direct Caring for the Nguyens Review the opening scenario of Nam Nguyen at the front of this book. 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 two short-term and two long-term goals for Mr. Nguyen based on this diagnostic statement. Remember that your goals must be realistic and take into account Mr. Nguyen's other health problems. ers of son.... 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. Zach: Nam: Zach: Nam: Zach: Nam: Zach: Nam: Yen: Zach: Yen: 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 bu 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 i 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.