Question

The RN is caring for a 30-year-old violinist who makes his living as a touring concert artist. While on a European concert tour, he fainted on stage, was taken to a hospital, and subsequently diagnosed with Type I Diabetes Mellitus. The RN is teaching the patient about self-monitoring of blood glucose, dietary considerations, and insulin injections. The patient tells the RN that he cannot possibly manage this regimen, since he spends a lot of his life “in airplanes and on stages.”

Initial Discussion Post:

Address the following:

Discuss an approach the RN can take to assist this patient to understand his disease and comply with treatment.

What factors would the RN need to consider with this patient?

How might the regimen need to be adapted, based on this patient’s lifestyle?

Answer 1

1. The nurse must use therapeutic communication technique to deal with the patient . Before teaching the patient about the disease nurse must ensure what knowledge patient has about the disease . Nurse must focus on the needs of the patient and plan a care according to the same .

Nurse should encourage to express the feeling of the patient and the needs . In this case the patient is a travellerand stage performer and he does not have the knowledge regarding the disease and how to manage it.

Nurse must provide a detailed explanation of the disease including what diabetes ,it's signs and symptoms ,about the treatment , regarding insulin therapy , nutritional therapy ,changes in lifestyle and it's complications . When the patient is aware of the disease and it's complications ,how it can affect his daily living ,the patient will show desire to manage it .

2. The factors which nurse must include are :

-encouraging the patient to be independent ,that he can take care of himself. Making him feel that he can do it and telling about the various support systems available . Then teaching about :-

- life style modifications

- glucose monitoring

- exercise plan

- self administration of insulin

- self care

- care of foot

- management of complications

The nurse can use flashcards ,ppt presentations and health education techniques to explain above factors.

3. For a patient who is a traveller and stage performer the treatment regimen include :-

The patient must carry all these:-

- medical identification bands every time

- having doctors card and phone number everytime

- list of the medicines the patient takes

- a box containing insulin syringes ,glucometer , swabs inhaler ,oral.medicines etc.

- hard candy and toffees for use during hypoglycemia .

- let the security checker in airports know that you are a diabetic patient and allow the medical supplies.

- while insulin shot in airplanes take half of air in insulin bottles because of increased atmospheric pressure.

- maintain the injection at proper temperatures.

- teach the patient to carry two pair of shoes to avoid blisters and pressure sores . Avoid open toe shoes and avoid going bare foot any where to prevent injuries.