Question

Aim of assessment The purpose for this case shudy essay is to enable students to produce an assignment using evidence-based information, to demonstrate their knowledge and understanding of dabetes and the nursing care required of these patients Conent should include a discussion on the pathophysiology of the condtion, analysis of the clinical maniestations, assessmentinvestigations for DKA treatment options based on national guidelines and implications for nusing practice Patient profile Bll Hughes is a 26 year-old man who lives with his wife. He has a history of type one diabetes and head and sleepy. His wife reports that he became very drowsy and confused after dinner. B has high blood sugar levels which were managed in the emergency department and he has been transfemed to the medical ward. You are the nurse assigned to care for Bil for the atemoon shft Following handover you go to introduce yourseltf to Bill you find he has tachypnoea and his skin is flushed and dry. You can smell his breath which has an acetone scent From his medical history you gather the following data Subjective data (provided by his wie) Was dagnosed with Type 1 diabetes melitus 2 years ago Is taking 48 U of insulin daily 12 U f reguiar insulin plus 20 U of sophane (NPH) belore breakfast, 8 U of regular insulin before dinner and B U of NPH at bedtme Has a history of fu-ke symptoms for 1 week with ing and poor appette Stopped taking insulin 2 days ago when he was unable to eat Objective data Physical examination Kussmaul breathing ВР9565.HR 93 bpm. Temp 35.6 °Cetus. Resp 22 bpm Acetone smel on breath Skin Sushed and dry GCS 14 Diagnostic studies Blood glucose level: 385 mmolt Blood HbA1c 9% ABGE pH 7.24, HCO3 18 mmoin USE's K4.1 mmolL Na 154 mmoit Urinalyss-ketonura Your assignment is to produce a written piece of work addressing the following areas Briefly explain the pathophysiology of Type 1 diabetes mellitus and the development f diabetic ketoac dosis (DKA) เก ยาย patent ih your answer denly the manifestations of DKA demonstrated by Bd and why these are occunting Outline the immediate nursing and medcal management Bill requires in the treatment of this episode of DKA. In your answer include the pharmacological management equired by a patient with Type 1 diabetes melitus MEDICATIONS Identity three medications that would be used in the treatment of MrHughes and outine the indication for use, mechanism of action, administraion method, side efects and nunsing care required for these medications There Guideines) Marks will be allocated as per SNM Assessment Rubric& the essay specific arteria below Submission instrucsons and the link is accessible under the "assessments tab Students should refer to the SM Presentation and Assignment Guide ECU APA Referencing Guide, and the SNM Marking Assessment Rubric Graphs, tables and fow charts to support the statistical data will not be accepted a word innit of 200 words ( 10% as per SM. Prese taton and Assgrment *

Answer 1

Type 1 diabetes is an autoimmune disease that causes the insulin-producing beta cells in the pancreas to be destroyed, preventing the body from being able to produce enough insulin to adequately regulate blood glucose levels.

Type 1 diabetes is caused by a fault in the body’s immune response in which the immune system mistakenly targets and kills beta cells, the cells in the pancreas responsible for producing insulin.

As more insulin-producing cells in the pancreas are killed off, the body can no longer control its blood glucose levels and the symptoms of diabetes begin to appear.

What causes the initial fault in the immune system is yet to be discovered, however, research suggests that the condition results from a combination of genetic predisposition with an environmental trigger.

Symptoms may include:

• Above average thirst
• Tiredness during the day
• Needing to pee regularly
• Unexplained weight loss
• Genital itchiness

Diabetic ketoacidosis (DKA) is a dangerous complication faced by people with diabetes which happens when the body starts running out of insulin.

DKA is most commonly associated with type 1 diabetes.

Clinical Manifestations:

• Vomiting
• Dehydration
• An unusual smell on the breath –sometimes compared to the smell of pear drops
• Deep laboured breathing (called Kussmaul breathing) or hyperventilation
• Rapid heartbeat
• Confusion and disorientation

Management:

Treatment of diabetic ketoacidosis involves administering intravenous fluids to correct dehydration and to replace any salts that may be lost from the body during ketoacidosis through passing excessive quantities of urine.

Insulin is also required to instantly suppress the ketone bodies that the body manufactures.

If an infection has been the underlying causes of DKA, you will be given a sick day plan to help you take the right amount of insulin. Close observation of the patient to quickly identify and prevent complications is essential until your his levels have stabilised.

Medications:

• Fluid replacement: fluids either by mouth or through a vein (intravenously) until the stage of normal hydration. The fluids will replace those you've lost through excessive urination, as well as help dilute the excess sugar in your blood.
• Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge, such as sodium, potassium and chloride. The absence of insulin can lower the level of several electrolytes in your blood. The electrolytes administered through a vein to help keep heart, muscles and nerve cells functioning normally.
• Insulin therapy. Insulin reverses the processes that cause diabetic ketoacidosis. In addition to fluids and electrolytes, administer insulin therapy usually through a vein. When blood sugar level falls to about 200 mg/dL (11.1 mmol/L) and blood is no longer acidic, it may be able to stop intravenous insulin therapy and resume normal subcutaneous insulin therapy.