University of Missouri, Columbia NURSE 5015NUR 5015 - Module 2 Case Study - Course Hero.Nursing 5015 Summer & Fall Semesters
Theories of Nursing
Chapter 7 Case Study
Case Study, Chapter 7, Grand Nursing Theories Based on Human Needs
Mr. Juan Duran is a 60-year-old patient who has been coming to the diabetes clinic at the
VA for a few months. One day, the clinic director, Jim Carlson, finds him wandering the hallway,
appearing somewhat dazed, with a bag of supplies for blood glucose testing and insulin
administration. Mr. Duran tells him that he has been instructed to start insulin for his diabetes but
doesn’t know how. He doesn’t recall receiving any appointment or instructions. Mr. Carlson
finds the diabetes nurse educator, Jenny O’Connell, and asks her to fit Mr. Duran in for an
unscheduled appointment.
Jenny O’Connell starts the appointment with a thorough assessment of Mr. Duran. In
addition to the physical assessment, she covers psycho-social-spiritual issues. She discovers that
Mr. Duran has had diabetes for about 10 years, and, recently, his blood glucose levels and
HgbA1c cannot be controlled with oral medications and exercise. The physician wants to start
him on insulin. Here are notes that she took from her assessment:
 Sixty-year-old Mexican American patient. He is exceedingly polite and respectful of
health care personnel (and does not like to interrupt or ask too many questions). He has
been in the United States more than 50 years; he is a Navy veteran.
 Married; lives with wife in a comfortable apartment in Chula Vista, California.
 Mr. Duran speaks fluent English, but his wife’s English is limited. They speak Spanish at
home.
 Because Mr. Duran has limited vision, his wife has to administer the insulin.
 Had one (single) daughter, who was found murdered in the apartment parking lot less
than 2 weeks ago, leaving Mr. and Mrs. Duran to care for her child