A patient has been coming into a clinic for the last 5 years. His medical history includes DM type II, hypertension, and obesity.

A patient has been coming into a clinic for the last 5 years. His medical history includes DM type II, hypertension, and obesity.  Previously his blood sugars and blood pressures were well controlled with diet, exercise, and antihypertensive.  However in the last 2 years, the patient has had uncontrolled blood sugars, and his blood pressure is consistently in the severe range, regardless of how medications are prescribed.  You are assigned to this patient, and on entry to the clinic the patient looks to be sad, and disheveled. 

While taking the patient’s vital signs, the patient shares with the nurse that “this medical stuff is just too hard, my wife use to take care of it for me, but she died two years ago, and now I just don’t understand it all.”  As a nurse, you use your therapeutic communication with the patient and find that he has not been taking his medications as ordered, and has not been reading food labels on how to eat a healthy diet.  The patient states again,  “Well my wife always did all that stuff for me, she took care of the bills, and all of the documents, and all that stuff, and now I just don’t know what to do anymore.” After further questioning, you find that the patient is not able to read more than just a few words, and had been “non-compliant” because he hasn’t been able to read his medication labels and by extension doesn’t know how to read nutrition labels.  

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What can you do for this patient?  What types of patient teaching would be useful for this patient? What resources could you use in his care? Write a nursing diagnosis for this patient, and create a teaching plan for this patient, including expected learning outcomes for this patient. 

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