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  1. Critical thinking – mod 5 Nguyen – Planning    


    Meet Nam Nguyen, a construction worker supervisor, who arrives at the Family Medicine Center for his first physical exam in more than 10 years. His knee pain has caused him to seek help because it affects his work. But as you will see, Nam will discover that he has other serious health problems that require him to be more vigilant about his health. As you read and work through the exercises in Caring for the Nguyens, you will also come to know Nam’s wife, Yen Nguyen; his grandchild, Kim Phan; other members of his extended family; and his friends as they deal with health issues and life changes.
    Mr. Nam Nguyen is a new patient at the Family Medicine Center. He arrives at the center for a scheduled physical exam and completes the following admission questionnaire:
    The Diagnosis
    During the visit, the clinic nurse records the following information in Mr. Nguyen’s chart:

    Height 5 ft 4 in.
    Weight 165 lb. (75 kg)
    BP 162/94 mm Hg
    Pulse 84 beats/min
    RR 20 breaths/min
    Temp 98.2°F oral
    Presenting Complaint: Patient states he is here to become established as a patient at the center and that he has not had a physical exam in more than 10 years. Wife accompanies. He is currently experiencing bilateral knee pain that is affecting his work performance. “I supervise construction workers. To check on things, I have to climb up and down ladders, lift things, and crawl around a lot.” Has not missed any work but has been using increasing amounts of acetaminophen and ibuprofen “to get through the day.” The medications provide only limited relief. States pain occurs daily even if not at work and is achy and dull. Feels best when he is off his feet. Desires pain relief and checkup. Explains that both parents have heart disease, his father had cancer, and his mother has diabetes. Wife expresses worry that he may be developing heart problems “because he’s so tired after work and he gets short of breath easily.”
    The nurse explains to Nam that he will be seen by the nurse practitioner shortly. She asks him whether he would like his wife to be present for the exam. He answers yes.
    Zach Miller, MSN, FNP-BC, is on duty at the center today. Zach has 10 years of experience as an RN in the emergency department and urgent care clinic. He has been a family nurse practitioner (FNP-BC) for 5 years. Zach enters the room and introduces himself to Mr. and Mrs. Nguyen. To begin the exam, Zach reviews the information Mr. Nguyen supplied on the admission form and then asks Nam about his family history.
    Are your parents still living?
    Yes, they’re both alive. My father is 80 years old and my mother is 76.
    I’d like to hear a little more about your family history. Tell me about your father’s cancer. How old was he when he was first diagnosed? Has he had treatment?
    He was probably about 60 when he first found out about it. I know he had some kind of surgery and takes medicines, but I don’t know the details. He seems all right though.
    Your father also has high blood pressure and heart disease. Please tell me a little more about that.
    My father and mother both have high blood pressure and heart disease. They both take medicines for their blood pressure. My father had a small heart attack about 10 years ago. My mother has never had a heart attack that I know of, but she sometimes has chest pain.

    Your mother also has diabetes?
    She’s had that for a long time. A lot of people in my family have diabetes, especially on my father’s side—but nobody in my mother’s family. Yet my mother is the one with the diabetes!
    A lot of people in my family have diabetes too. But so far I’m okay, I think.
    Have you had a health exam lately, Mrs. Nguyen?
    Not in about a year, but I’m going to schedule an appointment here.

    The Nguyens and Zach continue to review the health information. After reviewing the history and discussing current complaints, Zach performs a complete physical exam.

    As the clinic nurse, you have written the following nursing diagnostic statement: Overweight r/t inappropriate food choices and serving size as evidenced by body mass index (BMI) of 28.5.

    Write at least three short-term and three long-term goals for Mr. Nguyen based on this diagnostic statement.
    Remember that your goals must be realistic and consider Mr. Nguyen’s other health problems.

    Rubic Grading
    Please avoid linking to literature.
    25.0 pts
    Level 4
    Critical thinking skills
    Questions are logically answered with feasible and acceptable interventions backed by literature.

    20.0 pts
    Level 4
    Responded to assignment questions with knowledge and insight from literature.

    5.0 pts
    Level 4
    Grammarly and Scholarly Composition. Students are articulate and no grammatical errors are noted.


    Treas, L. S., Wilkinson, J. M., Barnett, K. L., & Smith, M. H. (2018). Basic Nursing: Thinking, Doing, and Caring(2nd ed.).

    Gulanick, M., Meyers, J.L Nursing care plans: Diagnoses, intervention, and Outcomes (9th edition)




Subject Nursing Pages 6 Style APA


Short and Long Term Nursing Goals for Mr. Nguyen

After patient assessment and accurate diagnosis, healthcare providers map out goals for the patient that may be both long term and short term.  According to Treas et al. (2018), nursing goals are expected outcome of a particular nursing intervention that are associated to the established nursing diagnosis. Nursing goals, therefore, provide guide for selecting an appropriate nursing intervention and evaluating the progress of the patient. This essay, therefore, provides short and long terms goals for the patient based on the case study provided.

Short Term Goals

The first short term goal is reduction of blood pressure to the normal level within 24 hours.  Based on the assessment, the patient’s current blood pressure is 162/94 mm Hg.  This is above normal blood pressure that has the ability to cause several diseases such as heart disease and eruption of small veins, which could put the life of the patient in an extreme danger. It is in this context that it should be reduced to the normal level using medication within a period of 24 hours.

The second short term goal is to ensure that the patient reduces his weight to prevent being obese. Based on the BMI of the patient, it is clearly evidenced that he is overweight hence any additional weight will lead to obesity. The patient should check his food choices and do physical exercise to reduce his weight to about 65 in a period of six months.

The last short term goal is to reduce the pain to about two in a scale of 1 to 10. The current pain on the knee that the patient is experiencing does not allow him to perform his daily activities. One of the ways of reducing the pain is using strong pain relievers since the current one do not work for the patient. Similarly, the dose of the current pain relievers can be increased for an increased effect.

Long Term Goals

The first long term goal is knee replacement after six month.  One of the best ways and permanently solving the continuous pain on the knee that will enable the patient to manage his daily activities is replacement of the knees. Also known as knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. Replacement shall enable the patient to stop taking pain relieving medication whose compliance is also difficult.

The second long term goal is management of diabetes. Based on the information provided by the client, his close relatives have diabetes, a factor that demonstrates that the patient too is likely to develop the disease if measures are not taken early enough. It is in this context that the patient should correctly choose the food he nit taking and avoid those that are likely to cause the disease. Results show that the variations in two previously identified risk genes for type 2 diabetes, THADA and KCNQ1, cause an increased risk of acquiring the disease in the child if they are inherited from the mother.

The last long term goal is to prevent heart diseases by exercising and choosing types of food. It is important to note that diets full of fats are likely to cause heart diseases. On the same note, regular exercise enables effective circulation of blood hence prevents heart related diseases.


Treas, L. S., Wilkinson, J. M., Barnett, K. L., & Smith, M. H. (2018). Basic nursing: Thinking, doing, and caring. FA Davis Company.

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