BUS020C4143 Case Study on Diabetic Patient Level 5

Potential Medical And Nursing Management Approaches For A Hypertensive Diabetic Patient

The case discusses regarding a patient, Bill, who is 58 years old, diagnosed with type 2 diabetes. He is a chain smoker and have a heavy alcohol history as well. He is presently on increased dose of oral metformin of 1000mg since last 6 months. However, medicine has not been able to control his glucose level and hence, fluctuating since last 3 months. Increased blood pressure of 170 / 100 mmHg has also been noted which is currently asymptomatic (Dunning, 2013). Increased level of protein in urine, that is, 4+ and blood test reflected increased level of urea (25 mg / dl) and serum albumin (6.1 mg / dl). It also revealed the increased Glomerular Filtration rate.

Hypertension is extremely common comorbid condition in case of diabetes, affecting approximately 20 to 60% of the patients. In the patient with type 2 diabetes, hypertension is actually present as a part of metabolic syndrome of body getting resistant to insulin. It generally increases the incidence of stroke, Cardio Vascular Disease, retinopathy, neuropathy and other macro and micro vascular complications (Brown and et.al., 2017).

It is important to follow nursing and medical interventions that can help patient to bring the glucose level in blood under control. A nurse must be involved in assessing nursing interventions for the detection of high blood pressure. A collaborative nursing plan with the patient can help in promoting healthy lifestyle among the diabetic patients. Improving the management of blood pressure is an important aspect to be followed. The process of management generally starts with bringing change in lifestyle (Tricco and et.al., 2012). It can be in the form of weight reduction, regular exercising and allowing only moderate use of alcohol, sodium and protein. Other dietary approaches can also help patient in better management of hypertension. It includes fibre, calcium, saturated fat, hike in potassium, low intake of sodium and high consumption of fruits as well asvegetables can help in decreased blood pressure to a high extent (6 Hypertension Nursing Care Plans, 2013).

The combination of hypertension and diabetes can be deadly and together can increase the occurrence of stroke and heart attack. Having a family history of diabetes and blood pressure increase its presence in the next generation as well. In case of Bill, his mother died due to heart failure. Hence, prevalence of the same can be quite common in case of Bill as well. Hence, nursing approach must also be inclusive of checking laboratory data at regular intervals such as blood cell count, electrolytes, cardiac enzymes, urea nitrogen and CBC report. The nurse must also be aware of blood, wounds and secretions on the body of Bill. Since, he has been facing increased blood pressure, it is his duty to monitor and record BP at regular intervals from both arms and thighs for three times in a day (Lin and et.al., 2012). He / she must be knowing correct cuff size and accurate technique of measuring it.

It is also important for the nurse to observe moisture and colour of skin, temperature and capillary refill time. Dependent or general oedema must also be noted on regular basis. It is also important for a hypertensive diabetic patient to be kept in some calm and restful surroundings with minimal activity and noises so that an uninterrupted rest can be gathered by the patient. Monitoring medications and its control activity is also an important aspect of measuring the condition of Bill, as a nurseso that any side effect can be assessed at an initial stage only. In case of extreme non-comfortability of Bill, collaboration of medications in the form of analgesic and sedative drug can also be given (Hendriks and et.al., 2012). In such cases, the main purpose is maintaining blood pressure and glucose level at permissible range. Moreover, the intervention will help in extending medical advice to Bill and ensuring that it is effectively being met. It will also help in delivering better outcomes and functioning of the body (Hwang and et.al., 2012).

Conclusion

It can be concluded from the above report that adoption of healthy lifestyle measure can effectively help in controlling the medical condition of Bill. Hence, it is the duty of nurse to make him follow a particular diet plan, check laboratory data in regular intervals and keep an eye over changing body functions.

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