Question

- If this client was in a hospital setting for multiple days, what information could a nurse use to educate the client and what benefits would this provide for the Client? Question must be answered in paragraph form, no short answers can be accepted for the assignment.

"Case Study Mrs. S, a 45-year-old woman, came to your doctor’s office because she had a sore that would not heal on her leg. She is 5 ft 5 in. and weighs 200 lb (body mass index [BMI] = 33.5). Vital signs are temperature 98.6°F, pulse 70 beats per minute, respirations 16 breaths per minute, and blood pressure 160/95 mm Hg. Mrs. S reports a gradual increase in her weight since her third child was born 20 years ago. That baby weighed 12 lb. Two previous pregnancies produced infants weighing 10 and 11 lb. She has no known allergies. None of the children live at home. Mrs. S lives with her husband, who works as a construction laborer. She has been seasonally employed as a hotel maid at a nearby resort. Health insurance coverage is sporadic. They have a new insurance policy now. Mrs. S is the oldest of six children. Her father died of a heart attack at age 60. Her mother died of a stroke at age 62. Both parents reportedly “had a little sugar.” The sister who is closest to Mrs. S in age developed diabetes 3 years ago and is being treated with oral medication. Their youngest sister was diagnosed with type 1 diabetes at age 18 after an episode of mumps. Mrs. S reports a good appetite and a fluid intake of about 3 quarts per day. Her favorite beverage is iced tea with sugar and lemon. She does most of the grocery shopping and cooking. Mrs.S, hit her left ankle with the screen door about 2 months ago. The resulting sore has not healed but has gotten worse. Mrs. S knows that a sore that does not heal is a sign of cancer, which is why she sought medical attention. The ankle now has an open lesion 5 cm in diameter over the lateral ankle bone. The entire foot is swollen to twice the size of the right foot. The bandage over the sore had greenish-yellow drainage on it. A random blood glucose test 3 hours after her last meal shows a glucose level of 400 mg/dL. Her urine glucose was negative for ketones. The physician diagnoses Mrs. S with type 2 diabetes.

Answer 1

Type 2 diabetes is a condition in which cells cannot use blood sugar (glucose) efficiently for energy. This happens when the cells become insensitive to insulin and the blood sugar gradually gets too high.

The nurse has an important role and clear responsibilities when treating people with diabetes. Nurse can teach the patient to control diabetes. Managing type 2 diabetes includes a mix of lifestyle changes and medication.

Lifestyle changes

You may be able to reach your target blood sugar levels with diet and exercise alone.

Weight loss. Dropping extra pounds can help. While losing 5% to 10% of your body weight is good, losing 7% and keeping it off seems to be ideal. That means someone who weighs 180 pounds can change their blood sugar levels by losing around 13 pounds. Weight loss can seem overwhelming, but portion control and eating healthy foods are a good place to start.

Healthy eating . There’s no specific diet for type 2 diabetes. A registered dietitian can teach you about carbs and help you make a meal plan you can stick with. Focus on:

• Eating fewer calories
• Cutting back on refined carbs, especially sweets
• Adding veggies and fruits to your diet
• • Getting more fiber

Exercise. Exercise is very important if you have this health condition. Exercise makes cells more insulin sensitive, pulling glucose out of the blood. This brings down blood sugar, and more importantly, gives you better energy because the glucose is being transferred to the cells. Any type of exercise will do this, but you gain extra benefit when the activity helps build muscle, such as weight training or using resistance bands. The benefits of exercise on blood sugar last about 48-72 hours, so it is important for you to be physically active almost every day.

Try to get 30 to 60 minutes of physical activity every day. You can walk, bike, swim, or do anything else that gets your heart rate up. Pair that with strength training, like yoga or weightlifting. If you take a medication that lowers your blood sugar, you might need a snack before a workout.

Watch your blood sugar levels: Depending on your treatment, especially if you’re on insulin, your doctor will tell you if you need to test your blood sugar levels and how often to do it.

The roles and responsibilities of the nurse relating to diabetes care include:

• Prevention advice, using behaviour change and health coaching techniques (See: Making Every Contact Count & Support Behaviour Change)
• Screening, prevention and early detection of type 2 diabetes
• Promoting self-care
• An awareness of how mental health issues can affect people with diabetes
• Assessing and meeting the patient’s nutritional needs
• Urine monitoring
• Blood glucose monitoring
• Oral therapies
• Injectable therapies
• Identifying and treating hypoglycaemia
• Identifying and treating hyperglycaemia