Question

Story: Stephen Smith is a 58-year-old male who has type 2 diabetes mellitus, (diagnosed 5 years ago) hypertension, and hyperlipidemia .His body weight is 115 kg. His glucose was 350, Hemoglobin A1C is 13, and his last cholesterol is 350. He is currently taking metformin 500 mg bid "sometimes" but he knows nothing about how the medicine works and not sure he even needs it. He was also prescribed regular insulin on a sliding scale, but stopped taking it 5 months ago because his stomach was getting sore from the injections and he felt “just fine” without it. His blood pressure today is 188/92 mm Hg. When he was asked about his diabetes, he doesn't understand what it is or what the fuss is all about. He was unable to name any long-term complications. He has not spoken in-depth about his disease with a healthcare professional for several years, and he does not see a physician on a regular basis. He is diagnosed as having uncontrolled diabetes type II.

You are Mr. Smith's  nurse, and you recognize there are many areas where patient education is needed. Identify one of these areas where Mr. Smith needs education. Then:

1. Create a dialog that you would have with the patient. Begin your plan with-"Mr. Smith, I am your nurse and  I have noticed that__________and would like to educate about it.
2. Must include your reference.

Answer 1

Mr. Smith, I am your nurse and I have noticed that you have uncontrolled type 2 diabeties mellitus, hypertension and hyperlipidemia and would like to educate about them.

Type 2 diabeties mellitus: It is a chronic condition that affects the way the body processes blood sugar ( glucose ).

The body may either doesn't produce enough insulin or resist it resists insulin.

It is treatable my medical professional on regular lab investigation, medications or insulin therapy and regular follow up of treatment.

Treatment includes self care ( diet, exercise, medications and insulin therapy.)

Lifestyle modifications includes physical exercise, Quitting smoking, weight loss, diabetic diet intake along with dietary fiber helps in lowering blood cholesterol level, regular medications and insulin therapy. Along with regular health check-up.

Golden rule for diabetes - No feasting , No fasting

- Achieve and maintain desirable body weight

- Regular exercise helps to improve blood glucose and lipid levels.

- Fenugreek helps in the management of diabetes by lowering blood glucose levels. Recommended dosage 6g/ day.

- Artificial sweeteners like sucralose are preferable than others and it can be used in moderation.

" Learn to manage your Diabetes rather than allowing it to manage your life".

Hypertension : A Condition in which the force of the blood against the artery walls is too high.

Usually hypertension is defined as blood pressure 140/ 90 and severe if it is 180/ 120.

High blood pressure often has no symptoms if left untreated it may lead to heart disease and stroke.

By eating a healthier diet with less salt, exercising regularly and taking regularly anti - hypertensive drugs. With regular follow up with medical physician.

Hyperlipidemia:

It is condition in which there are high levels of fat particles deposits in the blood.

Example for fat deposits ( lipids ) include cholesterol and triglycerides. These substances deposit in the walls of blood vessels and restrict the blood flow. This creates the risk of developing heart attack and stroke.

It will not cause any symptoms can only diagnosed by routine blood test. So it is recommended to have blood test for every 5 years for an adult.

Regular exercise, treatment follow up, Low fat diet, weight loss can prevent the risk of heart attack and stroke.