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Diabetes Mellitus (Diagnostic test (Fasting blood glucose level This test…
Diabetes Mellitus
Diagnostic test
Fasting blood glucose level
This test is done in the morning after fasting overnight. Diabetes is diagnosed if a fasting blood sugar level is 126 mg/dl or higher (VanMeter and Hubert, 2014, p.408).
The Glycosylated hemoglobin test (HbA1C)
It indicates the average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin. The acceptable range for HbA1C is lower than 7% (VanMeter and Hubert, 2014, p.408).
Glucose Tolerance test:
In this test, the blood sample is taken after the overnight fasting. Then, certain amount of sugar liquid is given to drink and blood sugar levels are tested for next two hours. A blood sugar less than 149 mg/dl is normal and more than 200 mg/dl after two hours indicates diabetes (Mayo clinic, n.d., para. 11).
Treatments
Diet and Exercise
Foods that are high in nutrition; high in fibers such as whole-grain foods, low in saturated fats and cholesterol, fruits and vegetable helps to control sugar
A regular moderate exercise can increase the uptake of glucose and lowers the blood sugar level by moving sugar into cells. Moreover, exercise increases the sensitivity to insulin
(VanMeter and Hubert, 2014, pp 408-409).
Oral Medications
Antidiabetic medication such Metformin are useful in the treatment of Type 2 diabetes. This medication stimulates the beta cells of the pancreas to increase insulin resistance (VanMeter and Hubert, 2014, p. 409).
Insulin replacement
Insulin is given to the people with type I diabetes because their body isnot producting insuli (Mayo clinic, n.d., para. 33). Insulin can be rapid acting, long acting and intermediate, and depending on the need insulin is given (Mayo clinic, n.d., para. 33-35). Insulin can be injected subcutaneously (VanMeter and Hubert, 2014, p. 409).
Nursing Diagnosis
Risk for impaired skin integrity related to peripheral neuropathy as evidenced by prolonged wound healing
Goal
Patient’s skin on legs remains intact during the hospital stay.
Interventions and Rationales:
Patient will be assessed for the integrity of the skin: Skin on the lower extremities are at greater risk for ulceration.
Patient feet will be washed daily with mild soap and warm water: Decreased sensation increases the risk for burns.
Patient feet will be inspected daily for erythema and injuries: Daily inspection for the feet for any skin conditions make aware of need for prevention.
Provide teaching to the patient to use appropriate footwear all the time: Walking without shoes keep patient at the high risk of injuries and may increase risk for ulceration and infection.
(Potter et al., 2019, pp. 1304-1310).
Imbalanced nutrition less than body requirement related to insulin deficiency as evidenced by recent weight loss.
Goal
After a week of nursing intervention, the patient will be able to gain weight
Interventions and Rationales:
Patient weight will be taken daily: Weighting is one of the assessment tools that will help to determine the adequacy of nutritional intake (Potter et al., 2019, p. 1120).
Patient dietary intake will be compared with recent intake and encourage patient to make eating habits and encourage for diabetic diet- The patient should take proper diet to meet health needs such as high fibre food and low saturated fat because this will help to reduce blood glucose level (Potter et al., 2019, p. 1120).
Observe for the signs of hypoglycemia (Shakiness, pale skin, irritability, hunger, rapid pulse, and change in LOC i.e. slurred speech, vision change) and perform glucose testing: It can affect nervous system and if left untreated it can be life threatening or can cause brain damage (VanMeter and Hubert, 2014, p. 409).
Risk for unstable blood glucose level related to deficient knowledge of diabetes.
Goal
To maintain blood glucose level within normal range
Interventions and Rationales:
Teaching patient about the proper regularity of the meal: It helps to maintain proper body weight
Encourage patient to have food high in fibres and low in saturated fats: High fibre food helps to reduce blood glucose level.
Encourage patient to be involve in moderate exercise: Physical activity will increase uptake of glucose by muscles substantially without an increase in insulin use. Also, exercise helps to control body weight, reduce stress and improves cardiovascular fitness
(VanMeter and Hubert, 2014, pp. 408-409).
Type I Diabetes
Type I diabetes is an autoimmune disorder where the body’s immune system attacks its own pancreas which will inhibit its capacity to produce insulin. Type- I diabetes is also called insulin-dependent or Juvenile-onset diabetes. Type I diabetes is more common in children and adolescents.
(VanMeter and Hubert, 2014, p. 406).
Sign and symptoms
polyuria, polyphagia, polydipsia (VanMeter and Hubert, 2014, p. 407).
Type II Diabetes
Type II diabetes is a disease condition in which the body cannot make enough insulin, or the body does not use the insulin it makes and becomes insulin resistance. Type II diabetes is referred to as non-insulin dependent diabetes which occurs in older adults.
(VanMeter and Hubert, 2014, p. 406).
Sign and symptoms
shakiness, dizziness, hunger, sweating, slurred speech, inability to concentrate, pale skin (VanMeter and Hubert, 2014, p. 407).
Complications
Hypoglycemia, Diabetic ketoacidosis, Hyperosmolar Hyperglycemic Nonketotic coma, Angiopathy, Peripheral Vascular Disease, Retinopathy, Nephropathy, Neuropathy, Infections (VanMeter and Hubert, 2014, pp. 409-415)
Risk factors
Age, genetic, high blood pressure, obesity, high cholesterol, illness, infection, sedentry lifestyles, Polycystic ovary syndrome, gestational diabetes
Pathophysiology
Diabetes is a disease that is characterized by a high level of blood sugar (VanMeter and Hubert, 2014, p. 406). Diabetes is caused when beta cells of the pancreas do not produce enough insulin or when the body cells cannot use the insulin it produces (VanMeter and Hubert, 2014, p. 406).
Sign and symptoms
Frequent urination, weight loss, increased thirst, increased hunger, fatigue, blurred vision, Slow-healing sores and infections, and frequent UTI
(VanMeter and Hubert, 2014, p. 407).
Student Name: Nitu Thapa
ID: 384218
References
Potter, P.A., Perry, A.G., Stockert, P.A., Hall, M.J., Astle, B.J., & Duggleby, W. (Eds.), (2019). Canadian fundamentals of nursing (6th ed.). Toronto, Canada: Elsevier.
VanMeter, K.C., & Hubert, R.J. (2014). Gould’s pathophysiology for hr health professions (5th ed.). Missouri, St. Louis: Elsevier.
Mayo clinic. (n.d). Diabetes diagnosis. Retrieved from
https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451