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CNA603 Context Of Diabetes Mellitus

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Question:

In your essay you need to provide a case/practice example to highlight your key points to the essay. Consider a case if it presents an opportunity to increase awareness of a diabetes condition or issue. In your case highlight assessment findings, non­pharmacological or pharmacological interventions, evaluation and follow up. The case may suggest a discrepancy in best practice or demonstrates an existing or need for, a nursing or intervention or model for improve management.

Activity One
Identify a tool/instrument to measure health status? that would be helpful to you in the assessment of patients (or group of patients) that you review regularly (see Dunning page 50). Why did you identify this tool? (Think back to demographic and population indicators e.g. People with diabetes have a higher incidence of depression than the general public).

Activity Two
Identify a patient in your practice living with diabetes. Based on their presentation identify why and 
when (frequency) self­monitoring for BGL’s would aid in your assessment of the patient progress (see Dunning Chapter
Linking evidence with practice These questions are once again dependent on your patient scenario. For example the frequency of monitoring (Self­monitoring of BGL’s) is dependent on what type of diabetes the patient has and type of medications and type of insulin regimen (look at insulin profiles? action and duration). It comes down to what is the purpose and meaning of monitoring.

Patients’ Health Belief systems are paramount to diabetes care. Often the role of the nurse is one of a non­judgemental interpreter. Think back to skills that you have as nurses that allow you to work with patients with different belief systems from your own. This may lead to a patient case you would like to highlight in Assessment 2.This component of your essay allows you to focus on one of the conditions or issues that highlights the essays directive. A condition a known (in the literature and/or clinical experience) entity that you observe in your practice.

Examples may be:
Greater frequency of hypoglycaemic episodes in patients with renal impairment on a medical surgical unit Overcoming needle phobia in patients who have been directed to start insulin in primary care Prevalence of diabetes distress in patient living with type 2 diabetes in primary care Frequency of malnutrition and poor glycaemic control for patients treated for chronic wound infections in the community Frequency of undiagnosed patients with diabetes presenting in emergency departments Indication for GLP 1 analogues in patients living with type 2 diabetes in secondary and primary care Impact in motivational interviewing with Type 1 adolescent females Screening and monitoring for diabetes for patient living with schizophrenia in clozapine clinics.

Activity Three
In your practice conduct a medication review. Why is this important to your patients living with diabetes? What is a medication review? Linking evidence with practice
Medication of patients living with diabetes can be numerous and patients are at risk of polypharmacy and medication misadventures. As you complete the task utilise resources to assess the indication of the medication, mechanism of action potential interactions adverse drug interactions.

Issues on the other hand can be discrepancies in what is commonly been practiced at your workplace and through your research is not matching best practice evidence.Examples may be Insulin needle length recommended for insulin requiring patients Screening guidelines for GDM in remote community care Pre/intra/postsurgical care of the patient at risk for and living with diabetes Clinical recommendations for glycaemic control for suspected and confirmed CVA patients.Whether you identify a condition or issue, the point is that your main body of the essay will support your findings AND lead you to identify evidence for your observation and possible nursing interventions (remember nursing interven
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