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Original Question

This is Sherman “Red” Yoder’s follow up visit to your community health center for treatment of an open wound on his right big toe. Sherman Red Yoder is an 80-year-old former farmer who lives alone in the farmhouse where he grew up. It is located 20 miles outside of town. Red has been a widower for 10 years and still misses his wife. She did all the shopping, cooking and cleaning. He attends religious services “when he can.” He regularly visits his local VFW to play cards and have a beer and donut with his friends. Red’s current medical problems include insulin dependent diabetes complicated by an open foot wound on his right big toe. He received the wound after he wore a new pair of shoes that were tight for him. Red has been treating the open foot wound by soaking it in hot water and searching the internet for information on treating his wound. He says the photos of the wounds on the internet cause him to feel anxious about his wound. Red has a cane, but he does not always use it. He says his toe hurts him when he walks so, he has been mainly sitting in his recliner watching TV. He has difficulty sleeping and drinks 2 beers in the evening and takes over the counter “sleep aid” pills to helps him sleep. He gets up several times during the night to void and must walk as fast as he can to make it to the toilet. He tells you he feels his over health is fine. He says because of his diabetes, he tries to follow a “low sugar diet” when he can but does enjoy a piece of cake or cookie after dinner. Red says he wants to be independent as possible. He has hearing aids and wears glasses. He drives himself back and forth to town to get his groceries and other supplies. Red weights 190 lbs and is 5′ 9″ Home health care nurses have been caring for Red’s would at his home. They have been teaching him how to care for his wound so he can become independent in his wound care. You note his wound has evidence of healing. As part of his visit to your health center, you will be providing health teaching. List one measurable teaching objective for each of the learning domains. Implementing a health literacy approach to Red’s patient education plan, describe how you would teach him to care for his wound. How will you assess Red’s understanding of his wound care? Red tells you his home health nurse said he can eat anything he wants and does not need to watch his intake of cake and cookies. He stated having the wound on his toe made him realize how diabetes affects his health. He said he understands that diabetes is a very serious disease and how important his dietary intake is to his health. He wants to learn more about healthy eating. He stated that he wanted to “see his grandchildren grow up and get married.” He stated that after his wound heals he plans to walk 30 minutes a day, starting with 3, 10-minute intervals. He stated the nurse mentioned “MyPlate” to plan his eating. He asked you for information on MyPlate. Using each of the components of the Health Belief Model analyze the factors that contribute to Red’s perceived state of health or risk and the probability of his making a sustainable change. Based on Red’s history of using the internet for health-related information, you determine that using MyPlate is a good option for health teaching. Visit https://www.myplate.gov/ Using Red’s information, take the MyPlate quiz to gather nutritional information for Red. Navigate the site to learn what resources are available. What resources are appropriate for Red?

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