Case Study of Clara Mitchell
Diabetes is a form of disorder that mainly results in the rise of the blood glucose resulting in failure of different other organs. The cells become unable to get appropriate amount of glucose from the blood that is extremely necessary for the production of energy by the process of respiration. This is mainly because the insulin, which is a hormone significant for the helping, the cells to take in glucose decreases in amount or the cells become resistant to the acceptance of glucose from the blood. As a result, the cells fail to produce energy that affects the working mechanisms of many organs (Butcher et al., 2018). This may result in life threatening situations for the individuals who are suffering from the disorder. Therefore, it becomes extremely important for the healthcare professionals to develop interventions that would help the patients to overcome such situations and thereby lead better quality life. Researchers are of the opinion that proper lifestyle interventions as well as effective following of medications and its management may help in proper care of the patient and ensure safe life (Marques et al. 2017). It is also important to educate the patients in ways by which they become aware of their disorders and develops proper ideas about how to maintain themselves. This assignment would mainly depict a case study of a patient who had been suffering from diabetes and the ways the professional can help the patient to lead better quality life.
A patient of 61 years old names Clara Mitchell was admitted to the ward after she had faced a fall in the garden while she was watering her plants in the garden. She complained to her granddaughter that she was feeling dizzy and she was feeling weak as well. Before her granddaughter could call her son, the patient had fallen down resulting in bruises and cuts on the skin. After she was admitted to the healthcare center, the nursing professionals conducted a diagnosis and found several other cuts and wounds on her body that was ill maintained and was not healing properly. Moreover, her son complained that her mother always used to remain confused about the medications and the insulin doses and even used to forget about taking the insulin on the right time. There had been many situations where the patient had forgotten to take the medications and therefore took the insulin doses altogether. Besides, the patient often used to feel thirsty and extremely fatigued. Her daughter in law had requested her to take walks and be physically active but she complains that she is fatigued and does not feel like going outside houses. Her wounds are giving her hard time as well. Moreover, her vision has become blurry for which she has lost her confidence to take walks or even in driving which she used to like a lot. She had thereby isolated herself and had got tired of the various issues that she is facing with her health. She remains depressed, as her heavy weight had also made it difficult for her to be active and participate in social gatherings. She has a BMI of 30 that gives her the status of obesity. The patient wanted the professionals to help her overcome all the issues so that she can live a better quality life.
Analysis of the Case Study
Analysis of the case study:
The nursing professionals need to conduct a critical analysis of the case study in order to collect cues and thereby understand the main factors that had resulted in the situation of the patient in the case study. It is extremely important for the nursing professionals to undertake clinical reason cycle so that they can address the patient cues and symptoms, identify the contributing factors, relate them with the pathophysiology of the disorders, identify the care priorities, develop the goals and action plans and thereby help in providing the best care to the patients (Frauenfelder et al. 2018).
After the documentation of the medical history of the patients, the narratives of the family members and identifying the cues from the physical condition of the patients, nurses need to develop interventions and management programs that match with the requirements of the patient. After thorough analysis, it was found that the main issue that had resulted the patient to fall is hypoglycemia. Symptoms of hypoglycemia involve feeling of dizziness where patients complain about feeling blinded before collapsing. Such issues were identified in the case of the patient and this was verified after conducting the blood sugar level test (Fan and Sidani 2018). The blood sugar test was mainly conducted and it was found to be below 4.0 mmol/L. In case of the patient the blood glucose level test showed that the glucose level of the patient’s blood was fallen below 3 mmol/L. therefore, it was seen that the patient was suffering from low blood glucose level and it was important to understand what had led to the situation. Detailed analysis revealed that the patient had actually forgotten to take the insulin injections at the right time and therefore she had taken two insulin injections together when she suddenly remembered that she had forgotten the previous insulin injection (Sapkota et al. 2015). She was completely not aware of her condition and did not know the steps of taking medication, the effect of the medication and the dosage of the medication and the harmful effects of the wrong doses of wrong procedures of the medication. This could be attributed to the fact that she was not properly educated about her disorder of diabetes. She did not know the details of the disorders and even complained that she becomes tired of taking the medication as she is not aware why she as taking the medication (Moorhead et al. 2018). Therefore, one of the most important care priorities that is required is helping the patient to develop health literacy about how to manage the symptoms of diabetes effectively and thereby develop a detailed knowledge about how proper lifestyle management would help her to overcome dangerous situations.
Importance of Health Literacy
A number of other cues were also found that gave the idea that the patient was not being able to manage her blood glucose levels effectively. It has been found in the patient that she was having several infected wounds that were not healing for a long period. This is mainly because she was diabetes patient and she was not being able to maintain her blood glucose levels effectively. Researchers are of the opinion that diabetic patients suffer from issue of wound healing due to a number of factors (Kuipers et al. 2016). High levels of blood glucose levels that mainly result from improperly managed diabetes can, over time, affect the nerves of the patients. It can thereby lead to poor blood circulation and therefore it makes it difficult for the blood that is extremely important for the skin repair to reach the different parts of the body that are affected by the wounds. This results in the wounds to remain open making the wound stay in unhealed situations for months (abubakari et al. 2016). Researchers are of the opinion that when wounds remain open for long period and is not properly dressed, the skin is exposed to a number of the infections with increased risks of attacks resulting in fungal infections, bacterial infections as well as gangrene. Researchers are of the opinion that when patients are able to keep glucose levels under control, it can result in the reduction of the slow healing of the wounds that help in less suffering and better quality lives (Sherifiali et al. 2015). Researchers are also of the opinion that slow healing of different wounds mainly like that of the grazes, blisters and cuts when occurring in feet, it becomes particularly problematic. This is mainly because when such situations affect the feet, there might rise situations when infections become so uncontrollable that there requires amputation of the feet. In order to help the patient to manage her conditions of diabetes effectively, it is very important for the patient to help her learn how to measure blood sugar level effectively (Jones et al. 2016).
The symptoms of the patient show that she not only had the feeling of continuous thirst but also had issues with blurry vision and extreme fatigue. Researchers are of the opinion that excessive thirst as well as increased urination is two of the most classic diabetes symptoms. When patients are seen to have diabetes, excess of blood glucose levels are seen to build up in the blood. This makes the kidneys to work overtime for filtering as well as absorbing excess of sugar. When the kidneys ultimately fail to keep up with the procedure, excess sugar starts to release huge amount of sugar into the urine. This procedure results in the dragging of excess of fluids from the tissues that result in frequent urination as well in the patient (Baird 2015). This results in making the patient dehydrated and results in feeling of extreme thirst in the patients. The individuals are seen to drink more fluids that result in urination that is more frequent. Therefore, in the patient of the case study as well, the nursing professionals can ensure that as the patient had been failing miserably to maintain a proper blood glucose level, there is high chance that hyperglycemia is resulting in increased thirst for the patient. The fatigue that has been experienced by the patient also has clear explanation when evidence based articles are searched (Harris 2018). Many of the researchers say that dehydration from the cause of increased urination is one of the factors that make individuals feel fatigued. On the other hand, as the cells do not get enough glucose to produce energy, the organs are seen to network properly and this lack of energy results in a feeling of fatigue where the individuals do not feel like working anymore (Lohan et al. 2015).
Effective Medication Management
Insulin should be administered in ways by which it can mimic the natural pattern of the insulin secretion by the pancreas. However, it is true that the complex pattern of natural insulin is very difficult to achieve. Various types of insulin are seen to differ in the pharmacokinetics that is mainly the amount of time until the insulin starts to work as well as the duration of their action after the injection is pushed. Four different types of insulin injection doses like the rapid acting insulin that begins to work after 5 minutes after the time of administration are present (Games et al. 2016). The peak effect mainly occurs in one hour and the effect lasts for 2 to 4 hours. Another is the regular insulin that takes place within 30 minutes to take action and peaks after 2 to 3 hours after injection and last for about 3 to 6 hours. Intermediate acting insulin typically begins for lowering of the blood glucose about 2 to 4 hours after injection, with peak above 4 to 12 hours and lasting for about 12 to 18 hours. Long actin insulin mainly takes place within 6 to 10 hours lasting for 20 to 24 hours. After the nursing professionals identify the requirements of the patients, they need to develop a care plan by integrating the insulin injection timings, doses and procedures and accordingly educate the patients. For helping the patient to remember the timings, the nurse can suggest for alarm calls as well as alarm reminders so that the patient does not forget them. One of the most important interventions that the nurse should also undertake is to develop the health literacy of the patients (Zhang et al. 2015). The patient should be given detailed explanation about the reason of the occurrence of the diseases, the causes that result in the disease as well as the symptoms. Researchers are of the opinion that health education helps patient to understand the cause of their disorder and makes them more careful as they understand the threat associated their ignorance. It makes them more careful and reduces their anxiety helping them to be compliant with the medication. The procedure of the use of insulin should be also discussed in details. The nurses should educate about the use of insulin pumps as well as the pre-filled insulin pens that would be used/ the nurse should provide a demo and accordingly ask the patients to conduct a practical session in front of them to ensure that the patient has learnt well.
Importance of Lifestyle Interventions
Educating the patient about the details of the lifestyle interventions would help the patient to be out of risk of the serious threats that low blood sugar may result. Researchers are of the opinion that the recommended lifestyle of diabetes mainly includes taking two and half hours of moderate intensity physical activity in each of the weeks or one hour and fifteen minutes of high intensity exercises. Other of the interventions that should be involved is the losing of weight gradually for achieving of the high intensity exercise so that healthy body mass index can be achieved. Therefore, many of the studies suggest that patients with diabetes should mainly participate in replacing refined carbohydrates with wholegrain foods (Dunkley et al. 2014). The patient should also concentrate on the increase of the use of vegetables in the diet as well as with foods that are high in the dietary fibers.
Many of the researchers are of the opinion that constant stress can make blood glucose level rise very high and when an individual becomes highly stressed, there is high chance that threatening situations may occur. Therefore, the nursing professionals can teach effective management techniques such as mindfulness, which is mainly a simple, as well as a non-toxic way for controlling stress related blood sugar levels (Fan and Sidani 2017). It has been seen in the studies that by the effective reduction of the stress levels, there are high chances that risks of many disorders like that of the heart diseases, stroke, hypertension as well as the mental health conditions including depression and anxiety will also reduce.
Conclusion:
From the above discussion, it becomes extremely important for the healthcare professionals to develop total knowledge about the disorders to help the patients develop their life conditions. Therefore the professionals need to properly identify the symptoms present in the patient and identify the issue that the patient faces in effective management. Proper medication administration as well as effective management of the lifestyle patterns is extremely important for the patients to develop proper quality life and be safe from any threatening situations. Effective management of the insulin treatment and helping the patient to learn about the procedures helps to ensure that the blood glucose level remains in check. The patent should monitor the blood glucose level regularly. The patients should also be able to adapt different lifestyle intervention like diet and exercise so that risks of developing the symptoms of the disorder decrease. Moreover, the development of stress can also influence rise of blood glucose level. Therefore, effective stress management techniques should be also taught to the patient to endure better quality life. Development of health literacy of the patient can help the patient overcome different barriers and conduct her won treatment successfully reducing life-threatening risks.
References:
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