StudentShare
Contact Us
Sign In / Sign Up for FREE
Search
Go to advanced search...
Free

Pathophysiology of Clinical Manifestations of Type 1 Diabetes, Nursing Considerations Related to the Administration of NovoRapid - Assignment Example

Summary
The paper “Pathophysiology of Clinical Manifestations of Type 1 Diabetes, Nursing Considerations Related to the Administration of NovoRapid” is a  worthy variant of an assignment on nursing. The primary cause of diabetes type I is lack of insulin production to counter elevation of glucose levels…
Download full paper File format: .doc, available for editing
GRAB THE BEST PAPER92% of users find it useful

Extract of sample "Pathophysiology of Clinical Manifestations of Type 1 Diabetes, Nursing Considerations Related to the Administration of NovoRapid"

Health Variations 2 Assessment 1: Case study Type 1 diabetes Student name: Student number: Question1. Pathophysiology of clinical manifestations of Type 1 diabetes 1. High blood glucose level The primary cause of diabetes type I is lack of insulin production to counter elevation of glucose levels (Craft et al., 2015). It is majorly caused by autoimmune autoantibodies against beta cells of the islets of Langerhans including insulin and against beta cell enzyme glutamic acid decarboxylase leads to lack of insulin secretion. Insulin normally converts excess glucose into glycogen for storage in muscles, adipose and hepatocytes. In insulin deficiency, dietary glucose would not be converted into storage form (glycogen) and would therefore circulate in blood resulting into hyperglycaemia. 2. Glucose in the urine Decreased glucose absorption and storage in form of glycogen by insulin leads to elevated blood glucose levels (Craft et al, 2015. The systemic blood flow is therefore hyperglycaemic. The renal arteries that serve the kidneys therefore supply blood with increased glucose concentration. The resultant impacts overwhelm the functional threshold for renal reabsorption by the counter current system between the blood and the proximal convoluted tubules (Craig et al, 2014). This would therefore lead to diminished glucose reabsorption leading to loss of glucose through urine, glycosuria. 3. Increased urination Elevated blood glucose leads to supply of kidneys with hyperglycaemic blood. This exceeds the kidneys’ reabsorption of glucose through selective reabsorption. This would then lead to glycosuria as explained above (Craft, et. al, 2015. The presence of glucose in urine, glycosuria, exerts an osmotic pressure, osmotic diuresis which then leads to increased withdrawal of water from the blood into the renal tubules which then results into increased urgency to urinate. This leads to polyuria (Craig et al., 2014). This causes immense loos of water and electrolytes. 4. Increased thirst The hyperglycaemic blood supply to the kidneys leads to elevated kidney tubules glucose content. Water would then be drawn into the kidney tubules through osmotic diuresis. The continued loss of water due to the osmotic diuresis exerted by increased urine glucose levels results into hyperosmolarity (Craft et. Al., 2015. The elevated osmolality is also due to elevated blood glucose levels as a result of poor glucose absorption and lack of storage of the absorbed glucose. The elevated osmolality leads to diminished intracellular water levels as intracellular water is utilized as a response to reduce the hyperosmolarity (Craig et al., 2014). This then triggers the osmoreceptors the thirst centres of the brain. This then leads to intense thirst that would be resolved by increased water intake, polydipsia. 5. Increased appetite With lack of insulin, the parameters shift from the insulin-induced anabolism to catabolism of both fats and protein (Craig et al., 2014). What then follows is enzymatic breakdown of proteins, proteolysis and subsequently lead to removal of gluconeogenic amino acids by the liver and used up as glucose building blocks (University of Western Sydney, 2016). As breakdown of proteins and fats continues, a negative energy balance ensues. The negative energy balance in turn stimulate increased appetite, polyphagia. This completes the pathological triad of the triad of diabetes, polyuria, polydipsia, and polyphagia. 6. Ketones in the urine and blood The alterations from the normal dietary intake, physical activities, infections as well as stress predisposes a type I diabetic patient to diabetic ketoacidosis. Insulin deficiency results into stimulation of lipoprotein lipase. Lipoprotein lipase would then lead to increased and excessive breakdown of adipose stores (University of Western Sydney, 2016). This is so to serve as an alternative source of energy production with the diminished carbohydrate breakdown to serve as the major source of ATP (University of Western Sydney, 2016). Breakdown of adipose tissues leads to production of free fatty acids, the simplest forms of fats. When oxidised by the liver, the free fatty acids produce ketones. Ketogenesis is strategy that serves to alleviate starvation to meet the energy demands of essential organs such as brain and blood. 7. Weight loss Lack of insulin shifts the normal process from insulin-induced anabolism to catabolism of proteins and fats as a counter regulatory process to restore the lack of energy. The adaptive mechanism to restore the glucose levels in form of increased food intake, polyphagia, cannot meet the excessive catabolism of proteins and fats (University of Western Sydney, 2016). This would then leads to an energy depleted state in which catabolism supersedes polyphagia. The resultant effect is muscle weakness, energy loss and weight loss (Marieb & Hoehn, 2016). This is therefore the principal diagnostic criteria for diabetes. Question 2: Nursing considerations related to the administration of NovoRapid Prior to administration Prior to administration, the nurse should be cautious about any malabsorption syndromes Bianca might be having, in this case, celiac disease. This would necessitate decreased insulin therapy. Before administration, the nurse should determine whether the patient has symptoms such as diarrhoea, nausea, vomiting, (LeMone et al, 2013). Others that the nurse should consider are hepatic impairment. These symptoms necessitate decreased insulin requirement. The nurse should therefore have a plan to mange the symptoms such diarrhoea with antidiarrheal drugs such as loperamide (Bullock & Manias, 2014). If Bianca has conditions such as fever, graves disease, traumatic conditions, infectious manifestations, surgery among others, the nurse would consider increased insulin therapy. In Bianca, there is a higher possibility of hyperthyroidism such as Graves’ diseases as autoimmune conditions usually occur together. During administration The FlexPen must never be shared between Bianca and other patients. This is to prevent cross contamination through blood borne diseases. The dosage should be 1mm units/Ml for injectable. Prefilled syringe is 100 units/ Ml (3mL NovoLog FlexPen or Flex Touch). This would prevent overload and under dosage to Bianca. The nurse would administer 200units/mg/day and avail a maintenance dose of 500units/mg/day to ensure that Bianca is constantly on an appropriate dosage. The nurse, while considering that aspart is a rapidly acting pro-insulin drug that would rapidly deplete the elevated glucose levels, would have a plan of basal insulin and more total insulin to counter the possibility or pre-prandial hyperglycaemia that might occur in Bianca (LeMone et al, 2013). After administration Watch out for adverse effects such as allergic reactions throughout Bianca’s body to prevent late stage diagnosis of these conditions. The nurse should also watch for hypoglycaemia, hypokalaemia. Hypokalaemia would be controlled by periodic controlled potassium (Bullock & Manias, 2014). Weight gain is an effect that has occurred due to anabolic effects and reduced glycosuria with other patients and should therefore be monitored in Bianca. At injection sites, they would be a possibility of lipodystrophy, irritation and allergic reaction on Bianca. Skin diseases might also occur. The nurse should therefore adopt a strategy that would minimize the impacts of these side effects most probably be appropriate measures that would limit the impacts (Burke, 2013). The level of glucose in Bianca’s blood and urine are determined periodically to prevent excessive loss and elevated levels. In so doing, the nurse should be cautious of any major illness, patterns postprandial and co-administered drugs. Hypoglycaemia that would occur in Bianca would require the nurse to closely monitor its effects. This is so to avoid lack of glucose for the normal functioning of the brain. Hypoglycaemia would lead to hypotensive effects including headache, drowsiness, blurred vision, tachycardia, profuse sweating (Bullock & Manias, 2014). Other effects of hypoglycaemia are convulsions and tremors. Additionally, diabetes requires a particular type of selective dietary intake for Bianca, regular blood testing as well as strict adherence to self care medication (Burke, 2013). This should be adhered to for regulated impacts that would occur on Bianca. Question 3: The potential impact of type 1 diabetes on Briana and her family Emotional Emotionally, diabetes may leads to depression of the family as stress sets in. Hypoglycemia, a feature of diabetes, is more commonly associated with convulsions (Burke, 2013). This may lead to irritating behaviors thus depressing the people around the patients, in this case, Bianca’s family. With seizures, the family is at a risk of compromised performance due to impaired concentration that may set in during situations such as driving (University of Western Sydney, 2016). Physical Occurrence of accidents due to prolonged reaction times as convulsions may occur when Bianca is holding something. Physically, Bianca may suffer from a long term complication of diabetic foot due to damaged blood vessels by accumulation of AGES forming sticky surface for lipids (National Diabetes Services Scheme, 2016). This leads to atherosclerosis and infarction at the end arterials. Nephrons may be damaged; retina may also be damages (retinopathy) (National Diabetes Services Scheme, 2016). Question 4: Adaptation of nursing care to accommodate Tom’s intellectual disability According to a study, person with intellectual disability, Tom, do not have an understanding for diabetes and as such have difficulty to function in an effective satisfying way (University of Western Sydney, 2016). Tom would therefore be opposed to Bianca’s medication and adaptation to life. People with Intellectual disability tend to demand for things most so foodstuffs that they do not have. At times demand for chocolate, beer and lollies (Flixercise, 2017). From the study, the conclusion was that patients with patients with intelligent disability have negative perception in all aspects towards patients living with diabetes. The nurse should therefore manage Tom’s conditions through language therapists, special educators, and occupational therapists Mr. Tom’s lifestyle should be regulated to icorporate exercise, and management of individual effects such as pains with NSAIDs, Acetaminiophen for neuropathic effects, sedatives (Bullock & Manias, 2014). References Bullock, S., & Manias, E. (2014). Fundamentals of pharmacology (7th ed.). Frenchs Forest, NSW: Pearson Australia. Burke, K. M. L. P. L. (2013). Medical-Surgical Nursing VS. : Pearson Education Australia. Retrieved from http://www.ebrary.com Created from wsudt on 2017-01-31 21:06:21. Craft,J., Gordon, C., Tiziani, A., Heuther, S., McCance, K., Brashers, V., & Rote, N. (2015). Understanding pathophysiology (2nd ed.). Chatswood, NSW: Elsevier Australia. Craig, M. E., Jefferies, C., Dabelea, D., Balde, N., Seth, A., & Donaghue, K. C. (2014). Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatric Diabetes, Downloaded from ClinicalKey.com.au/nursing at University of Western Sydney December 07, 2016. For personal use only. No other uses without permission. Copyright ©2016. Elsevier Inc. All rights reserved. Flixercise Adapted Physical Education 2017-01-31 21:06:21. LeMone, P., Burke, K., Levett-Jones, T., Dwyer, T., Moxham, L., Reid-Searl, K. Raymond,D. (2013). Medical-surgical nursing: Critical thinking for person-centred care (2nd Australian ed.). Frenchs Forest, NSW: Pearson Australia. Marieb, E. N., & Hoehn, K. (2016). Human anatomy and physiology (10th ed.). Essex, UK: Pearson. The National Diabetes Services Scheme is an initiative of the Australian Government administered with the assistance of Diabetes Australia. Published June 2016 Read More

CHECK THESE SAMPLES OF Pathophysiology of Clinical Manifestations of Type 1 Diabetes, Nursing Considerations Related to the Administration of NovoRapid

Clinical Assessment, Diagnosis and Treatment of Diabetes

pparently, type 2 diabetes is caused by a combination of genetic factors that are related to the secretion of insulin, the resistance of insulin, and environmental factors such as lack of exercise, overeating, and aging.... Hence, it is assumed that pathogenesis is involved in the genetic abnormality, in the molecules related to the regulatory system of glucose metabolism.... It explains the clinical manifestations of the condition.... Nonetheless, the advancement of type 2 diabetes is purely associated with a family history of diabetes like in the case of Sarah....
10 Pages (2500 words) Essay

Diabetes and Evidence-Based Nursing

The nursing situation, in this case, is based on the appropriate care of the diabetic patient, the assistance given in the administration of the patient's medications, and the monitoring of the patient's vital signs, diet, blood sugar levels, and blood pressure.... t calls for insulin administration for a short period of time and later to be shifted to oral diabetic medications.... The paper "Diabetes and Evidence-Based nursing" discusses that generally, the nurse has to teach and instruct the patient that he would have to undergo regular eye examinations, yearly microalbumin checks, foot examinations, and kidney function monitoring....
6 Pages (1500 words) Research Paper

History of Type 1 and 2 Diabetes

Differential Diagnoses It is important for a physician to determine correctly whether a patient has type 1 diabetes or Type 2 diabetes.... Results obtained from physical examination, laboratory tests and the patient's history can be used to make the right diagnosis that will help clinicians differentiate type 1 diabetes from Type 2 diabetes (Colvin, & Lane, 2011).... Thin patients, who have had diabetic ketoacidosis for a long period and have always depended on insulin since childhood, can be diagnosed with type 1 diabetes (Laine, 2007)....
6 Pages (1500 words) Case Study

The Epidemic of Diabetes Mellitus

2004) the most frequent cause of type 1 diabetes is an autoimmune destruction of -cells in the islets of Langherhans.... Thus presence of high titres of such antibodies are an important predictor of the risk of type 1 diabetes mellitus development.... Other immunological indices also important for understanding pathogenesis and diagnostics of type 1 diabetes, e.... Nevertheless some cases of type 1 diabetes may not have autoimmune origin (Kahn et al....
5 Pages (1250 words) Essay

Planning and Initiating Care in Nursing Practice

Modern nursing involves many activities, of them perhaps the most important are concepts and skills related to basic sciences related to clinical care of the patient.... This systemic approach based on the pathophysiology of the existing condition and potential complications of the prevailing condition is known as the nursing process.... The pathophysiology of a disease condition ultimately determines the signs and symptoms of the disease and directs the management....
15 Pages (3750 words) Case Study

Nursing Care Plan - Diabetes

The paper 'nursing Care Plan – Diabetes' look at Diabetes Mellitus as a metabolic disorder characterized by the presence of hyperglycemia due to defective insulin secretion, defective insulin action or both.... In line with the health consequences of diabetes, the US trend, risk factors, risk reduction strategy, and pathophysiology will be briefly discussed followed by developing a proposed nursing care plan which is effective in preventing and treating diabetes mellitus will be provided in details....
4 Pages (1000 words) Case Study

Clinical Manifestation of Diabetes

type 1 diabetes results from failure of the pancreas to produce enough insulin into the blood stream.... type 1 diabetes can either result from the pancreas producing less insulin or the insulin from the pancreas being ineffective.... type 1 diabetes is more of a genetic condition while type 2 is due to lack of physical activity and obesity among other life style living.... he clinical manifestations of diabetes vary depending on the type of diabetes....
5 Pages (1250 words) Term Paper

The Difference between Type 1 and Type 2 Diabetes

It is, therefore, the current author's strong belief that the symptoms manifested by David described in the scenario is reminiscent of type 1 diabetes and the patient is thus in need of constant monitoring and care.... Research has further indicated that suffers from type 1 diabetes is dependent on exogenous insulin whose withdrawal would lead to advance conditions.... This discovery, therefore, forms the basis of this essay which will outline some basic instructions required on the diabetes nursing care plan....
6 Pages (1500 words) Case Study
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.
Contact Us