Case management diabetes

The risk factors for developing diabetes type 2 include family history of diabetes, obesity, history of gestational diabetes among others (Skyler et al. Diabetes is characterized by three common symptoms polyuria, polydipsia and polyphagia (Skyler et al. Complications of the disease can be devastating and include peripheral neuropathy, diabetic retinopathy among others. Pathophysiology and Causes of The Patient’s Post-Operative Wound Status The occurrence of diabetes type 2 is in Gina’s case is potentiated by risk factors such as obesity which increases the peripheral tissue resistance to insulin leading to increased accumulation of blood glucose and worsening of the glucose control and regulation (Skyler et al. Increased blood glucose levels in the patient coupled with dyslipidemia due to obesity and worsening insulin resistance foster the progressive development of peripheral vascular disease in the patient.

Deprivation of oxygen and nutrients to the tissue results in reduced healing of the surgical site wound causing tissue necrosis which is characterized by dehiscence along with the surgical site (Okonkwo & DiPietro, 2017). Gina also presents with poor medication uptake where she reports forgetting her medications as well as seeing no reason to take all her medications. Poor management of diabetes in Gina. s case is characterized by hyperglycemia (she has a reported glucose level of 12. 6 mmol/L. The rationale of managing the wound is to prevent further infections of the wound as its already open and with diminished immune system activation and hyperglycemia, the risks of further infections in the hospital environment are likely. Wound management also prevents the occurrence of complications related to infection such as septicemia which can be life-threatening, the spread of infection to other tissues such as bone causing osteomyelitis and development of gangrenous foot (Shanmugam et al.

Wound dehiscence is associated with increased risk of mortality, long hospital admission and psychological torture for the patients experiencing the occurrence of wound dehiscence (Gili-Ortiz, González-Guerrero, Béjar-Prado, Ramírez-Ramírez & López-Méndez, 2015). Nursing interventions The priority patient need in the case study is to manage the hyperglycemia which is evidenced by the measurement of 12mmol/L as per the blood glucose levels for Gina. The immediate nursing intervention in the management of the hyperglycaemic state will be to obtain additional patient information on her medication use and uptake. Education for Gina on lifestyle modification is critical as she is already obese hence at risk of developing the cardiovascular commodities associated with obesity and hyperlipemia. The health education ought to involve teach-back sessions with the patient on the correct way for insulin self-injection.

Lack of adequate self-care skills such as insulin self-injection could be a contributory factor for Gina's refusal to take all the medications prescribed. According to Atalla, (2016), the effectiveness of insulin self-injection improved following the nursing intervention and patient's education sessions which also improved the patient's outcomes of care and blood glucose control and regulation. Wound care also forms part of the priority care needs of the patient. Complications in diabetes such as peripheral vascular disease reduce the patients wound healing processes and increase their risks of developing diabetic ulcers. Other complications such as the development of ketoacidosis can be fatal due to increased glucose levels in the blood. The complexity of diabetes management hence requires a collaborative care approach involving various members of the interdisciplinary team members to ensure a holistic approach to patient care.