Understanding Type 1 Diabetes – Diabetes Mellitus Example

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"Understanding  Type 1  Diabetes" is a perfect example of a paper on diabetes mellitus. My report will analyze case scenario 1. This case scenario revolves around a patient diagnosed with Type 1 Diabetes. The patient had tried to treat a persistent headache using Panadol Osteo tablets. The Panadol Osteo tablets had an unknown quantity of bourbon and the patient had been ingesting them for about two and a half hours. The patient had a history of struggling to adjust to his diagnosis of diabetes where he missed taking his dose of insulin on several occasions.

The Emergency RMO seeks to establish the level, effect, and need for treating Type 1 Diabetic patients who have ingested Panadol Osteo tablets. I think the key issues in this case scenario include the ‘ guidelines for the management of paracetamol overdose’ Nomogram, managing Type 1 Diabetes and the effects of stress, and missing the insulin dose on Type 1 Diabetic patients. To understand this case better, I will need additional information about Type 1 Diabetes, Panadol Osteo tablets, and the regular medication for Type 1 Diabetes, NovoRapid Lantus. The questions that will boost my understanding include: What are the side effects of NovoRapid Lantus in managing Type 1 Diabetes? Does continued stress inform of strained relationships, economic hardships, academic failure, and lack of established family comfort have a significant effect on the management of Type 1 Diabetes? Do age and gender have any effect in managing Type 1 Diabetes? What does managing Type 1 Diabetes entail? What are the effects of missing the insulin dose for managing Type 1 Diabetes? What is the biology and effects of Panadol Osteo tablets on Type 1 Diabetic patients? What are the guidelines for managing paracetamol overdose’ Nomogram? What are the recommended Paracetamol levels for Type 1 Diabetic patients? What are the role and an acceptable quantity of bourbon in Panadol Osteo tablets? What do withdrawal and teary eyes that cannot make eye contact suggest for Type 1 Diabetic patients? The answers to these questions will help me to understand the main cause of the persistent headache that the patient was trying to treat with the Panadol Osteo tablets.

They will also help me to establish the actual condition of the patient based on the symptoms.

The knowledge of managing Type 1 Diabetes will help me to understand the potential risks that the patient may experience after missing the insulin dose and taking the Panadol Osteo tablets. This will relate with the knowledge on the effects of Panadol Osteo tablets on Type 1 Diabetic patients. Moreover, I will derive the factors that jeopardize the management of Type 1 Diabetes. The answers to these questions will equally enable me to establish whether the intravenous therapy Normal Saline will be effective for the patient. Type 1 Diabetes refers to a condition where the pancreas stops making insulin thus limiting the capacity of the body to convert glucose into energy (Diabetes Australia 2008).

This condition begins in childhood or adolescence. Clinically, Type 1 Diabetes is manageable through daily insulin injections (Diabetes Australia 2008). Failure to follow the management guidelines may lead to serious complications, Hypoglycaemia. Indeed, missing the insulin dose, stress, and another disease can raise blood glucose levels and lead to Hypoglycaemia (Diabetes Australia 2013). Consequently, Hypoglycaemia leads to dehydration, thirst, tiredness, and persistent headaches as seen in Jeremy’ s case (Diabetes Australia 2013).

Moreover, Type 1 Diabetes leads to eye damage that is evident in the scenario (Mayo Clinic 2014). Panadol Osteo is a recommended medication for persistent pain like headaches and tension headaches. However, only doctors can prescribe Panadol Osteo. Patients with liver or kidney disease should not take Panadol Osteo. An overdose of this drug requires urgent medical attention. The management of paracetamol overdose’ Nomogram depends on paracetamol levels, patient’ s history, and time of presenting the patient (Daly 2008, p. 300). Intravenous therapy Normal Saline over 4 hours and N-acetyl cysteine (NAC) intravenous infusion guarantees complete detoxification for patients presented within 8  hours of paracetamol ingestion (Daly 2008, p.

300). This raises the question as to what necessitates N-acetyl cysteine (NAC) intravenous infusion. This question is relevant to my study because it defines the current and next stage of managing Jeremy’ s case. The theoretical principle of life span and development relates to the fact that development takes place throughout the human lifespan. Life-span developmental psychology analyses the consistency and change in human behavior using psychosocial developmental theories. Erickson’ s psychosocial development theory classifies development into eight distinct stages.

In the Identity vs. Role Confusion stage, adolescents seek to navigate their identity as seen in Jeremy’ s case where he struggles to adjust to his diagnosis of diabetes (McLeod 2013). In the Intimacy vs. Isolation stage, adolescents explore intimate relationships as seen in Jeremy’ s case where he suffers from a relationship breakdown (McLeod 2013). This case presents identifiable health-promoting behaviors where Jeremy misses his dose of insulin when out socializing. This risk behavior may affect Jeremy’ s health status since it may lead to advanced Hypoglycaemia or death (Mayo Clinic 2014).

Notably, the identified health behavior affects the pathophysiology underlying the clinical presentation because it may limit the success of managing the paracetamol overdose if Jeremy continues to miss prescribed medications. The issues raised in this case scenario include how to manage Type 1 diabetes, the risk of failing to follow management guidelines, the risk of taking overdose medications, risk of taking self-prescribed drugs and failing to accept the diagnosis, how to manage paracetamol overdose’ Nomogram, and the effect of time in presenting a patient for urgent medication.

I can support this client by advising him to avoid self-prescribed drugs, follow the management guidelines for any disease, and accept his diagnosis of Type 1 diabetes. As a registered nurse, I will rely on the national competency standards set by the Australian Nursing and Midwifery Accreditation Council (ANMAC) (Nursing and Midwifery Board of Australia 2010, p. 1). These standards help to help nurses to offer safe and competent care (Nursing and Midwifery Board of Australia 2010, p. 1). Considering the paracetamol levels, patient history, the required nursing interventions, clinical skills and procedures required, and risks involved in managing a paracetamol overdose’ Nomogram for a Type 1 diabetic patient, I think the patient is more safe continuing with care while at the Emergency Department.

To provide holistic and person-centered care for the patient, I will apply the professional practice, provision and coordination of care, provision and coordination of care, and critical thinking and analysis competency standards (Nursing and Midwifery Board of Australia 2010, p. 2). To achieve this I propose two nursing management strategies that would enable nurses to work effectively.

I think relying on the established process and required skills would provide optimal and holistic nursing care for the client. My nursing management connects to the identified pathophysiological processes that advocate for the completion of the paracetamol level review by the Emergency RMO, the intravenous therapy Normal Saline, the Paracetamol level review by the doctor, and the review by the psychiatric team. In continuing care for the client, I will consider on-going safety concerns that include the patient’ s behavior, patient’ s medical history, and the risk of a paracetamol overdose on Type 1 diabetes. This case study has taught me the detrimental effects of lifestyle choices and risk behavior on the patient’ s future.

The patient’ s choice of missing insulin dose, taking overdose medications of self-prescribed drugs, and disregarding his diagnosis may lead to Hypoglycaemia, unconsciousness, or death in extreme cases.  

References

Daly, F, Fountain, J, Murray, L, Graudins, A, & Buckley, N 2008, ‘Guidelines for the management of paracetamol poisoning in Australia and New Zealand — explanation and elaboration,’ The Medical Journal of Australia, vol. 188, no. 5, pp. 296-302.

Diabetes Australia 2008, Type 1 Diabetes, retrieved 27 August 2014, < http://www.diabetesaustralia.com.au/Understanding-Diabetes/What-is-Diabetes/Type-1-Diabetes/>

Diabetes Australia 2013, Hypoglycaemia, retrieved 27 August 2014, < http://www.diabetesaustralia.com.au/Understanding-Diabetes/What-is-Diabetes/Hypoglycaemia/>

Mayo Clinic 2014, Type 1 diabetes, retrieved 27 August 2014, < http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/complications/con-20019573>

McLeod, S 2013, Erik Erikson, retrieved 27 August 2014, < http://www.simplypsychology.org/Erik-Erikson.html>

Nursing and Midwifery Board of Australia 2010, National competency standards for the registered nurse, retrieved 27 August 2014, < file:///C:/Users/Acer/Downloads/Nursing-and-Midwifery-Board---Standard---National-competency-standards-for-the-registered-nurse.PDF>

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