High blood glucose level
High blood glucose level is a medical condition that develops in the body of a human being. It occurs when the cells are not able to absorb all the glucose in the blood (Hanas, 2007). Glucose powers all the cells in the body and therefore is important in determining the performance of the body.. Failure to absorb glucose by the blood cells may result to damage of nerves, blood vessels, organs and even interfere with the flow of blood in the body. Some of the common factors that contribute to high levels of glucose in the body include; too much food, failure to do physical exercises, illness, stress or infection (Lv, Ross & Tori, 2017). The signs and symptoms experienced by Briana such as increased thirst, frequent urination, fatigue, and weakness as well as increased appetite. Briana has type A diabetes since the blood capillary test shows that glucose level is at 25 mmol/L which is way above normal. Diabetes is triggered by a variety of factors. Sometimes the immune system of the body produces antigens and antibodies that destroy the insulin producing cells. These cells include islets and Langerhans. The destruction of these cells means that the body can’t produce enough insulin and therefore causing diabetes. The other possible causes of diabetes include exposure to virus and other environmental factors that trigger the disease. Diabetes is sometimes seen to be hereditary and therefore associated with genetic predisposition.
The test is conducted to determine the level of glucose in the urine is called glycosuria. This test is mainly important to monitor past cases of diabetes in an individual patient. The presence of glucose in urine indicates that the patient has a rare condition referred to as renal glycosuria. This occurs when glucose is released from the kidneys to urine even when the level of glucose in the blood is normal (Levy, 2011). The body is not able to produce enough insulin it means the glucose in the blood stream is not adequately absorbed in the cells and this contributes to loss of weight by the patient. Since the level of glucose in the urine for Briana Martin is 1.5moll/L, it therefore means that it is very high and requires urgent medical attention. It is treated by injecting insulin to the body of the patient so as to facilitate the absorption of glucose into the cells.
When an individual has diabetes type 1, they tend to urinate very many times compared to an individual whose condition is normal (Gupta, 2015). This is because the presence of extra glucose in the blood means that the kidney works extra hard to eliminate the glucose from the urine. This is the only way that the body can eliminate the excess sugar in the blood when an individual has diabetes type 1. As this happens, the excess glucose in the blood soaks up water from the body resulting to more urine. This may cause dehydration in the body and therefore individuals will tend to become thirsty more often.
Glucose in the urine
Increased thirst for Brian Martin is as a result of extra work by the kidneys to eliminate the excess glucose in the blood. When the sugar levels in the blood are abnormal, the body has to come up with a mechanism to reduce this sugar levels so that they cannot damage major organs of the body. The lack of insulin means that the glucose levels will remain high in the blood. The high concentration of glucose means that the glucose will draw water from the cells which causes increased sweating and therefore making the patient to be thirstier. The excess glucose absorbs water from the various cells in the body and this means that the body will become dehydrated since the water is taken off the body through regular urination (Brunk, 2011).
For Briana Martin, his appetite has increased because the body does not get the food it needs. The cells of the body draw their energy from glucose in the blood stream. When an individual has high blood sugar, it means that the body can’t absorb all the sugar since there is not enough insulin in the blood. Failure to absorb this sugar which is vital in functioning of cells means that the body will starve and therefore will start breaking down fat to generate energy (Davis & Kerley, 2009). This therefore will mean that individuals will tend to eat more in order to compensate for the fat broken down and to meet the energy requirements in the body.
Ketones are formed in the body when there is no enough sugar in the body to supply the energy needs. Ketones are mostly formed on the liver and during fasting when a person has not eaten enough or a untreated diabetes type 1. The Ketones are picked by the extra-hepatic tissues and then converted to acetyl-CoA which is then oxidized to produce energy. The combination of low insulin and normal glucagon and epinephrine levels causes fat to be released and processed. These fats are taken to the liver where they are processed into ketones. These ketones then are absorbed back into the blood stream and are used by muscles and other cells to fuel their metabolism (Brunk, 2011).Ketones are responsible for a portion of energy for the brain. This is because the brain does not get enough glucose from the body when a person has diabetes. Ketones also result into a drop in the PH levels in the blood hence resulting in ketoacidosis.
Increased urination
During the medical assessment, the doctor found out that Brian Martin had lost 5Kg in one month. This is a cause for concern for the patient since diabetes type 1 results to weight loss. Inadequate insulin in the body results to high levels of sugar in the blood since most of the sugars are not absorbed by the cells and organs. To fuel cell metabolism, the body results to breaking down of fat to provide the energy needed in the body (Hanas, 2007). Continuous breakdown of these fatsthat an individual will lose weight especially when they fail to eat enough food to compensate for the broken down fat.
Nursing responsibilities and rationales related to the administration of Aspart (NovoRapid).
It is vitally important that nurses or whoever is administering Insulin to a diabetes patient is responsible and rationale enough to ensure that the desired outcome of administering the medicine is achieved. These responsibilities also guide the administering personnel to reduce the risk of error in administration of the medicine. The administering staff must be competent with the following before administering Novorapid to Briana:
One must understand the interpretation of Aspart (NovoRapid) prescription sheet
The person administering should be aware of areas to inject the insulin
Putting the right dosage of insulin into an injection
Examining of injection areas and lymphy areas
Administration of sub-cutaneous injection
Disposing needles safely after use
Using the meter of blood glucose to measure blood glucose level
The person should ensure that they are able to react to hyper or hypogylcaemia
Being able to keep medical records
The following are the nursing responsibilities and rationales during administration of Insulin:
The nursing staff should ensure that the insulin is administered 5-10 min before a meal.
Blood sugar levels should be measured just before injection to ensure that the right dosage is administered to a patient.
Draw up insulin aspart first when mixing with NPH insulin. Give injection immediately after mixing. Do not give NPH mixture by IV.
The insulin should be refrigerated at between 2degrees and 8 degrees.
The medicine should not be administered into a vein.’
Each time the medicine is injected, a different site should be used. This helps to avoid thickening of skin.
Novorapid should not be mixed with any other insulin.
The administering staff should always use a new needle for each injection to avoid contamination.
The inner needle cap should never be put back when removing from the needle. This helps to prevent the risk of needle sticks.
Increased thirst
The dose selector should be selected to 2 units before injecting the medicine. This prevents injecting of air into the blood.
The following are the nursing responsibilities and rationales after administration of insulin;
The nursing staff should ensure that they do not administer an overdose to Briana. In case of overdose, hypoglycaemia develops in sequence. Mild overdoses can be corrected by the patient consuming glucose or sugar directly to lift the levels of sugar in the blood (Mathews & Liebenberg, 2011). Severe hypoglycaemia should be treated by glucagon (0.5-1mg). The nursing staff should therefore take precaution to avoid overdose.
The nursing staff should ensure that Briana is able to maintain and stick to the diet restriction that the patient is advised to observe. This helps in managing the glucose level in the blood and making the insulin effective.
The nursing staff should ensure proper disposal of needles used to inject Aspart (Novarapid) to Briana. This prevents injuries and infections.
Extra physical exercise or strenuous activity may cause hypoglycemia and this will require adjustment of dosage by the nursing officer depending on the glucose level in the blood.(Gupta, 2015) Since Briana is active in sport, it will be very important for the nurse to monitor glucose levels after the physical exercises.
Transferring Briana to a new type of insulin should be done under strict medical guidance. (NovoRapid) patients may require an increase in the number of injections per day and this change mostly occurs in the first dosage or first weeks after beginning of treatment (Levy, 2011).
Potential impact of type 1 diabetes on Briana and her parents:
Diagnosis of diabetes is usually stressful for family and the patient themselves especially if both did not expect the outcome. This may affect their productivity at work and may cause grief to a married couple.
Diabetes also causes emotional distress since diabetes affects the long term health of an individual. The disease may also affect the education of Briana due to emotional distress as a result of the disease.
Diabetes results to patients being advised not to consume some foods and drinks and this may affect the patient emotionally if this affects their lifestyle.
Hypoglycemia is scary especially when it is severe and may cause emotional distress to patients and family alike (Robertson, 2016). The patient may live in fear of collapsing and dying.
High blood sugar damages the blood vessels of retina (Watson & Preedy,2013).
Increased appetite
This may affect the vision of Briana and may eventually cause blindness if not treated.
Briana may develop chronic kidney disease. This may eventually lead to kidney failure and this would be fatal for Briana.
The liver and other major organs of Briana may be affected by diabetes.
I would adapt nursing care for Briana and her family in such a way that the family is able to understand and take care of Briana despite the intellectual disability of the father. The first thing I would do is explain adequately to the mother and any other guardian who is close enough to the family on the causes, effects, and medication of diabetes type 1(Holt, Cockram, & Goldstein, 2011). I would also ensure that the guardian understands the consequences of failure to manage the condition.
I would adequately advise the parents on the diet restrictions for the Briana and follow up on the family to ensure that the kid is adhering to the restrictions. This will mostly involve Briana avoiding sugary foods or foods with high glucose levels (Bruttomesse& Grassi, 2015).It is important to inform the teachers at school and school nurse on the medical condition of Briana.
I would also train Brian guardian on administration of insulin to the kid to ensure that they understand all that is required and the right dosage is administered.
References
Brunk, D. (2011). Early Carotid Disease Seen in Type 1 Diabeties. Internal Medicine News, 44(13), 34-35. https://dx.doi.org/10.1016/s1097-8690(11)70667-9
Bruttomesso, D., & In Grassi, G. (2015). Technological advances in the treatment of type 1 diabetes.
Davis, M., & Kerley, M. (2009). Influence of diet, production traits, blood hormones and metabolites, and mitochondrial complex protein concentrations on residual feed intake in beef cattle. Columbia, Mo.: University of Missouri–Columbia.
Gupta, A. (2015). Evaluation of Correlation of Blood Glucose and Salivary Glucose Level in Known Diabetic Patients. Journal Of Clinical And Diagnostic Research. https://dx.doi.org/10.7860/jcdr/2015/12398.5994
Hanas, R. (2007). Type 1 diabetes. New York, NY: Marlowe.
Holt, R. I. G., Cockram, C., Flyvbjerg, A., & Goldstein, B. J. (2011). Textbook of Diabetes. New York, NY: John Wiley & Sons.
Lv, S., Ross, P., & Tori, K. (2017). The optimal blood glucose level for critically ill adult patients. Nursing In Critical Care. https://dx.doi.org/10.1111/nicc.12285
Levy, D. (2011). Type 1 diabetes. Oxford: Oxford University Press.
Mathews, E., & Liebenberg, L. (2011). A Practical Quantification of Blood Glucose Production due to High-level Chronic Stress. Stress And Health, 28(4), 327-332. https://dx.doi.org/10.1002/smi.2415
Robertson, E. (2016). Systemic Psychotherapy: an effective tool for treating children and young people diagnosed with Type 1 Diabetes. Endocrine Abstracts. https://dx.doi.org/10.1530/endoabs.45.dp1.2
Usman, T., Olatunji, L., & Alada, A. (2014). Acute high blood glucose level attenuates histamine-stimulated acid secretion in male Wistar rats. Journal Of Basic And Clinical Physiology And Pharmacology, 0(0). https://dx.doi.org/10.1515/jbcpp-2014-0022
Watson, R. R., & Preedy, V. R. (2013). Bioactive food as dietary interventions for diabetes. Boston: Elsevier/Academic Press.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
