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Microvascular Complications (Diabetic Retinopathy (Pathophysiology…
Microvascular Complications
Diabetic Retinopathy
Pathophysiology
Hyperglycaemia
Leading to vascular dysfunction
Increasing vascular permeability
Followed by vascular edema
Then retinal neovascularization
Risk Factors
Prolonged diabetes Mellitus
Poor blood glucose control
High blood pressure
Too much fats in the blood
Clinical Manifestations
Blurry vision
Dark areas of vision
Difficulty in perceiving colours
Blindness
Causes
Prolonged high glucose level
Small blood vessels damage
Lack of oxygen supply to small blood vessels
Assessment and Diagnostic findings
Visualization of Retina by Opthalmoscope
Fluorescein angiography
Medical Management
Steroids for tissue repair
Blood vessel growth inhibitor
Surgical Management
Vitrectomy
Laser coagulation
Laser surgery
Nursing Care Plan
Assesment
Change in sensory acuity
Lerthagy
Dependency on significant others
Change in usual response to stimuli
Bilateral blindness
Nursing interventions
Assess the patient's general physical condition
Establish rapport
Listen and respect the patient's expression of dependency
Explain the procedures, expected sensations and outcomes
Position doors and furniture so they are out of path
Administer Antidiabetics as prescribed
Nephropathy
Pathophysiology
Involves glycosylation of proteins
Hormonally influenced cytokinin release
Deposition of mesangial matrix
Alteration of glomerular haedynamics
Risk factors
Uncontrolled Hypertension
Poor control of blood glucose
Smoking
A family history of diabetic nephropathy
Clinical Manefestationns
Nocturia
Tiredness
Headaches
Nausea
Medical Intervention
ACE inhibitors
Dialysis
Angiotensin II receptor blockers
Surgical Management
Kidney transplant
Causes
Untreated Diabetes Mellitus
Uncontrolled Hypertension
kidney damage
Assessment and Diagnostic Findings
24 Hour urine sampling for microalbuminurea
Test for serum creatine and BUN levels
Blood pressure Monitoring
Nursing Care Plan
Assesment
Tiredness
Vomiting
High blood pressure
Fatigue
Nursing interventions
Monitor vital signs for blood pressure
Restrict Sodium diet
Restrict protein diet
Administer Antihypertensive drugs as prescribed
Administer Antidiabetics as prescribed