Question

Lab Assignment

Gary is a 62-year-old man with diabetes, diagnosed 3 years ago, who presents to the outpatient diabetes clinic for a routine preventive checkup.

Subjective Data
Complains of occasional dizziness when rising in morning
Follows 1,600-calorie diabetic diet
Married with two grown children
Retired construction worker
Goes to the gym 3 times a week

Objective Data
Vital signs: T 37 P 118 R 18 BP 120/68
Glucose reading: 96
Weight: 165
HT: 5 feet. 8 inches

Questions

What type of assessment should the nurse perform on this patient? Explain your answer. (5 points)

What prevention level is this visit? Explain your answer.

What other prevention levels should be included in this patient’s care? Explain your answer.

What step-by-step approach should the nurse take to identify and resolve this patient’s problem?

What five (5) interventions might be included in the plan of care for this patient? Explain your answers.

Answer 1

ANSWER

1. ASSESSMENT SHOULD THE NURSE PERFORM ON THE PATIENT

1. To assess any problems in glycaemic control and address them to improve it.

2. To detect any complications of diabetes and treat them as appropriate.

3. To educate and reinforce healthy lifestyle advice.

4. To assess the patient's overall health and to treat any associated or coincidental illness, physical or mental.

5. To provide support and advice to the patient on how to cope with living with a chronic illness and how they can best alter their lifestyle to maintain their health.

2. THE PREVENTION LEVEL IS VISIT

Diabetes prevention is as basic as eating more healthfully, becoming more physically active and losing a few extra pounds. It's never too late to start. Making a few simple changes in your lifestyle now may help you avoid the serious health complications of diabetes in the future, such as nerve, kidney and heart damage.

1. Get more physical activity

There are many benefits to regular physical activity. Exercise can help you:

1. Lose weight

2. Lower your blood sugar

3. Boost your sensitivity to insulin — which helps keep your blood sugar within a normal range

Research shows that aerobic exercise and resistance training can help control diabetes. The greatest benefit comes from a fitness program that includes both

2. Get plenty of fiber

Fiber may help you:

1. Reduce your risk of diabetes by improving your blood sugar control

2. Lower your risk of heart disease

3. Promote weight loss by helping you feel full

Foods high in fiber include fruits, vegetables, beans, whole grains and nuts.

3. Go for whole grains

It's not clear why, but whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your grains whole grains.

4. Lose extra weight

If you're overweight, diabetes prevention may hinge on weight loss. Every pound you lose can improve your health, and you may be surprised by how much. Participants in one large study who lost a modest amount of weight — around 7 percent of initial body weight — and exercised regularly reduced the risk of developing diabetes by almost 60 percent.

5. Skip fad diets and just make healthier choices

Low-carb diets, the glycemic index diet or other fad diets may help you lose weight at first. But their effectiveness at preventing diabetes and their long-term effects aren't known. And by excluding or strictly limiting a particular food group, you may be giving up essential nutrients and often craving such foods.

3. OTHER PREVENTION LEVEL INCLUDE IN THE PATIENT CARE

Here are 13 ways to avoid getting diabetes.

1. Cut Sugar and Refined Carbs From Your Diet

Eating sugary foods and refined carbs can put at-risk individuals on the fast track to developing diabetes.

2. Work Out Regularly

Performing physical activity on a regular basis may help prevent diabetes.

3. Drink Water as Your Primary Beverage

Water is by far the most natural beverage you can drink.

4. Lose Weight If You’re Overweight or Obese

Although not everyone who develops diabetes is overweight or obese, the majority are.

What’s more, those with prediabetes tend to carry excess weight in their midsection and around abdominal organs like the liver. This is known as visceral fat.

5. Quit Smoking

Smoking has been shown to cause or contribute to many serious health conditions, including heart disease, emphysema and cancers of the lung, breast, prostate and digestive tract

6. Follow a Very-Low-Carb Diet

Following a ketogenic or very-low-carb diet can help you avoid diabetes.

Although there are a number of ways of eating that promote weight loss, very-low-carb diets have strong evidence behind them.

7. Watch Portion Sizes

Whether or not you decide to follow a low-carb diet, it’s important to avoid large portions of food to reduce the risk of diabetes, especially if you are overweight.

Eating too much food at one time has been shown to cause higher blood sugar and insulin levels in people at risk of diabetes

8. Avoid Sedentary Behaviors

It’s important to avoid being sedentary if you want to prevent diabetes.

If you get no or very little physical activity, and you sit during most of your day, then you lead a sedentary lifestyle.

9. Eat a High-Fiber Diet

Getting plenty of fiber is beneficial for gut health and weight management.

10. Optimize Vitamin D Levels

Vitamin D is important for blood sugar control.

Indeed, studies have found that people who don’t get enough vitamin D, or whose blood levels are too low, have a greater risk of all types of diabetes

11. Minimize Your Intake of Processed Foods

One clear step you can take to improve your health is to minimize your consumption of processed foods.

They’re linked to all sorts of health problems, including heart disease, obesity and diabetes.

12. Drink Coffee or Tea

Although water should be your primary beverage, research suggests that including coffee or tea in your diet may help you avoid diabetes.

13. Consider Taking These Natural Herbs

There are a few herbs that may help increase insulin sensitivity and reduce the likelihood of diabetes progression

Curcumin

Curcumin is a component of the bright gold spice turmeric, which is one of the main ingredients in curries.

It has strong anti-inflammatory properties and has been used in India for centuries as part of Ayurvedic medicine.

Berberine

Berberine is found in several herbs and has been used in traditional Chinese medicine for thousands of years.

4. STEP BY STEP APPROACH SHOULD THE NURSE TAKE TO IDENTIFY AND RESOLVE PATIENT PROBLEM

step 1: make a actual diagnosis for diabetes

Step 2: Understand Diabetes

First, make sense of your diagnosis – then learn how to manage your type 2 diabetes so that you live a healthy, vigorous life.

Step 3: Create Your Team

It’s time to enlist the help and support of a team of professionals who can show you how to get on track and help you stay there.

Step 4: Make a Plan

You can take control of your diabetes through diet, exercise, and medication — we'll give you the tools to make it happen.

Step 5: Build Healthy Habits for Life

Start making simple, smart choices every day that will help you move forward on the path to a long and healthy life.

Step 6: Succeed Through Setbacks

diabetes puts you at an increased risk for serious health problems — but you can help prevent these by learning to recognize problems and knowing what to do if one develops.

5. FIVE INTERVENTION MIGHT BE INCLUDE IN NURSING PLAN OF CARE

five interventions that reduced mortality, comorbid illness, symptoms and critical outcomes in adult patients being treated for diabetes.

1. Physical activity reduced mortality rate in adults with diabetes

Prognoses for adults with diabetes are likely to improve with increased moderate physical activity, translating to lower death rates from cardiovascular disease and all causes.

2. Early childhood intervention improved adult health

New research showed improved adult blood pressure and BMI after nutritional and educational initiatives were used as intervention strategies in young children, particularly for males

3. Initiative yielded modest benefit in diabetes care among Hispanics

A modest improvement in HbA1c levels was seen in Hispanic adults with diabetes after visits by community health workers compared with usual care, according to data from the Northern Manhattan Diabetes Community Outreach Project

4. Lifestyle changes reduced mortality, diabetes rate in adults with IGT

The potential for weight loss and exercise to prevent deaths from cardiovascular disease and all-causes in adults with impaired glucose tolerance is clearer, according to results from the Da Qing Diabetes Prevention Study.

5. Intensive BP, lipid regimens improved CVD outcomes in diabetes

Compared with combined standard treatment options, intensive blood pressure or intensive glycemia treatment alone were shown to improve major cardiovascular outcomes in patients with diabetes with no additional benefit found with combining the two treatments.