Management of Hospitalized Patient With Diabetes Mellitus Essay

Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.

Diabetes is a serious medical condition that can also be a risk factor for the development of many different diseases and conditions including dementia, heart disease, and CVA. Thus, effective management of diabetes is very important. Patient compliance can be difficult to achieve if the person affected with diabetes is not educated about the illness or treatment, has not fully accepted the diagnosis or its severity, will not change habits or believes that the prescribed treatment regime is too difficult or ineffective, has cultural beliefs conflicting with the treatment regime, experiences stressful events, lacks social support, or suffers from psychiatric issues unrelated to diabetes (Gerard, Griffin, & Fitzpatrick, 2010). As one may expect, adequate education programs are essential tools when dealing with diabetics. Solid education will provide the patient with information as well as teaching the necessary skills to manage the disorder. The primary focus of any diabetes education program must be to empower patients as a part of the multidisciplinary team. This team should be focused at integrating diabetes into the lives of the patients and this focus should be based on the decisions made by the patient, otherwise the treatment plan can be looked on as forced (Gerald et al., 2010). Every patient stricken with diabetes has the right to benefit from an education program of this type. First, basic education and facts should be administered directly following the diagnosis of

“Diabetes is a silent killer” (Demille 2005, p.5). It is a metabolic disorder that can result in impaired quality of life and serious complications. This study aims to understand the case of Mr. Skyler Hanson who is newly diagnosed with Diabetes Mellitus Type 1 that leads to diabetic ketoacidosis which was confirmed by the presence of moderate to high ketones in the urine and a high blood glucose level. It was noted that he has a history of fatigue, headache, abdominal pain, nausea and frequent urination. Furthermore, it was disclosed that he has difficulty in adjusting to his diagnosis and he occasionally missed administration of insulin dose when socialising. Subsequently, he was admitted in the Critical Care Unit for rehydration,

Fluid and electrolyte management in Diabetic Ketoacidosis and Hyperosmolar Hyperglycaemic state in the emergency department

Type 1 diabetics make little to no insulin. This makes the symptoms of diabetes very serious. Without insulin the cells in the body cannot get the needed glucose to perform their designed tasks. Most type 1 diabetics can feel quite sick and need to be taken to the hospital in a very short period of time, because of high blood glucose (Ruder 26).

Mrs. J. was diagnosed with type2 diabetes one year ago, and has been on treatment since then. She manages her own medication, and has a case manager who regularly checks up on her to ensure that her medications are up to date, as well as her physical exercise regime. However, the admission into the emergency room a week ago is an indication that she has not been taking enough water and observing her diet, which has resulted into the observed symptoms. Her diagnosis is: Hypernatremia related to excessive loss of water and elevated sodium consumption as

Mrs. Jameson was diagnosed with type 2 diabetes one year ago, and has been on treatment since then. She manages her own medication, and has a case manager who regularly checks up on her to ensure that her medications are up to date, as well as her physical exercise regime. However, the admission into the emergency room a week ago is an indication that she has not taken enough water and observing her diet, which has resulted in the observed symptoms. Her diagnosis is: Hypernatremia related to excessive loss of water and elevated sodium

DKA is presented with three major physiological disturbances which are hyperosmolality due to hyperglycemia, metabolic acidosis because of the buildup of ketoacids, and hypovalemia from osmotic diuresis. Diabetic ketoacidosis is caused by a profound deficiency of insulin, its most likely occur in people with type 1 diabetes, inadequate insulin dosage, poor self management, undiagnosed type 1 diabetes, illnesses and infections. In type 1

This is a diabetes case study of Mr. Charles D., a 45-year old male who is experiencing classic symptoms of hyperglycaemia. Recently divorced and living alone in a new home, Charles has complained of recent weight loss, excessive thirst, and frequent urination. He is a busy CEO for a major technological company. This case study for Charles will educate him as to what are the causes of diabetes: explain the presenting signs and symptoms emphasize the psycho-social impact to his amended life, and instruct him in the economic impact that he and millions share.

Ramirez should also be taught that skipping doses of her medication is not appropri-ate. Since she is experiencing GI problems with this medication we can try to switch her to a different type of oral medication or she can take 2 different oral antidiuretic medications at lower doses. The options will have to be discussed with her provider. Since she is having financial problems that do not allow her to buy her insulin we can suggest that she applies to a program that might help her pay her insulin or that it can cover all of the cost. He can ask a social worker to speak to Mrs. Ramirez about all of the financial help that is offer for people that need help buying their medications. Part of our nursing teaching also requires us to teach our patients the importance of checking their blood glucose levels often to prevent episodes of hypoglycemia or hyperglycemia. We must also teach them the sign and symptom of hypo/ hyperglycemia and what to do in each situation. For instance, if their blood glucose is <70 they should be told that they need to consume 15g of carbs and recheck their blood glucose in 15 minutes. Some of the foods that they can consume in this situation are: 1 cup of whole milk, 4 oz. of juice, 5-6 hard candies and 3-4 glucose tablets. It is also important to teach the family about the signs and symp-toms of hypo/ hyperglycemia and what to do in such situation. Patient should also be told that inspecting their feet daily is highly

Hyperglycemia is a major complication of diabetes (Umpierrez et al., 2012). Hyperglycemia during hospitalization is a common finding and represents an important marker of poor clinical outcome and mortality in patients with and without a history of diabetes. Recent studies have focused attention to the possibility that hyperglycemia in the hospital is not necessarily a benign condition and that aggressive treatment of diabetes and hyperglycemia results in reduced mortality and morbidity (Vasudev & Johnston, 2011). These findings are supported by the results of a study by Rasekaba, Lim and Hutchison (2012) that found in developed countries, diabetes is a leading cause of cardiovascular disease and renal failure, and, in the over 60

Brian has now been told by the doctor he needs to monitor his blood sugar levels for the next month in which he can't do on his own. So, he could also feel an increase in severity of his condition as he's taking more medication and will have to come back in a months time.

The most important goals for the patient will include maintaining fluid and electrolyte imbalance, maintaining stable blood glucose levels, ability to accomplish diabetes self-care capabilities at home and controlling weight, whether it be the reversal of weight loss (usually in type 1 diabetes) or losing weight (usually in type 2 diabetes).

Microvascular complications:are basically created by diminished flow through the littlest arterioles of the body's organs, and are specifically connected with drawn out hyperglycemia bringing about retinopathy (prompting to visual impairment), nephropathy (prompting to renal disappointment), and neuropathy (prompting to Charcot foot and fringe diseases). Different reviews have demonstrated that the improvement of these microvascular confusions can be altogether postponed by strict and steady control of the blood glucose, most regularly by keeping up glucose at under 126 mg/dl.

Nursing has provided me with a unique set of experiences that has altered the way in which I process a situation. Part of assessing an individual is not simply focusing on the admitting diagnosis or procedure but rather the whole picture. On Surgical Day Care, this assessment is often minimized to a checklist format that at times may hinder the ability to act as a part of the solution. With the goal of getting the person prepped and ready for the operating room in an efficient manner, there is often little time to discuss matters concerning all of the social determinants of health. This realization was emphasized by a recent elderly patient I admitted for debridement of a below knee amputation secondary to insulin dependent diabetes. The aim of this paper is to outline a clinical care map for the pre-operative care of a diabetic patient to further adopt an holistic approach to surgical nursing practice.