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Evaluate the following case study. Determine the actual vs. Potential problems this client may be facing. Keep your nursing diagnosis according to the NANDA guidelines.


Mr. X is a pleasant 67 year African American male who has significant problems with his health history. He lives with his second wife and one of his children in a rental home. The patient has some college and worked in various positions until his health forced him to apply for SDI earlier this year. His history is significant for tobacco and alcohol abuse. The patient states he had his last drink 10 years ago and quit smoking 15+ years ago.

He considers himself a man of faith and received solace from the chaplain visits. His wife and daughter are in good health and will be able to provide good environment for recovery. It is important that the wife and daughter are educated regarding food choices for Mr. X and how to monitor his blood glucose levels. His past medical history shows a poor monitoring and control. Education about the value of monitoring as it relates Mr. X health may help improve compliance.

Mr. X is at Erickson's Ego integrity vs Despair stage. It is normal at this time of life to reflect upon accomplishments and contributions and ask yourself if you have done good over life. An unhealthy preoccupation with missed opportunities will inhibit thinking about the positive contributions that your life has made. Mr. X has a chance to move to the Ego Integrity. I think it may be difficult because history would seem to indicate a struggle to pass through the previous adult phases. With help from the VA system and his support team at home, this may be the opportunity Mr. X moves into the healthy part of his phase.

Posted Aug 26 2019

Answered on Aug 27 2019
The actual or potential physiological complication is to monitor the patient to detect a change in the status of the patient. (1) Mr. X might be concerned about his SDI due to his poor health conditions. (2) Mr. X might have been worried about his dependency on his family members. (3) Mr. X would have been thinking about what had led to this health condition, when he had quit smoking and drinking a long time ago. The diagnosis of diabetes and poor control of Mr. X's diet must be explained politically to the family and a low-carbohydrate diet and blood glucose control medication must be given. It is advisable to let him be on his ego integrity side because it makes X's life meaningful and important and he may continue to be a productive person. The nurse may ask family members to help him with hobbies, socializing and caring for grandchildren, so that he continues to feel that his life is important.

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