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Case study 1 George is a 51-year-old Aboriginal and Torres Strait…

Case study 1

George is a 51-year-old Aboriginal and Torres Strait Islander (ATSI) man. He recently had an annual health check by his general practitioner (GP). At that visit several issues were identified. George is unstable with his diabetes due to his poor diet control and often has blood glucose readings of ‘HI’ as well as experiencing hypoglycaemic episodes. His kidney function is slowly deteriorating; he has high blood pressure, has gained some weight and has raised cholesterol. George lives with his wife in their own home with their three children. They both receive Centrelink payments: he gets the disability pension and she receives a carer’s payment since he had a stroke 2 years ago. George says a couple of his extended family members are on dialysis.
George is prescribed perindopril and Lecarnidipine, Furosemide, Atorvastatin, Metformin, Sodium Bicarbonate, and Vitamin D. He does not know the names of his tablets and is vague about why they were prescribed. He wonders if he really needs to keep taking them and he is not sure if they are doing him any good. George was referred to your clinic because his kidney function has deteriorated, and the blood pressure is still high.
On examination, the following information was derived. Weight = 104cm, Height = 168cm, There has been a weight gain of 10 kg in the past 1 year. Blood Pressure= 153/93mm of Hg, HR = 92/mt, respiratory rate = 22 per minute with oxygen saturations of 96% on room air. George is an Ex-smoker. Blood test results are as follows: Hb1Ac = 7.8, eGFR= 27ml/mt, S. Creatinine = 237micromol/L

Read the case study below and address the following questions.

1.1. Review literature and list down 3 (three) complications of Diabetes Mellitus. Briefly explain the pathophysiology of how these complications occur.
1.2. Based on the case study, which of the complications does George have? How do these complications affect George’s activities of daily living and psychosocial health? (100 + / – 20 words)
1.3. List 2 (two) nursing interventions for George and present a comprehensive discussion and justification of the interventions. (Students are encouraged to review the literature relevant to this case and link their nursing interventions to the findings of the literature review







2)   Case study 2

You are working as an enrolled nurse at district health hospital. The senior nurse educator of the hospital introduces you to Mr Teddy, an Aboriginal client, diagnosed with type 2 Diabetes Mellitus. He is an alcoholic and a smoker. He does not practice healthy eating habits. You are assigned to provide health education to Mr Teddy about his conditions, about the medications and the tests which he has to undergo.

Answer the following questions as prepare  for health education.

2.1. What is the normal blood glucose level (BGL) before meals? Why do we check the fasting blood sugar?
2.2. With regard to diet, what general suggestions can you make to assist Mr Teddy in controlling his BGL?
2.3. What changes or modifications could you suggest to Mr Teddy to manage Diabetes?
2.4. Identify the client’s care as per priority and explain the management of diabetes.
2.5. What is the role of Aboriginal and Torres Strait Islander Nurses and Midwives in the management of Diabetes while maintaining the cultural safety?






3)   Case study 3

Mr John is a 60-year-old man with a four-year history of type 2 Diabetes Mellitus. He is an obese person with poorly controlled Diabetes. Despite his best efforts, he could not alter his diet and activity levels. He comes to you and seeks advice. His general practitioner advised him recently to take extra care of his feet. He asks you the importance of taking care of the feet.

Answer the following questions

3.1. What is a Diabetic foot?
3.2. Explain glycaemic control and how to control weight gain by maintaining optimal nutrition?
3.3. Explain blood glucose monitoring and the importance of taking oral hypoglycaemic drugs