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 â€˜HIâ€™ 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 carerâ€™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. The required word counts for each question is 30-70.
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 Georgeâ€™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