1. My Patient: BF The diabetic 56 year old, male By Chad Ford

2. HP Assessment/Data Type 2 Diabetic for over 20 years (Takes Lantus) Hypertension slowly becoming greater problem Cholesterol elevating (Total = 190, HDL = 50, LDL = 123 as of 5/16/2013). Hemoglobin A1C 7.8 as of April (Down from 8.4). BMI 25 Is physically active, but not keeping up with exercising on a regular weekly basis.

3. Goals! HP GoalsAn InterventionMeasuring Success Short Term: Stretching before workouts for 5 to 10 minutes and each morning 3 times a week Being a positive role model. Stretched with BF before workouts. Patient actively participates. Patient shows initiative to stretch independently. Intermediate: Works out twice a week 30-45 minutes, moderate intensity. One day cardio, other lifting. Helps prevent feeling of monotony. Strength training exercises shown to improve insulin action, decrease triglycerides, and help counter heart failure (Hurley et al., 2011). BF keeps up with weekly exercise goal. Participates in weight lifting. Voices continued interest to workout. No feeling of monotony. Long Term: Decrease cholesterol by 10% (171 target goal). A food and exercise journal/diary, written in daily. Reviewed weekly. Great for tracking overall progress before next lab draw. Can spot BF’s weaknesses better.

4. The Short Term Goal Stretching Interventions 1. Positively role model 2. Show printed material and exercise videos to show patient proper stretching exercises. Overall stretching will help prevent injury. 3. Educate patient on how relaxation techniques can be combined with stretching to help decrease stress (NCCAM, 2013). Relaxation techniques fit into the CREATION Model under the importance of “Rest” Results Patient actively participated with me in stretching He voiced slight improvement in his flexibility BF is stretching before workouts now. Wish to continue to see happen at home.

5. Evaluation Plan To continue weekly checking in on BF’s progress. Monitoring activity and diet. BF keeps a journal of blood sugars and blood pressures. BF has called me at times asking if I’d work out with him. He shows initiative. Useful time to evaluate progress and be positive encouragement. Monitor BF for building a habit of weight bearing exercises. Short term cardio exercise goal was met. True evaluation of long term goal not till next blood draw in August.

6. Conclusions BF had hoped not to have to go onto a statin and 2 nd black box diabetes medication by working hard on his diet and exercise. He decided to start taking them in the middle of this project. I’ve encouraged him not to give up on improving his diet and on building an exercise routine. He is doing well and moving on to my intermediate goals. I told him about the diabetics in “Forks over Knives” going off all their medications by changing to a whole foods/plant-based diet. He is skeptical, but he is interested to watch the movie.

7. References NCCAM. (February, 2013). Relaxation techniques for health: An introduction. Backgrounder. Retrieved from relaxation_introduction.pdf Hurley, B. F., Hanson, E. D., & Sheaff, A. K. (2011). Strength Training as a Countermeasure to Aging Muscle and Chronic Disease. Sports Medicine, 41(4), 289-306. doi:10.2165/11585920-000000000-00000. Retrieved from http://proxy.kc.edu/login?url=http://search.ebscohost.com/login.aspx?direct= true&db=rzh&AN=2011069518&site=ehost-live http://proxy.kc.edu/login?url=http://search.ebscohost.com/login.aspx?direct= true&db=rzh&AN=2011069518&site=ehost-live Cummings, D. & Reed, M. (2012). Creation health discovery: Your path to a healthy 100. Orlando, FL: Florida Hospital Publishing. Pender, N., Murdaugh, C., & Parsons, M. A. (2011). Health promotion in nursing practice. (6th ed.). Upper Saddle River, NJ: Pearson Health Science.