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Diabetes mellitus (DM) is a multisystem disease with both biochemical and anatomical consequences. It is a chronic disease of carbohydrate, fat, and protein metabolism caused by the lack of insulin. In type 1 diabetes, insulin is functionally absent because of the destruction of the beta cells of the pancreas. Type 1 DM occurs most commonly in juveniles but can occur in adults, especially in those in their late 30s and early 40s. Unlike people with type 2 DM, those with type 1 DM generally are not obese and may present initially with diabetic ketoacidosis (DKA).
In this particular case, Yusuf, a 12-year-old boy was diagnosed with type 1 diabetes after exhibiting some of the following symptoms: weight loss, excessive urinating, and an unquenchable thirst. More recently, Yusuf was again admitted to the hospital after complaining of nausea, vomiting and intense thirst. The doctor observed that he appeared confused and was breathing with difficulty. All of these symptoms are effects of metabolic events within young Yusuf's body, which were playing havoc with his organ systems.
Thirst is due to the hyperosmolar state and dehydration. The weight loss with a normal or increased appetite is due to depletion of water and a catabolic state with reduced glycogen, proteins, and triglycerides. This may be due to muscle wasting from the catabolic state of insulin deficiency, hypovolemia, and hypokalemia. Nausea, abdominal discomfort...
Acute fatty liver may lead to distention of the hepatic capsule, causing right upper quadrant pain. Persistent abdominal pain may indicate another serious abdominal cause of DKA, eg, pancreatitis. Chronic gastrointestinal symptoms in the later stage of diabetes are due to visceral autonomic neuropathy. Symptoms at the time of the first clinical presentation usually can be traced back several days to several weeks; however, beta cell destruction may have started months, or even years, before the onset of clinical symptoms.
All type 1 DM patients should learn how to self-monitor and record their blood glucose levels with home analyzers and adjust their insulin doses accordingly.
Insulin-dependent patients ideally should test their plasma glucose daily before meals, in some cases 1-2 hours after meals, and at bedtime. In practice, however, patients often obtain 2-4 measurements each day, including fasting levels and at various other times, including preprandially and at bedtime.
Instruct patients with type 1 DM in the method of testing for urine ketones using commercially available reagent strips. Also, advise patients to test for urine ketones whenever they develop symptoms of a cold, flu, or other intercurrent illness; nausea, vomiting, or abdominal pain; polyuria; or if they find an unexpectedly high plasma glucose level…
Risk Factors for Mr. Jablonski CHD: Mr. J is a classic case for a potential Coronary Heart Disease (CHD) patient. His history shows several risk factors, which can be divided into uncontrollable and controllable risk factors. The uncontrollable factors are his age (48 years old) -- older people are more susceptible to CHD, his sex (male) -- men are more likely to get CHD, and his family history. The controllable risk
Nursing is one of those professions that provides the opportunity not only to further oneself on a professional level, but also on a personal level. It provides the individual with the opportunity to connect with others by providing a platform of health care, while also providing a helping hand that promotes not only short-term healing, but also long-term well-being. This makes nursing one of the most caring professions, as it
Nursing Theory "Discuss several aspects of professional communication as it relates to the use of language in terms of form (e.g., clarity, accuracy) and content (culture and/or ethics)." (Question, 2014, p1). Communication is the reciprocal process where messages are received and sent between two or more individuals. Communication involves exchange of ideas, or opinion, which could be in form oral or written form. On the other hand, communication involves a series of
Nursing Theorists The objective of this study is to identify, describe, research and apply the concepts of a specific nursing theorist and compare and contrast it to other nursing theorists. As well, this work in writing will provide examples of clinical situations from personal nursing practice that illustrates the concepts and application of the framework and will describe these in ways that serve to illustrate and clarify the use of the
Nurse Reflection Experience Reflection Using John's Model of Reflection Description The event was relatively straightforward, though ultimately still profound, with a standard healthcare office (a nurse's office, specifically) providing the setting for the interview. Girls aged about thirteen years old were the subjects of the interviews in this study; they arrived with a parent (almost exclusively the mother), and were interviewed privately so as to obtain greater levels of honesty in the responses.
Behavioral approaches alone or combined cognitive behavior therapy may be used. Behavioral techniques might include simply not buying trigger foods or avoiding certain shops; that is, building up new habits to replace existing ones. Another example would be modifying eating behavior such as eating in the same place each day, or concentrating solely on eating and not watching television at the same time (Fiona Mantle, 2003)." It is worth noting