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concept notebook glucose regulation
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Name Concept: Glucose Regulation Course: Activity: Faculty Facilitator: Date & Time of ELA in MST:
Client (virtual or living) background: Please tell us a little about the client you cared for today, either virtual or living. For living clients, no personal identifying information needed. The patient is a long-term resident at the facility who was admitted in the hospital for diabetic ketoacidosis. The patient was treated with insulin, fluids and electrolytes and was later transferred back to the nursing home. Related concepts (explain): 4 Related exemplars: For the concept of glucose regulation, nutrition is a related concept. Nutrition plays an important role in the regulation of glucose for this patient who has diabetes. If the patient’s nutrition is impaired, it could lead to episodes of hyperglycemia or hypoglycemia. Tissue integrity is a related concept to glucose regulation. An impairment in glucose regulation in the patient with diabetes can lead to poor wound healing, which is an impairment to tissue integrity. Sensory perception is a related concept to glucose regulation. An impairment in glucose regulation in the patient with diabetes can lead to vision changes and nerve damage, causing impairment to sensory perception. Patient education is another concept that relates to glucose regulation. A deficit in knowledge regarding disease management in the patient with diabetes can lead to impairment in glucose regulation. Type 2 Diabetes Mellitus Diabetic Ketoacidosis Insulin Resistance Overcorrection of hypoglycemia Insulin treatment
Related Assessments (explain): 5 Related Lab & Diagnostic Test (explain): 5 Related Nursing Interventions (explain): 5 Assess the patient’s skin by doing an examination. The assessment would allow the nurse to check if the patient’s skin is warm, cool, moist, clammy, or diaphoretic. This would let the nurse know that the patient is not exhibiting signs of hypoglycemia. Assess the patient for signs of hypoglycemia like weakness, shakiness, hunger, and palpitations. This would allow the nurse to determine if the patient is hypoglycemic. Assess the patient for signs of hyperglycemia like dehydration, feeling thirsty, fatigue, and nausea. This would allow the nurse to determine if the patient may be hyperglycemic. Assess the patient’s mental status to see if they are alert, confused, irritable, or unconscious. This would allow the nurse to recognize any signs of hypo or hyperglycemia. Assess the patient’s respiratory status to see if there are any changes in respirations, any odor in their breath, or if they have deep/rapid respirations. This will allow the nurse to recognize signs of hypo Blood glucose testing- It is important to check the patient’s blood sugar depending on the healthcare provider’s order. It could be anywhere from once a day or before meals and at bedtime. A normal range is between 70- 100mg/dL. When the blood glucose is too high or too low, the patient can be hypoglycemic or hyperglycemic. (Medline Plus, 2022). Glycosylated hemoglobin- This test is used for diagnostic screening and monitoring diabetes management. It is important to do this test to check the patient’s blood sugar within the last few months. A normal level is below 5.7% (Medline Plus, 2022). Lipid analysis- This test measures HDL, LDL, and triglyceride levels. Triglyceride levels can show how well a patient manages their blood sugar. A normal triglyceride level is less than 150 mg/dL, LDL level under 100 mg/dL, and HDL great than or equal to 60 mg/dL. High levels of HDL can also tell us that the patient may be resistant to The nurse will educate the patient on the importance of following a diet to keep the blood sugars under control. The patient should avoid processed grains, fried foods, canned foods, and sugary drinks to avoid hyperglycemia. The nurse will instruct the patient on how to check blood glucose levels in the morning and before meals to prevent hyperglycemic episodes. The nurse will educate the patient on how to safely administer insulin per orders to prevent injury or hypoglycemia. The nurse will inspect the patient’s feet every shift to check for redness, breaks in the skin, or any tissue injury. This will allow the nurse to monitor for any tissue injury because it could lead to an infection. The nurse will encourage the patient to exercise or increase physical activity. This will help the patient’s blood sugar to decrease and help control high levels of blood glucose.
throughout the day (Drugs 2022). Metformin- an antidiabetic that is used to help control the patient’s blood sugar (Drugs, 2022). Ammonium lactate 12%- lactic acid and ammonium hydroxide in a topical form that the patient is using for dry or flaky skin that may be caused by his diabetes and poor blood circulation (Drugs, 2022). Atorvastatin- a statin drug that helps to lower LDL and triglycerides in the blood. The patient has high cholesterol and has had a previous stroke; this medication lowers her cholesterol which can help prevent stroke or heart attack (Drugs, 2022). and medication regimen, the patient would be at risk for atherosclerosis and stroke because the arteries could harden and become narrow (Giddens, 2021). If the patient with diabetes is noncompliant with diet, the patient can have kidney problems due to damage to blood vessels in the kidneys from high blood sugars. The patient should be on a low sodium diet (Morales-Brown, 2022.
References Drugs.com. (n.d.). Prescription drug information, Interactions & Side effects. Drugs.com. Retrieved July 11, 2022, from http://www.drugs.com/ Giddens, J. (2021). Concepts for nursing practice (3rd ed.). Elsevier. in-text (Giddens, 2021) U.S. National Library of Medicine. (2022, July 11). Health information from the National Library of Medicine. MedlinePlus. Retrieved July 11, 2022, from https://medlineplus.gov/ Morales-Brown, L. (n.d.). Can people reverse kidney damage from diabetes? Medical News Today. Retrieved July 11, 2022, from https://www.medicalnewstoday.com/articles/how-to-reverse- kidney-damage-from-diabetes