The Difference between Type 1 and Type 2 Diabetes - Case Study Example

Name of student: Nursing and Midwifery Bioscience 243 Diabetes Case Study – Essay Order#369613: Case Study – The Diabetic Patient Introduction There are two types of diabetes mellitus known to afflict human beings. Type1 diabetes is considered to be more prevalent in the younger population than Type 2 as explained by Henry (2001). Available study findings have indicated that diabetes is common in individuals whose pancreas cannot secrete hormone insulin and as such the body becomes incapable of breaking down carbohydrates. This leaves blood glucose in such individuals being very high, a condition referred to as hyperglycemia. Research has further indicated that suffers of Type 1 diabetes are dependent on exogenous insulin whose withdrawal would lead to advance conditions. It is therefore the current author’s strong believe that the symptoms manifested by David described in the scenario are reminiscent of Type 1 diabetes and the patient is thus in need of constant monitoring and care. This discovery therefore forms the basis of this essay which will outline some basic instructions required on diabetes nursing care plan. Diagnosis of diabetes mellitus Diabetes mellitus is accompanied by a number of symptoms and is known to disrupt a range of physiological processes in the affected individual. In the views of Bekele, Bunaye & Agarwal (2008), diabetes affects the heart rate and blood pressure of the patient in a big way. It is observed that the normal heart rate for individuals aged above eighteen years is 60-100 beats per minute at rest. Similarly, Mathews, Struijk & Loupas (2008) indicate that the normal blood pressure is considered to be at 120/80 mmHg. In his views, there is a much reduced risk of heart diseases for people maintaining this level. A blood pressure above below this level exposes the person to the risk of a heart attack and should therefore be corrected accordingly. In the same note, respiratory rate has been to be critical in maintaining good health as it provides a means for gaseous exchange in the body. Studies by Stagg (2007) have insisted that the respiratory rate be kept at 12-20 respirations per minute in adults for healthy living. Anything outside this range is indicative of an abnormality in the individual. Observations by Henry (2001) have further illustrated that a diabetic patient must undergo urinalysis to confirm the presence of sugar or ketones in the urine. It is important to have the right amounts of ions as well as the correct acid-base balance in the body. Most studies contend that the normal blood glucose level in mammals oscillate between 4 mmols/L and 7 mmols/L before taking a meal and below 9 mmols/L two hours after eating (Richard, 2005). However, a blood glucose level reading of over 20mmols/L should send danger signals to medical practitioners and probably prompt an immediate urinalysis. The same applies to blood potassium level which should be kept at 3.5-5.0 mEq/L for normal health. Findings by Daniels et al (2006) underscore the importance of potassium as an electrolyte in the body particularly for nervous coordination. Its balance in the body is controlled by the kidney which excretes any excess through urine. In consideration of the foregoing, the diabetic patient in the case study clearly demonstrates a deviation from the recommended values. The case shows that David’s heart rate is 110 beats per minute with a blood pressure of 100/65 which too low and a risk of heart problems. This is because a blood pressure reading of 115/75 has been demonstrated to expose the individual to having a stroke without much ado (Bekele et al, 2008). Moreover, David is being demonstrated as having a very high respiratory rate of 38 breaths per minute which supersedes the normal range. This is attributable to the rapid and deep breathing observed in the patient. The presence of glycosuria and ketonuria in David’s urine further demonstrates that he needs exogenous insulin to lower his blood sugar level. This condition exposes him to serious risks of suffering from heart failure. As earlier indicated, blood glucose level readings should not exceed 20 mmols/L but the case study shows David’s blood glucose level readings as 32 mmols/L. The same was noted of his potassium level readings at 7.1 mEq/L above the accepted 3.5-5.0 mEq/L range (Richard, 2005). These two excessive readings confirmed the presence of sugar and ketones in David’s urine after urinalysis. Although these deviations could have resulted from the effects of the influenza reported by his parents, there is a clear indication that he is diabetic. Hampson & Mackenzie (2006) observed that Swine influenza can cause the symptoms manifested by David. The comprehensive nursing care plan described below is deemed fundamental in addressing health care needs for David. Nursing care plan provided Researchers in the field of medicine have recommended that the nursing priorities for diabetic patients should focus on restoring the osmotic pressure of the patients as well as their ionic balance, all aimed at correcting the observed metabolic abnormalities (Stagg, 2007). Moreover, the plan should discover the root cause of the disease while attempting at the same time to mitigate any experienced complications. Richard (2005) argues that it is critical for the plan to offer information relevant in addressing the disease prevalence. This plan is made successful by foremost making the patients understand diabetes. This function is left to the responsibility of nursing care providers who take upon themselves to educate the diabetic patients. The underlying information is to demystify diabetes as a metabolic disorder that affect the body’s ability to utilise food as a source of energy. Armed with this knowledge, the patient understands the fact that the pancreas must secrete the hormone insulin so as to monitor and maintain normal blood sugar levels (Stagg, 2007). If the pancreas if malfunctioning, then the patient internalizes the fact that constant and regular use of exogenous insulin as directed by the doctor is mandatory. This then calls for constant monitoring of the patients to ensure proper administration of medications based on blood glucose value. This monitoring should include a compulsory urine test of all diabetic patients one week after admission to the hospital as suggested by Henry (2001). If on one hand the patient is tested positive, the new cases must be referred to senior medical practitioners who fit them with blood glucose monitors manned by the nurses (Henry, 2001). Alternatively, a negative test should elicit a recheck after sometime incase of persistent manifestation of diabetes-related symptoms. The case study indicates that David was monitored appropriately on admission to the hospital. Richard (2005) advises that all medicines should be given by nurses after they have been recommended by the doctor. Necessary precautionary measures should be observed before giving the medicine to the patient, as regards the right dosage and type because erroneous administration has serious detrimental effects on the individual (Mathews et al, 2008). Most important is the storage and handling of insulin medicines as pertains refrigeration and administration. Apart from the right administration of insulin, injection locations should be observed properly to avoid repetitions. This is done in conjunction with the particular patient’s medical history. In the views of Henry (2001), different patients have different history of past medical complications accompanied by varying blood pressure readings. Depending on the specific medical history of each patient, advice given should be suitable for each particular case (Mathews et al, 2008) whereas drug addicts should be requested to quit. Thus, every patient should be handled in a unique way rather than as a group response. Moreover, each individual patient should be educated on the importance of monitoring their blood pressure and adhering to any medication procedure prescribed by their physician (Emily & Sharon, 2006). This comes in the heels of emphasizing the significance of exercise and diet as part of the diabetic patients’ blood pressure control program to reduce their risk of common vascular related conditions (Daniels, Karanja, Elmer, Sacks, Appel & Brands, 2006). The patients’ diet requires careful planning with serious thought according to the ideals of Daniels et al (2006). The patient should therefore only eat food that is known to facilitate faster recovering probably those high in fiber. Dietary plans for all new patients must be done in consultations with a professional dietitian (Daniels et al, 2006) to avoid making irreversible mistakes. This can also be achieved by tracking the patient’s basal metabolic index on a monthly basis with comprehensive records for future reference. It is observed that majority of food substances have an adverse effect on insulin production and as such all diabetic patients need to receive adequate dietary education. Similarly, diabetes is known to affect the eyes of sufferers adversely and hence recommendations for routine retinopathy testing have been rife. Emily & Sharon (2006) further suggest that all new diabetic patients should have regular eye screening to save guard the onset of blurred vision. It is still suggested that diabetic people should ensure healthy foot care because majority are at risk of nerve damage, a condition referred to as neuropathy (Mathews et al, 2008). Research has shown that this can cause the loss of feeling in the affected feet due to poor flow of blood to the feet. It is only through educating the patients on the importance of having proper skin and nail care will help mitigate the problems (Bekele et al, 2008). Finally, nursing care plan can advise and instruct the patients about the importance of exercises in managing diabetes. According to study findings by Daniels et al (2006), exercises have been able to show improvements in blood pressure charts and reduce the risks of cardiovascular diseases as well as enhancing the mental state of the patient. On top of that, the nursing care plan should strive at subverting problems like continence and urinary tract infections that can affect the patient and increase health complications (Emily & Sharon, 2006). References Bekele, D. M., Bunaye, Z & Agarwal, R. (2008). “Prognostic significance of between- arm blood pressure differences”. Hypertension 51 (3): 657–62. Daniels, S. R., Karanja, N., Elmer, P. J, Sacks, F. M., Appel, L. J & Brands, M. W. (2006). “Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association”. Hypertension 47 (2): 296–308 Emily, S. M. & Sharon, S. M. (2006). Foundations of Maternal-Newborn Nursing. (4th ed.). P.476. Philadelphia: Elsevier. Hampson, A. W & Mackenzie, J. S. (2006). “The influenza viruses”. The Medical Journal of Australia. Henry, J. B. (2001). Clinical diagnosis and Management by Laboratory Methods (20th edition). Saunders, Philadelphia, PA. Mathews, V. J., Struijk, P. C & Loupas, T et al (2008). “Blood pressure estimation in the human fetal descending aorta”. Ultrasound Obstet Gynecol 32 (5): 673–81. Richard, K. (2005). Cardiovascular Physiology Concepts. Lippincott Williams & Wilkins. pp. 93–4. Stagg, E. V. (2007). “Blood pressure readings often unreliable”. American Medical Association. Read More