the concept map is significant and relevant. It is said by (Teixeira et al., 2017) that lack of information becomes an obstacle to user empowerment and treatment adherence. Her outcomes would vastly improve if she had the correct information and assistance from her surroundings. (Teixeira et al., 2017), also stated in the article that “Impaired sleep increases blood pressure, increases appetite and may compromise insulin sensitivity, and being associated with the incidence of diabetes.” Carole’s high blood sugar levels and the likelihood of future problems could be due to a lack of sleep, her age, and additional life stress.
Carole is alone and lacks a solid support structure necessary for self-care. Self-care is an acquired skill that is influenced by one’s surroundings. Nonetheless, family-centered care is founded on the belief that professionals cannot and do not know what is best for their clients, such as a family. The importance of a client’s role in their family significantly impacts their ability to self-care, which can have a long-term effect on a client’s commitment to behavioral changes and treatment regimens, and overall outcomes (Kumar, 2007).
Carole’s future success in caring for herself and her kid depends on addressing the risk of dangerous blood glucose levels, a lack of knowledge of diabetes II, and treating her high blood sugars. Due to cultural barriers and her family being isolated from the Native American community, inefficient family therapeutic regimen management is a nursing diagnosis I would use. Native Americans may not follow recommended treatment plans due to mistrust and misunderstanding of Western medicine. Therefore, gaining the trust of Carole and her family is essential in facilitating a better health outcome for her. Carole’s Native American background will be utilized when creating her care plan. In her care plan, I will ensure anyone she authorizes is involved in her care. Family members, tribal leaders, extended family, or other members of the community are part of the decision-making process for Indian patients (Patient and Family Educational Services, n.d.). Asking patients who’d like to be involved in their care can build trust between the family and the patient (Patient and Family Educational Services, n.d.). During my visit with Carole, I will avoid making direct eye contact, refrain from touching her hair, and thoroughly explain any treatments I may perform. By understanding that she may communicate discomfort through storytelling or express silence, I am aware that listening closely without interruption and utilizing humor is another step in achieving trust to encourage positive outcomes. During Carole’s visit, I will also remember that American Indians view illness from a holistic perspective. Individuals, communities, nature, and
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