Question

I would like you to develop a detailed teaching plan with an emphasis on self-management. Be sure to include a collaborative suggestion for another professional who would be involved in the teaching plan. Inclusion of culture, client developmental level, and socioeconomic factors should be considered

A 44-year-old female patient with type two diabetes. Her most recent A1C was 11.2%. She has severe neuropathy in her feet and recently had had an eye exam which showed progressive retinopathy. Your plan should include teaching about potential complications related to diabetes.

Answer 1

Based on the above given details the patient had neuropathy in her feet that is diabetic foot and diabetic retinopathy.These are microvascular complication for long term diabetes.

• Retinopathy is caused due to high range of glucose level for a long term can cause cataract in the eyes that can leads to loss of vision.To avoid such type of eye problems keep your blood glucose level with in normal range by yearly eye checkup.
• Patient had a neuropathy that is caused by the nerve damage also called as diabetic neuropathy.Nerve damage common sign in type two diabetes when diagnosed.
• Patient had glycated hemoglobin level was high that is 11.2% normal range is 5.7-6.4%.
• Teaching regarding the complicationo to diabetes client that diabetes will show effect on cardiovascular system, such as stroke,coronary artery disease.Diabetes can also effect renal function.Signs of complication should be included in teaching plan because it is leading disease in the united states.

To manage these complication your should maintain normal glucose level by pharmacological and non pharmacological methods.

Pharmacological therapy:

• Metformin:It is generally prescribed for type 2 Diabetes to lower glucose production in the liver and enhance the body sensitivity to insulin.It should be taken after meal.Common side effects are nausea and diarrhea
• Sulfonylurea:These help to secrete mor insulin.Examples:Glyburide,Glipizide and glimepride.Side effects include weight gain and low blood sugar level.
• Meglinitides:It works by stimulating pancreas to secrete insulin and these have risk of weight gain.Examples include Repaglinide, nateglinide.
• Dipeptidyl peptidase 4 inhibitors: These medication help to control blood glucose level in body.Examples include Sitagliptin,saxagliptin and Linagliptin.Side effects include pancreatitis, joint pain.
• Glucagon like peptideAgonist: These drugs help to slow the digestion process an help to lower blood glucose level,Examples include Exenatide,Liraglutide and Semaglutide.Possible side effects include nausea and pancreatitis.
• Sodium glucose co transporter 2 inhibitor: These drugs prevent kidneys from reabsorbing glucose in to the blood.Examples include canagliflozin and Empagliflozin.Side effects include Urinary tract infection, ketoacidosis, vaginal infection.
• Insulin:These helps to lower blood glucose level in body.Insulin is interfere with digestion by oral route insulin should be injected.Examples like Insulin glargine,insulin detemir.

Non pharmacological therapy: To avoid or manage complications life style modification play a major role

• Take your medicine as prescribed that helps to manage blood glucose level
• Have a complete and clear eye examination yearly once that helps to prevent the progression of disease.
• People with diabetes have high risk of developing gum disease.Brush your teeth after eating meal and have regular checkup.
• Drink plenty of water that help to keep your skin hydrate and prevent from dryness,cuts,redness.
• Patient has neuropathy that is nerve damage so wear comfortable shoes and clean your wound properly and consult physician if any numbness or tingling sensation of your feet.
• Monitor blood pressure and maintain healthy weight.
• Monitor cholesterol level because high cholesterol level have high chance to develop macrovascular complications that is coronary artery disease.