Nursing interventions Essay Example

NURSING INTERVENTION 4

Nursing Intervention

Pathophysiology

The pathophysiology of diabetes mellitus is related to insulin hormone, which is secret by beta cells of the pancreas. Insulin is responsible for maintenance of blood glucose levels and allows body cells to utilize glucose as a major energy source. In Type two diabetes mellitus, there is normal synthesis of insulin hormone but body cells are resistant to insulin. Because the body tissues and cells are not responsive to insulin, glucose stays in the bloodstream resulting to raised levels of blood glucose or hyperglycemia. This is relevant to Mr. Smith who has a blood 15.2 mmol/L instead of the normal blood sugar level of 11mmol/L.

Type 2 diabetes mellitus is commonly evident in adults of middle age who are usually above 40 years and is often associated with hypertension, elevated cholesterol levels and obesity. Since the normal blood pressure is 120/80, Mr. Smith is hypertensive and also obese because with a height of 164cm, he is supposed to weigh 65-70 kilograms. The obvious manifested symptoms of type 2 diabetes mellitus include increased urination, increased appetite, increased thirst, and excessive fatigue (Rios, 2008)

Pharmacology

Because type two diabetes mellitus is linked with hyperglycemia induced long term complications, obesity and hypertension, early diagnosis and management is important. The primary objective of treatment of type 2 diabetes is to attain and maintain appropriate glycemic control, to reduce other risk factors that may raise development of complications like high blood pressure and elevated blood lipid levels and to discover complications as soon as possible. When diagnosing type 2 diabetes, the doctor is supposed to carry a cardiovascular exam so as to reveal any signs of heart failure because of ischaemic heart disease. The patient might have unusual heart rhythm or cracles at the base of the lungs due to accumulated fluid.

Additionally, the doctor should check blood pressure and perform an ECG to detect ischemic changes. A Mid stream urine is also necessary for detection of microalbinumiria which is present in patients with diabetes mellitus. Type 2 diabetes is managed using oral antidiabetic drugs such as hypoglycemic agents like benzoic acid and sulfonylureas derivatives and antihyperglycemic agents like alpha-glucosidase inhibitors, thiazolidinediones and biguanides as well as a healthy diet and regular exercise .A healthy diet and exercise will enhance weight loss and reduce blood pressure in Mr. Smith who is already hypertensive and obese. In addition exercise will lower levels of blood glucose since exercising muscles uses more glucose and makes the body sensitive to insulin.

Nursing responsibilities

Since drugs used in management of type 2 diabetes mellitus have different modes of action, toxicities and adverse effect profiles it is the role of health care to help patients with the suitable use of medications to attain therapeutic goal. Type 2 diabetes is a progressive condition and the nurses have opportunities to lessen the risk of hypoglycemia through the continuum of diabetes care. Hypoglycemia occurs in majority of patients when they take too much antidiabetic medications, engaging in excessive exercise and skipping a meal. Therefore health care providers are supposed to monitor how patients take their medications and also recommend them on how to take their meals as well the amount of exercise to engage in.

Reference

Rios, S., (2008). Type 2 Diabetes Mellitus. New York: Elsiever.