Nursing Care for Type 2 Diabetes - Essay Example

Nursing care for type 2 diabetes Insert of Scenario This paper will critically examine my role as a mental health nurse with the assistance from the multidisciplinary team in helping a schizophrenic who has developed the condition due to type 2 diabetes come to terms with his condition. The discussions are based on a scenario whereby a patient, a man in his middle ages, presented himself to the clinic for mental health related attention. The man appeared shoddy in his dressing and seemed to have lost a sense with reality. He cared not what he felt or said and fully concentrated in his inner deep thought, at some point making him depressed and unable to speak. The man seemed to have lost much of his memory and could hardly remember most of the things in his life. He talked a lot to himself and at times found it difficult to concentrate on the questions asked. He occasionally shifted the conversations to suite what was going on in his mind. He seemed to wander far away at the time of the examination and occasionally talked and laughed with himself, a clear indication that he heard silent voices that made him behave in such a manner. He showed serious signs of delusion and occasionally suffered hallucination. He had false and unbelievable beliefs based on some things about his life and the surrounding. He told stories that were hard to connect and believed they were factual and upon which he held and repeatedly referred to. Further examination on the patient revealed that he had subjected himself to the use of antipsychotic drugs to help alleviate and sustain his schizophrenic condition. He also suffered an uncontrolled thirst and passed out a lot of urine, had blurry eyes and felt tired most of the time, occasionally wanting to lie prostrate on the ground or sit down to relax, a clear indication that he was suffering from the type 2 diabetes, diabetes mellitus. A close examination with the family members further revealed that there had occurred such a condition in some of his relatives, in close filmily lineage. He had a huge body size in comparison to his height, a sign of obesity. Introduction Schizophrenia is one of the greatly misunderstood psychotic conditions among many people in the world today. It is a very severe mental illness affecting human beings at all levels thus interfering with a person’s capability to think and reason normally. These persons also find it very difficult to manage their emotions, make significant and sound decisions on various tangible issues affecting their lives as well as relating with others. The condition is greatly misunderstood since most people misrepresent as a split personality which is normally not the case (Raleigh & Clifford, 2002). Some scholars have referred to schizophrenia as a purely psychotic condition and not related to any personality differences. The term psychotic is derived from the term psychological or psychosis whereby the condition affects the sensory organs of the persons involved. This leads to mixed feelings and reactions stimulated by the human sensory systems thereby changing their thoughts, beliefs, and experiences over time (Adams, 2008). Such experiences include among others; delusions, hallucinations, and mixed feelings about certain things and situations, what McLeod, (2007) refer to as disordered thoughts. Long term traumatic diseases such as the occurrence of type 2 diabetes, family quarrels, etc. in individuals are a prime factor which can lead to the development of schizophrenia (Barker, 2003). The role of nurses in helping individuals who have developed schizophrenia cope with their conditions and correct their stance is equally a very important step in the nursing profession. Much, however, need to be considered by these nurses to make sure that all relevant issues are addressed adequately at an appropriate time. In this paper, I will discuss my nursing role and that of the multidisciplinary team in helping a patient who has developed schizophrenia as a result of type 2 diabetes, diabetes mellitus. Role of a Mental Health Nurse and that of Multi-disciplinary Team in Supporting a Patient with Schizophrenia who has developed type 2 diabetes The causes of schizophrenia are varied from one person to another. There is no definite cause for schizophrenia as is the case in some diseases. Since it is a psychotic condition, it is caused by a number of factors all acting in combination contributing to the existence of schizophrenia in human beings. Some scholars have linked the occurrence of schizophrenia to the genetic transmission down the family line. This is because genetic characteristics are passed from generation to generation within the same lineage. There is, therefore, is every possibility that this condition can as well be passed along with the genetic factors down the lineage. As Williams & Pickup, (1999) record, the occurrence of an abnormal condition in the brain chemistry may also result into the occurrence of the illness. Some scholars have also argued that brain damage before or during birth may also result into the occurrence of schizophrenia in humans. Other causes are psychological stresses in various persons. This may be the result of a given disease inflicted in one during the stages of development. Some of these diseases may be stressful in life as the persons have to live with them their entire lives. Such include the occurrences of type 2 diabetes that deem very difficultly to manage and live with. Such stressful conditions may result into the development of schizophrenia in various persons. According to World Health Organization, (1999) the genetic characteristics responsible for the development of the condition may not prove valid until the persons are exposed to certain stressful conditions such as the occurrence of severe diseases like formally indicated. This leaves us with the traumatic characteristics in the lives of individuals such as type 2 diabetes as the most common causes of the condition in human beings. Attempts by nurses and multidisciplinary teams to correct the condition, therefore, require critical analysis and adequate address to the occurrence of glycemia prior to trying to correct the schizophrenic condition as glycemia conditions delay the recovery process. The condition, in its severe states, can be very threatening, and distressing to the persons concerned, their relatives and friends as well as anybody relating with them in different ways (Kessing, Thomas, Mogensen, & Andersen, 2010). However, schizophrenia is treatable under strict and gradual medical administration on the persons affected by it. While some people are able to live with the condition over a long period (Sajatovic & Dawson, 2010), others find it extremely difficult to survive in the society and succumb to it just after a few years (Fall, Holden, & Marquis, 2004). A variety of symptoms is often the results of the condition depending on the persons concerned. Different people express different behavioral change characteristics to the condition, and there are no definite characteristic symptoms for schizophrenia. Since this is a behavioral characteristic which keeps changing from one person to another and from one environment to another, different persons display different reactions to it. Nurses administering therapeutic assistance to schizophrenics should, therefore, focus on the underlying factors responsible for its development before embarking on its elimination. This is the most important step at the initial stages in discerning the facts behind the patient’s condition. A diagnosis on schizophrenia is conducted based on two types of symptoms as Edwards, (2005) notes. These are what he refers to as positive and negative symptomatic expressions and are varied in intensity and level of exposure from one person to another depending on their personality differences. The most recommended treatment for schizophrenia is the therapeutic administration of nursing support under controlled conditions to avoid extreme contact with other conditions or factors that may accelerate the condition. Schizophrenia as Bach & Grant, (2009) notes has a strong relationship with the physical happenings in the body of a human being. Certain chronic conditions such as the occurrence of type 2 diabetes is a great risk to those suffering from schizophrenia and the same can also inflict schizophrenic condition on the persons. It is, therefore, very appropriate for the nurses and the multidisciplinary unit team attending to schizophrenic persons to clearly analyze the situations and look for any link between the conditions and the physical conditions as the two are closely related. This can help the team in locating the possible causes of the condition on the persons involved and through this discern an appropriate medication to help arrest the situation. The connection between severe mental condition and the physical conditions affecting the various persons is of concern and need to be closely analyzed. The mind and the body are very closely connected as Bergenstal, Bailey, & Kendall, (2010) notes. What goes on in the mind affects what is experienced in the body and consequently, what affects the body influences the mental condition, controlled by the mind. The occurrence of diabetes is a common condition which inflicts a lot of psychological disorientations affecting the person’s body chemistry including the hormonal imbalances. Such factors influence the behavioral characteristics of the persons and often result into mental disorders such as schizophrenia (Bergenstal, Bailey, & Kendall, 2010). The ability to come to terms with type 2 diabetes in schizophrenics is a matter of concern (Knowler et al., 2002) to the nursing team and the persons affected by it as managing the disease throughout a person’s life is a tussle that many glycemic fear facing. Knowler et al., (2002), notes that poor mental conditions prompt the occurrence of type 2 diabetes. The major factor responsible for the occurrence of type 2 diabetes is an imbalance in hormonal secretion and composition of the persons especially the secretion of insulin. The main function of insulin in the body is to manage the levels of glucose in the body. Lack of it or its secretion in low quantities usually result into the concentration of much sugar in the body consequently resulting into diabetes mellitus, also called type 2 diabetes or glycemia (International Diabetes Federation, 2006). Glucose is the major component in all foods consumed at various levels. The occurrence of glucose in the body is managed by insulin. The optimum release of insulin must, therefore, be ensured to regulate the level of sugar/ glucose in the body. This requirement is highly dependent upon the contributions of the persons affected since glycemia is a lifestyle related disease. The patient’s contribution to the management and treatment procedures in turn requires a sound mindset on the part of the patient in order to be able to manage his or her abilities, reactions and behavioral characteristics effectively. Mental conditions such as the occurrence of schizophrenia in persons having type 2 diabetes can, therefore, highly deteriorate the process of recovery or sometimes lead these persons to early death especially where the patient cannot concentrate and take in advices more accurately. As Holmes, (2005) notes, the desires and values of the patients suffering from the glycemia must be considered at all levels. Sound mindedness on the part of the patient is, therefore, of great importance to the entire process and should be harvested by the nursing team in order to help properly manage the diabetic condition in the individual. Researches have proved that the body size of individuals can greatly influence their health conditions especially the occurrence of type 2 diabetes (Nyenwe, Jerkins, Umpierrez, & Kitabchi, 2011). While some medical researchers have recommended pure therapeutic administration on the persons suffering from the glycemia, a lifestyle change is an important step to managing diabetes. Besides, periodic counseling on the proper methods of maintaining the body conditions such as size, structure and weight is of prime importance to adequate management of the disease. Nurses conducting treatments on persons with glycemia must, therefore, ensure that their patients are in sound mindsets and administer such interpreted medication ranging from therapeutic to medicinal attention. Persons with big body sizes are liable to developing type 2 diabetes (Morgan, Currie, & Peters, 2000). As recorded by the Healthcare Commission, (2007), a reduction in body weight of individuals suffering from type 2 diabetes by 5- 10% can have tremendous positive contributions in the lives of the patients. This aids in controlling the glucose levels to the bloodstream. Weight maintenance in relation to proper management of glycemia is, therefore, of great importance to diabetic patients and to the nursing team. Great focus should be invested into the issue to by the nursing team for ease in achieving better results. Weight, according to Christensen, Williams, & Pfister, (2004) is highly determined by the type and level of food intake in every individual. This requires intensive therapeutic counseling by the nursing team on food intake by the diabetic patients. Dietary advices are usually personalized, and diabetic patients are advised to consume foods that are healthy and do not contain a lot of fats as this can hinder the process of weight reduction. The ability of the patient to be able to effectively manage his or her dietary system is largely based upon their ability to make sound decisions based on theyre diets (Brinkworth & Noakes, 2004). Besides these, in order to effectively reduce the weights of the diabetic patients, Mortimer & Kelly, (2006) recommends at least 150 minutes of intensive physical activity such as aerobics, resistance and flexibility trainings per week. This is meant to making the mind and the entire body alert and increases blood flow in the body. The nursing team, therefore, has to ensure that the patient is fully engaged on both physical and therapeutic medication to fully engage every body faculty and gear the body to the proper functioning. This helps in alleviating the conditions of the mind (schizophrenic conditions) in the individual as well as improving the functioning of the body. Schizophrenic conditions have the tendency of affecting the way people think and reason with one another and themselves. This affects concentration and proper decision making. The patients, therefore, end up making the wrong decisions on very important matters affecting their lives. Besides, frequent delusions and hallucinations which form the most common manifestations in schizophrenic persons affect the concentration on important life concerns. Advice on diet change in schizophrenic persons suffering from the glycemia may sometimes be perceived as a trick on them due to such mixed feelings. Patients having similar conditions have sometimes argued against advices on dietary changes, claiming that they are tricked to poisoning (Daly & Paisey, 2006). Administration of certain treatment methods on the diabetic persons suffering from schizophrenia sometimes deems a great challenge as the patients have mixed feelings about the things they do and experience. This is what (Redmon, Susan, Kristell, et al., 2003) refers to not appearing cooperative or vague out during the administration of medication. Proper analysis of the patients likes and dislikes should, therefore, be probed by the nurse and the multidisciplinary team so as to gain access to their minds for manipulative purposes. Moreover, schizophrenia inhibits effective communication between the patients and those with whom they interact. Proper explanation of the correct situations and happenings to the patients, therefore, deem a difficult task to achieve. In most cases, the nurses have to guess for themselves what changes are likely to have occurred in their patients’ lives. Diabetic changes do not all bear physical manifestations. Some of these effects cannot be seen from the outward look and have to be detailed by the persons suffering from such conditions (Van, Van de Laar, Van Leeuwe, et al., 2007). They are, therefore, required to give accurate and elaborate reports on various changes taking place in their lives. It is here that schizophrenic influences on the diabetic persons become significant and problematic. Anderson, Freedland, Clouse, et al., (2001) investigations on the viable options for ease in the recovery of diabetic patients suggest that the patients should always talk and communicate their problems to the experts put in charge of them or to the health care provision team. These include the well structured elaborate illustrations on the factors affecting the person at every instance and the changes that have occurred in their lives. The patients are also expected to communicate their preferences for various vaccines and immunizations and shots in order to keep them from engulfing other related sicknesses. Given the effectiveness of communication in solving such problems, the nurses and multidisciplinary team must ensure that the patient is able to describe his conditions for effective decision making on the correct measures. Persons with type 2 diabetes are likely to suffer from other diseases besides their diabetic conditions if all rounded help is not administered on them in good time. Bergenstal, Bailey, & Kendall, (2010) recommends that the diabetic patients should take as their sole responsibility the want to get better with time. On this regard, he says that the patients should be able to prepare a long list of questions and descriptions which they can present to the health care team wherever they meet them. It is for this that every diabetic patient needs to know everything they need to know about their diabetes and how to effectively manage it with time at a personal basis. It is, however, close to impossibility for schizophrenic diabetics to concentrate on such facts. In such cases, it is recommended for health care nurses and the multidisciplinary teams attending to diabetic patients to keep very keen and close watch at every happening in the lives of their patients to be able to correctly discern the developmental stages and factors taking place in their lives. This will help them in discerning the next curative procedure to be administered after every step. In the case where a diabetic patient contracts schizophrenia, it is often recommended that nurses employ integrated approaches in dealing with the situations in order to avoid an acceleration of one condition at the expense of the other. Both diabetes and schizophrenic treatment mechanisms are expected to be employed, and the person fully incorporated into the treatment process. Type 2 diabetes requires very close monitoring and medical attention as well as the schizophrenic conditions. It is, however, very important to concentrate on the eradication of schizophrenic conditions on the person so as to avoid inconveniences while attending to the diabetic treatments. Since the full participation of the persons suffering from type 2 diabetes is to be called on board, the elimination of the schizophrenic condition is of prime importance at the initial stages for enhanced concentration on the part of the patients. It is however alarming that most mental health care provider’s lack adequate training on physical health care practices to enable them provides all rounded medical care for diabetic patients suffering from schizophrenia. Treatments procedures for diabetic patients with type 2 diabetes require a joint procedural medication encompassing both the glycemic condition as well as the schizophrenic conditions. Of more importance is the prohibiting factor, the mental condition, which needs to be eliminated so as to allow room for eradication of the physical condition, the diabetic condition. Without proper medical attention to such patients, it becomes very challenging to eradicate the mental conditions from which they suffer. This exercise as Brinkworth & Noakes, (2004) notes requires adequate physical medication by administering close and relevant diabetic medication. Several factors surround the complexities involved in health care provision for mental patients having physical complexities. Collaborative approaches recommended for complete address to such complex situations is often marred by a number of factors ranging from specialization to collaborative procedures. In regard to this, Brinkworth, & Noakes, (2004) records; Misinterpretation of physical symptoms as being part of the consumer’s mental illness or late recognition of symptoms by health workers has a significant impact on health outcomes for this group. Failure of health professionals to refer consumers to services and stigma and discrimination towards consumers by health care staff can also be a factor. Additionally, there can be confusion around who is responsible for assessing and monitoring the physical health of consumers and a lack of knowledge and training within mental health services regarding how to undertake this. A focus upon crisis management by mental health services can also impede a planned approach to meeting the physical health needs of consumers (pp: 1679) such complexities as Daly & Paisey, (2006) asserts arise from incompetence and lack of proper training for mental health care providers on the basis of physical health administration. Conclusion In conclusion, I would like to reiterate here that the occurrence of various terminal illnesses such as type 2 diabetes, diabetes mellitus or glycemia often have numerous side effects as it may inflict other related illnesses on the persons involved. Such common conditions inflicted on such persons include schizophrenia, a mental condition which affects the reasoning capacity as well as tremendous changes on the behavioral characteristics of these persons. Such conditions may make it very difficult to the medical specialists attending to such persons as well as inhibiting the process of recovery in the concerned parties. The relationship between schizophrenia and the recovery process of the persons suffering from type 2 diabetes is quite dependent. The former affects the recovery in the later a great deal. 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