Question

Julie is 45 year old mother and lives on a cropping farm, run as a family business, with her husband and his brother. Julie has three children same, aged 14; Katie, aged 12 and James aged 8.The two older children attend boarding school and return home for holidays. James is at home and attends the local primary school 50 km away.
Both Julie's boys have type 1 diabetes that she manages.
Julie has lived with her diabetes for 37 years and has many comorbidities due her both her diabetes and celiac disease. which she developed as a teenager. Julie has stage 3 chronic kidney disease, poor eyesight and osteoporosis. She is currently tryinģ to give up smoking after having smoked since of 16.
Julie currently sees her endocrinologist in large metropolitan hospital every three-month at outpatient clinic. It take her five hours to drive by car to the appointment in the city a journey that she takes with her husband. Her nephrologist is based at the regional hospital about 2 hours drive from home.Julie engages with a diabetes educator via phone and face to face monthly . The local hospital is 50 km away and is small, rural hospital. with a locum doctor and regular nursing staff, who cover the acute inpatient ward, and community registered nurse. She attends a community chronic diseases self management program at the local church hall run by the community registered nurse once a week in town and does her weekly groceries. Julie has expressed to the diabetes educator that she need more assistance with managing her own condition. She is concerned that her son who have type 1 diabetes, may end up with the same comorbidities as her because she has an autoimmune chronic condition

1. consider the health care teams and services involved in Julie`s care, how would you as nurse caring for Julie engage the health care team to provide collaborative support to Julie to self manage her multiple chronic conditions.

2. Justify your chosen health care professional, relate the discussion direct to the patient.

3. Demonstrate your understanding of why collaborative care is important

Answer 1

Before starting the answer we need to understand the meaning of diabetes mallietus type and chronic kidney disease.

1) diabetes mallietus

A)Type 1 Diabetes

Type 1 diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset diabetes, because it often begins in childhood.

Type 1 diabetes is an autoimmune condition. It happens when your body attacks your pancreas with antibodies. The organ is damaged and doesn't make insulin.

B)Type 2 Diabetes

Type 2 diabetes used to be called non-insulin-dependent or adult-onset diabetes. But it’s become more common in children and teens over the past 20 years, largely because more young people are overweight or obese. About 90% of people with diabetes have type 2.

When you have type 2 diabetes, your pancreas usually creates some insulin. But either it’s not enough or your body doesn’t use it like it should. Insulin resistance, when your cells don’t respond to insulin, usually happens in fat, liver, and muscle cells.

As julie is suffering from type 1 DM and this is common in childrens as well and her both child suffer from the same.

2) comorbities related to DM1-Most common comorbid conditions were hypertension (82.1%), overweight or obesity (78.2%), hyperlipidemia (77.2%), chronic kidney disease (24.1%) and cardiovascular disease (21.6%).

A)colloborative support to julie to manage multiple chronic conditions -all condition she has suffering from are interrelated to each other.. julie started smoking at the age of 16. Smoking is root of all evil. Now she has Dm type 1, chronic kidney diseases and due to renal failure she has osteoporosis too...she has to manage these all of the condition and she needs rest but the hospital is 50 km apart from the house at this te she has to take care of her family too.as a health care team member i instrust her to do rest and ask her to increse her fluid diet.take low calorie and sugar diet..proper yoga and exercise to be instructed to her.stage 3 chronic kidney disease is ir reversible so i give her psychological support.

2)justification regarding choosen health care profession- nursing is a unique function of nurse to assist the patient and provide them direct care. Nursing is directly devoted to humanity. As a health care provider i feel satisfaction after giving care to the ill person.after our care if expected outcome met the goal get accomplished and the patient become good with time. Our care makes them feel better their condition improves day by day.as a nurse we took proper care of the DM patient we measure input and output strictly that helps to maintain proper fluid diet and also helps in knowing basic condition of the patient.we also assess vital signs weight and any more.

3)need of collaborative care- Collaborative Care is dedicated to a holistic and collaborative approach to mental health and family wellness

collqborative care means Focus on treating the whole person and whole family. As julie and her child are suffering from same illnes its really to give them collaborative care as they will able change their daily shedule and take proper food angghsh