Evidence-Based Nursing Process For Patients With Hyperglycemia

Management

The term evidence signifies all sorts of medical documents and nursing signifies taking care. Thus, evidence-based nursing states a nursing procedure that is developed with various medical tests and their documents. Evidence-based nursing is a process that that enables the healthcare officials to care for their patients using technology and tests for the effective outcome of the patient.  It includes the design of care plans, understanding the medicine-related interactions and review of pathophysiology.  This study will decode the nursing process of a 12 years old patient who is affected by type1 diabetes (Ackley, Ladwig & Makic, 2014). Therefore the entire study will discuss the assessment process, the nursing process, the planning process, the implementation process and evaluation process to diagnose the patient. Moreover, the importance of the involvement of the child and family care centre will be analyzed based on C &FCC model.  An analysis of potential complication will also be discussed followed by a certain conclusion.

Assessment should be done properly by the nurse so that the diagnosis of the patient can be performed in the right manner. Sarah and her mother are from a remote community so during the assessment of the patients’ health language can be barrier so proper stress should be given to that. According to the case Sarah has pain in her abdomen so a complete pain assessment should be done to map the exact details of the pain.  The conversation must be done with Sarah so she could open up and can express her difficulties.  Since Sarah has hyperglycemia immediate blood test should be done for the proper assessment of the sugar level. Sarah is afraid of needles so test might be done by the use of electronic testing kits which has a negligible syringe that causes no distress (Butler & Grobbelaar, 2017). Sarah is at a tender age of twelve so she should be handled delicately with empathy.  Evidence-Based Nursing Process For Patients With Hyperglycemia Discussion Paper

The fluid assessment should also be done. Patient with Hyperglycaemia often has the tendency to be dehydrated. If the proper fluid assessment is not done then the amount of saline that should be given to the patient cannot be calculated.  Proper assessment of ketone acidosis should be done be done by the measurement of the ketone bodies in the blood. The Assessment is mainly performed by an advanced level glucose measuring device or urine strip can also be used to determine the ketone bodies present. Proper assessment is necessary or else it can cause the fatal result to Sarah. The Assessment of the Ketone body is important because the Proper dose of insulin should be set by the doctor according to the assessment of ketone body inside the blood level. It is very much necessary to explain the overall situation of Sarah to her mother in an understandable language (Chaska, 2001). This will calm the nerves of her mother. The pediatric assessment is also necessary so that the proper condition of the child should be comprehended.

ORDER A PLAGIARISM-FREE PAPER HERE

Assessment

The main problems diagnosed in the case of Sarah are the Hyperglycemias, low blood pressure level, abdominal pain and the high amount of the ketone bodies present in the body. The nursing diagnosis should be done according to the condition of Sarah.  Since Sarah has low blood pressure as suggested by the report immediate saline channel should be made so that proper fluid system can be restored in the body.  If proper Blood pressure is not maintained then the patient can collapse. The pain in the abdomen can be caused due to the problem of the catheter. The Pain should be investigated properly. If the pain is caused due to ketone body formation then medication or insulin should be provided immediately, if proper medication is given it will lower the abdomen pain which will reduce the stress of Sarah (Tucker, 2017).

Since Sarah is suffering from the hyperglycemias proper diet should be given as per diagnosis. The main reason of type1 diabetes is low secretion of insulin and improper diet. If a Child develops the habit of taking a high-calorie diet or imbalanced diet then she is at risk of developing hyperglycemia.  A balanced diet is one of the essential components to cure diabetes in the long run. The real problem is to make the child understand the situation and to implement the proper diet. Since diabetes can cause a problem in the excretory system so the kidney and the urinary system should also be checked (Cheng, 2011). Creatinine test is performed to diagnose the condition of the kidney. A routing diabetes monitoring test is also performed to see the fluctuating level of diabetes. Thorough monitoring helps to set the insulin level which results in a proper diagnosis of Sarah.

Planning should be done keeping in mine Specific, measurable, achievable, realistic goal in a particular time frame.

Specific goals- There should be some long-term and some short-term specific goals set so that improvement can be made to the overall holistic health of Sarah. At first, the present situation analysis should be done and a short-term plan should be made to the patient can have some relief. Like proper medication and fluid for fluid maintenance. Insulin dose should be set so that the sugar level reduce instantly (Chowdhury, 2017). These goals are realistic and achievable in all sense.

The long-term specific planning should be done so that the disease can be cured. These planning should be done by discussing with Sarah and her mother. They should be awarded of the proper monitoring of the glucose level by the device. The technique should be taught and demonstrated to them (Sutton, Liao, Jimmieson & Restubog, 2011).  Proper diet chart should be done so that she can receive all the nutrients which are necessary for the body and will also maintain the glucose level of the body.

Nursing Diagnosis

After going out of the hospital the blood sugar level should be monitored and documented on a regular basis for three months.

The proper diet, insulin intake, and monitoring should be done regularly twice a day for three months. After that analysis should be made on the records of the test reports. Further treatment should be done according to the condition.  Besides that, another important factor is the performing daily exercise which is essential for patients with high blood sugar. Regular exercises that may be jogging is essential twice daily for at least for half an hour (Clarke & Forster, 2015).

The implementation of this action plan should be done by Sarah with help from her mother. Implementation is the most important step. Evidence-Based Nursing Process For Patients With Hyperglycemia Discussion Paper After performing the exercises and taking healthy diet it is expected that blood sugar level will slowly get into the normal figure.  During Implementation, it should be remembered that during use of insulin the measurement of the blood glucose level is essential (Conron & Denton, 2016).

Critical evaluation of the action plan and its implementation is necessary. The insulin level which is set for the patient during the stay in the hospital may not be needed after a few weeks due to maintaining a proper diet and physical exercise.   The insulin level should be considered and the condition of the patient should be evaluated properly.  The evaluation process must be done by proper monitoring and documentation of the blood sugar level and the creatinine level so that it could be inferred that the level of insulin is working properly for the patient or not. Critical adjustment to the diet or insulin level of the patient should be done after evaluation of the health of the patient (Evans & Lang, 2004).

The task of the members of the multidisciplinary team is to take care of each patient comes to the healthcare organization.  The members of the interdisciplinary team are the practitioner nurse, the doctor of podiatric medicine, the anesthetist nurse, the registered dietician, the therapist, the clinical psychologists and the pharmacist (Schoenly & Knox, 2013).  In this case study, as per C&FCC model the child specialist doctor, the registered dietician, and clinical psychologist are the influential members of the child management care.  The child specialist would take regular check-up of the child’s blood sugar level and blood pressure level (Grossman, 2011).  The dietician would check the medical reports regularly and would advise the types of foods that can be hygienic for the patient.

Planning

As per the case study, the child health care organization must advise Sarah’s parents to take effective care of Sarah’s medication, food habits and wounds.  They would be advised not to give Sarah sweet food and consult with a doctor soon if any unusual urinal problem is identified (Potter, 2003).  Moreover, the parents must care about any kind of physical wound of Sarah. Because bleeding from any kind of wound can be dangerous for Sarah’s health.  They must keep Sarah well away from any kind of alcohol consumption and alcohol consumption promotes type1 diabetes.  The food timing must be fixed for Sarah. She must be given breakfast, lunch, and dinner in a specific time and as early as possible (Mazurek Melnyk, 2007). Early to bed is must for Sarah.

ORDER  NOW HERE

The discharge plan and consideration from child health care in the remote community are:

• Evaluation: The health of the patient must be evaluated by any specialist if any further issue arises.
• Discussion: discussion would be done with the parents of the patient. As per this case study, the child health care staffs must discuss the future tasks with Sarah’s parents.
• Planning: The child health care then advice the patient either to go home or refer to any better place for further treatment.
• Determining:  the caregivers of the child healthcare determines to whatever any assistance is required
• Referrals:  The caregivers of the child care organization refer to any healthcare agency or care organization of the particular community of the patient so that the patient can be assured about the treatment process (Mazurek Melnyk, 2007).
• Arranging:  The healthcare staffs then advices the patients’ family for any further test. Here, Sarah must be advised to take insulin and a regular blood and urinal test.

Conclusion

The study has discussed several aspects of evidence-based nursing which includes several medical checkups and medical advice. In this study, a blood test is done as soon as Sarah was admitted to the child care organization.  This helps them to measure the blood sugar level of Sarah. Then insulin was injected for quick treatment. Thereon, the management assessed the symptoms, diagnose the symptoms, plans for Medicare, implemented the Medicare plans and then evaluated the Medicare process.  Therefore, the study analyzed the involvement of the disciplinary team, a potential comorbid compilation which includes several medical advice before discharging Sarah. Thus, evidence-based nursing is the most effective way to treat critical disease accordingly.

References

Ackley, B., Ladwig, G., & Makic, M. Nursing diagnosis handbook.

Butler, D., & Grobbelaar, A. (2017). Facial palsy: what can the multidisciplinary team do?. Journal Of Multidisciplinary Healthcare, Volume 10, 377-381. doi: 10.2147/jmdh.s125574

Chaska, N. (2001). The nursing profession. Thousand Oaks: Sage Publications.

Cheng, H. (2011). Perimenstrual Syndrome: Nursing Diagnosis Among Taiwanese Nursing Students. International Journal Of Nursing Terminologies And Classifications, 22(3), 110-116. doi: 10.1111/j.1744-618x.2011.01185.x

Chowdhury, A. (2017). Toward Better Support of Healthcare Professionals Advancing Multidisciplinary Team Mentoring. Diversity & Equality In Health And Care, 14(2). doi: 10.21767/2049-5471.1000e23

Clarke, D., & Forster, A. (2015). Improving post-stroke recovery: the role of the multidisciplinary health care team. Journal Of Multidisciplinary Healthcare, 433. doi: 10.2147/jmdh.s68764

Conron, M., & Denton, E. (2016). Improving outcomes in lung cancer: the value of the multidisciplinary health care team. Journal Of Multidisciplinary Healthcare, 137. doi: 10.2147/jmdh.s76762

Evans, L., & Lang, N. (2004). Academic nursing practice. New York, NY: Springer Pub.

Grossman. (2011). Management of type 2 diabetes mellitus in the elderly: role of the pharmacist in a multidisciplinary health care team. Journal Of Multidisciplinary Healthcare, 149. doi: 10.2147/jmdh.s21111

Mazurek Melnyk, B. (2007). Evidence to Guide Medication and Patient Safety Practices in Hospitals.  Evidence-Based Nursing Process For Patients With Hyperglycemia Discussion Paper