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MICROVASCULAR COMPLICATIONS (RETINOPATHY (ASSESSMENT FINDINGS AND SYMPTOMS…
MICROVASCULAR COMPLICATIONS
RETINOPATHY
PATHOPHYSIOLOGY
The basement membrane of the capillaries thickens due to the accumulation of sugars, which impairs the exchange of nutrients, gases and waste. This damages the blood vessels of light-sensitive tissue of the back of the retina
ASSESSMENT FINDINGS AND SYMPTOMS
Floaters
Blurred vision
Fluctuating vision
Impaired colour vision
Vision loss
DEFINITION
Complication of Diabetes mellitus that results in the formation of macro aneurysms in the retinal blood vessels followed by haemorrhage.
RISK FACTORS
Long duration of Diabetes Mellitus
Poor control of blood sugar levels
High blood pressure and cholesterol
Pregnancy
Tobacco use
CAUSES
Increased glucose levels in the blood
Prolonged high blood glucose levels
MEDICAL MANAGEMENT
NURSING MANAGEMENT
Nurse the patient in cot bed
Administer insulin
Monitor blood sugar levels
Manage patient for Diabetes
Provide adequate lighting
remove things that patient may trip over such as loose carpet
Administer oral diabetic medications
Ensure all stair way have rails
SURGICAL MANAGEMENT
Scatter photocoagulation
Vitrectomy
Focal photocoagulation
Delamination
Health education
Importance of maintaining blood glucose levels at healthy levels
Quit smoking or use of tobacco
Exercise regularly
Eat healthy
NEPHROPATHY
ASSESSMENT FINDINGS AND SYMPTOMS
Swollen ankles, feet and hands
Nausea and loss of appetite
fatigue and insomnia
Dry itchy skin
Difficulty in concentrating
PATHOPHYSIOLOGY
Diabetic patients experiences elevated levels of pathogenic oxidative chemistries that promote the development and progression of diabetic nephropathy. Hyperglycemia increases pathogenic oxidative chemistries which lead to formation and accumulation of advanced glycation end products which damage the kidney and promote diabetic nephropathy
MEDICAL MANAGEMENT
NURSING MANAGEMENT
Reducing dietary salt intake
Monitor blood glucose levels
manage high blood pressure
Promote regular exercise
Strictly monitor intake and output
SURGICAL MANAGEMENT
Kidney transplant
DEFINITION
A diabetic complication that result in the microvascular changes of the renal structure and function.
RISK FACTORS
Increased urinary albumin excretion
Elevated glucose levels
Smoking
Advance age
Dyslipidaemia
Obesity
CAUSES
Prolonged high blood sugar.
HEALTH EDUCATION
Importance of regular exercise
Emphasis on maintain a healthy weight
How to prevent hyperglycaemia and hypoglycaemia