Notes

Reflection
I learnt a lot of primary


3
-Health education
-Immunization
-Developmental Assessment
2
-Health education
-Communication
1
-

Care management
All the care managers are registered nurses specially trained in chronic disease management in primary care setting.
The care manager works closely with doctor, APN, healthcare team members and patients to their manage chronic conditions.

Care manager/Nurse will ask patient health history and assess their level of disease control (like ask their lifestyle ->meals, exercise, alcohol and smoke)
Identify factors that contribute to patient sub-optimal disease control
Provide education on lifestyle modification and teach self-management to empower patients to manage their own health
Monitor patients condition and work with their doctor to review their plan of care regularly.

Observe
If is diagnosed with DM --> will ask for blood glucose meter

This women is 40 something lah
It's quite young but diagnosed with hypertension
Then nurse ask her to bring BP set for the next appointment to have a so call check up to the BP set and also to check for the BP previous BP reading.
Educate about how to control their BP
-> take medication regularly
Ask the patient for medication compliance.
-> The women mentioned she will forget to take medication in the weekend.
--> The nurse educate her must take the medication regularly. The medication is to help you to control the blood pressure, if you skip dose, it means that your blood pressure is not well control.
-> check BP regularly
The women have some concern about the BP reading
-> The reading still the same after i take medication, is this normal or?
--> The nurse reassure her and explain to her our body's blood pressure is difference in every second. This is normal that the blood pressure is the same as long as not turning to hypertension. Also educate that emotional, environment and all the activities that you done will effect your blood pressure. So need to aware.
-> The women said that's why after i teach my son, my blood pressure like horrible.
--> The nurse said these are the factor may cause your BP increase. You must know how to self manage all your emotional.

Jump to DM
-> The nurse asked the women
Any one of your parent have diagnosed with DM?
If one of the parent have DM, pt may have high chance to have DM too.
Ask for lifestyle -> Drink alcohol? Do you smoke? Have do exercise regularly? You will cook yourself or mostly have your meals outside? --> this women not drinking alcohol and do not smoke. But do not have do any exercise and always take meals outside.
Talk about Lab result oral glucose tolerance test (OGTT).
Normal range is 3-6. She did this test twice. Her first result for OGTT is 6.4 and second is 6.1.
The nurse explain she do not have DM but because of her mother has history of DM and also OGTT result is a bit a bit out of the normal range so she still need to be aware.
Nurse start to educate with booklet.
Nurse educate about diet. Half of the plate - vege, One quarter of the plate - meat (chicken, seafood, fish) ->contain cholesterol so try not to take too much, One quarter of the plate - CHO (show the bowl)
About fruit also (almost all of the patient will ask the same question - natural sugar from fruit also cannot? - not cannot but still is sugar so better control )
Encourage exercise 3 times per week, each time 30 mins. Just exercise at home also can no need to go out.