Type One Diabetes
Question1. Pathophysiology of clinical manifestations of Type 1 diabetes
- High blood glucose level
High glucose level is followed by a considerable yet lethal lack in the proportion of secretion in insulin. As the malady gradually embarks on, the beta cells begin to destroy and become dysfunctional. This consequently causes a catastrophic decline in the functionality of the beta cells and insulin secretion. As the liver is unable to receive desired response from insulin, it increases its regular production of glucose. This is characterized by the denial to uptake glucose by the fat tissues and the insulin-intensive muscles. The cumulative effect of all the above-mentioned factors chiefly causes this abrupt rise in the blood glucose level.
1) Glucose in the urine
As it is illustrated in the section above, the presence of glucose in an erratic proportion in the blood is mainly caused by the sheer refusal of the insulin-intensive tissues to absorb the prevalent glucose. This excessive amount of glucose finds it channel by spilling itself in the urine that simultaneously increases the glucose level in the urine. This is the chief reason of the abrupt presence of glucose in the urine and that is sometimes used as indicator to discern the Diabetes Type 1.
2) Increased urination
The available amount of unused glucose is started channelling itself into the urine due to the denial of insulin-intensive tissues to uptake that. This subsequently hampers the balance of urination and discharge of the wastes. This eventually causes frequent urination of the respective patient in order to lead the disposal of wastes towards the desired proportion. This characteristic trait is also a reliable index to detect the respective malady.
3) Increased thirst
As it is well-established from the previous discussion that the excessive presence of glucose in the blood increases the frequency of urination since the body has to maintain the disposal of wastes in the prevalent proportion. The spilling of excessive glucose in the urine is a seminal medical phenomenon, which is called the osmotic diuresis. This phenomenon usually intends to restore the balance of urine secretion and the consecutive intake of water. This can be cited as the reason of increase in thirst as the physique needs to retain the balance of among the secretion of urine and intake of water.
4) Increased appetite
Erratic levels of insulin and glucose heralds the physique of the patient to collapse. This is due to the fact that the imperative ingredients that chiefly stabilizes the energy content begin to disintegrate and sediment in the bloods. Moreover, as the body is chiefly involved in extracting the excessive amount of glucose while inherently neglected the energy-stabilizing components to manifest. This can be expressed as the main reason of increased appetite as the physique is committed to restore the proportion of the components up to the desired extent.
5) Ketones in the urine and blood
The excessive and volatile proportion of insulin and glucose advocates a physical process that is usually known as ‘accelerated starvation’. The significant lack in energy stabilizers that is mainly derived from glucose alter the frequency of several processes chiefly associated with the absolute metabolism of the body. This leads the physique to overproduce the acidic ketone bodies and this phenomenon (which is considered as a medical emergency) is known as diabetic ketoacidosis. This erratic over presence of the ketone bodies is mainly the product of spilling of blood and urine. This can be cited as the chief reasons of the excessive presents of ketone in the blood.
6) Weight loss
This is very evident from the previous discussions that the improper distribution of the prevalent glucose in body might cause it to collapse. This condition is furthermore consolidated by the refusal of the glucose by the insulin-intensive muscles and tissues and the foundational proteins of the physique begin to disintegrate. This process of dissolution id further followed by the collapse of fat granules that is the principal cause of this considerable drop of body weight. This is how a considerable loss of weight can be a reliable indicator of Diabetes Type1.
Question 2.Nursingconsiderations related to the administration of NovoRapid
Prior to administration
1) Validate the medication order
The medication order is necessary to be verified in order to derive the legitimacy of appeals and instructions that are in scripted in the order. Furthermore, the prescribed doses of medicines administrated need to be approved and monitored in regular intervals. The employed staffs need to ensure the medicinal doses and attached instructions has been administrated after the affiliation of the relevant authority.
2) Have comprehensive knowledge of the medication
The nurses needs to develop a pedantic awareness about the sort and dose of insulin they are supposed to administrate. In this current context, the nurses need to ensure the sort of insulin is NovoRapid. Apart from that, the nurses should possess a philanthropic awareness about the mode of application and possible consequences for each of the cases respectively.
- Prepare the medication safely
The dosage of the prescribed medicines needs to be approved and numerously crosschecked by some relevant authority. In addition to that, in accordance with the impulses of the administration, the prescribed dosages need to be fixed for respective patients. Moreover, the syringes that need to be employed should be properly calibrated into units in order to make it desirable to use (de Goffau et al. 2015). A aspect of critical sincerity needs to be imparted in order to track the expiry and quality of the syringes.
- Assess the patient
The nurses need to assess the patients properly immediately after agreeing upon the prescribed amount of dosages of medicines and the attached precautions (trapping of air bubbles in the syringe tube is one of such problems that might lead the apparatus and the patient to collapse). On that note, the cardinal signs that may have the symbolic traits of the patient is desired to be traced by the nurses along with the amount of food and other amenities that the patient is supposed to take. Furthermore, the proportion of glucose present in the blood need to be known in order to enhance the caring capabilities of the nurses.
- Administer the medication safely
In order to ensure the proper administrative premises during the employment of insulin needs to be retained. Moreover, the cleanliness as well as the calibration of the syringe needs to maintain its precision in order to refrain the insulin from the leaking from its desired dosage. The generation of the air bubbles need to resisted since it prevents the entire amount of insulin to be injected and may cause rapid decline in the functionality of the dose. The region of employing the insulin needs to be cleaned a significant number of times in order prevent the chances of infection (Harding, Shaw, Peeters, Cartensen & Magliano, 2015). Proper selection of the veins is also a cardinal criterion that a nurse is must capable of since it facilitates the functionality and effectiveness of the insulin. On that note, a prominent and transparently visible vein needs to be chosen. In this course of application of insulin, the nurses may choose the gastrointestinal traces to employ the medicine. However, at any point of time, and specially in case of implementing the NovoRapid insulin, the prominent vein in the arm is the most favourable among all the options.
- Document nursing care
In this process of assessing a patient to providing the patient with the correct medicine with appropriate dose, all the relevant, significant (sometimes minute as well) needs to documented in a systematic and transparent manner in order to avoid ambiguity and other sort of mistakes that might transform itself into lethal. On that note, the significant details consisting of the details of the insulin, the level of glucose present in the blood, governing signs and behaviours of the patients need to address in the document systematically and chronologically. Furthermore, it is imperative for the nurse or other attendants to seek the affiliation and consent of the relevant authority such as doctors and the patient party. On that note, the credentials and the other associated nuances of the patient needs to keep confidential in prudent privacy.
- Ensure patient safety
Any kind of inconvenience from the patient’s side need to be addressed with care and critical sincerity. Furthermore, an in-depth understanding about the behavioural patterns of the patients must be developed in order to soothe the patient with proper means (Nimri et al. 2014).
- Monitor the patient
The glucose level in the blood, the appropriate dosage of the insulin and certain disorder and compulsive behaviours needs to be monitored and addressed to the relevant authority in the regular basis is an imperative criterion that a nurse or the appointed attendant needs to perform (Škrtić et al. 2014).
Question 3. The potential impact of type 1 diabetes on Briana and her family.
It is quite an exaggeration to admit that this is going to be very painful and stressful event for the family of Briana. This can cause development of anxiety and trauma within their family members and spread a significant impact on the afterlife the parents of Briana. Furthermore, the aftermath if this immediate psychological collapse might have severe and lasting effects.
Briana is afflicted with Diabetes Type1 and suffering from excessive urination, considerable weight loss and severe inconvenience. Apart from that, as it is impossible for her to perform her daily tasks with equal efficiency and capabilities, an overburden of tasks awaits her to be performed in the subsequent days.
Question 4. Adaptation of nursing care toaccommodateTom’s intellectual disability.
The lack of intellectual ability that restricts Tom to understand some of the terms associated with medicines needs to be recovered by employing a prudent and sincere attendant to take care of Briana. Furthermore, instructing Tom and Robyn with simpler tasks that facilitates the method of care taking might also work.