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NUR3005 Nursing For Syndromes, And Diseases

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  • Course Code: NUR3005
  • University: Monash University
  • Country: Australia

Questions:

Topic 1

Chronic diseases are the leading cause of fatal burden of disease in most age and sex groups and the leading cause of illness, disability and death in Australia (AIHW, 2015)
 
Discuss the role of the nurse in delivering interprofessional person-centred care which addresses illness prevention, promotes self-management and is responsive to changing patient needs. Your essay should focus on one patient group.

Instructions/ Teachers recommendation

Select one chronic disease eg: stroke, diabetes ,Osteoarthritis, cancer etc
 
Your introduction should briefly describe your chosen topic, why it is important and set out for the reader what you plan to cover in your paper. Set the context of the chronic illness or disease by briefly describing the pathophysiology and how the signs and symptoms impacts a person’s life. You need to define your terms and describe each of your major points to establish and develop your argument. Your discussion should draw from key experts and current evidence. Headings will help focus your discussion. Your conclusion should summarise your major points and make recommendations drawn from your discussion. It is expected your paper will be well supported with recent (< 7 years) literature. 
 
you must integrate the role of the nurse throughout your work and ensure that you cover illness prevention, promotion of self-management and responsiveness to changing patient needs. You also need to include a brief description of the pathophysiology of the condition you are covering.
 
In choosing your patient group you need to be able to address all components of the topic and the instructions with your chosen condition. Have a think about how you would do this and what information you would include in your discussion on pathophysiology.
 
If you are able to adequately cover all of the components of the instructions into your assignment then you will be okay.
 
your fact sheets are from official government organisations such as Diabetes Australia, Epilepsy Foundation, heart and stroke foundation Australia etc. If so, then they are publications and the APA 6th edition does provide guidelines for the citing of these sources.
 
It would be wise to have an understanding of the National Strategic Framework for Chronic Conditions as there are for sure specific areas that relate to the selected topic that could be used to plan your essay, especially objective 2. 
 
You need to briefly define terms that you use related to the National Strategic Framework for Chronic Conditions as they would be addressing the foci of this essay. You need to discuss the primary care nurse role of a group of people who have a chronic illness.The focus of this assignment is on the management of chronic illness in the community.
 
Chronic conditions have complex and multiple causes; are generally long-term and persistent, and often lead to a gradual deterioration of health and loss of independence. While not usually immediately life threatening, chronic complications are responsible for most illness and death associated with the chronic condition.
 
Illness prevention in this assignment needs you to discuss how to  prevent chronic complications and not prevention of the chronic diseases. In topic one you are required to discuss the role of the nurse in reducing the chronic complications and promoting chronic complications management

 

Answer:

The essay brings about the discussion on the nursing assignment through an analysis of the chronic illness or disease and the impact on the individuals or patients throughout their life. Chronic illness or diseases are the cause behind the deaths of individuals at an early age. The term chronic refers to those diseases or health problems which lasts for more than 3 months. These diseases have severe impacts on the health of an individual, which require diagnosis and treatment timely. The common chronic illness includes diseases like arthritis, asthma, diabetes, and some viral disease such as hepatitis C, and acquired immunodeficiency syndrome. If these diseases last for a longer period, ending into death of the person they are termed as ‘terminal illnesses. Chronic conditions have used in several dimensions, which explain about different states of the human body such as impairments, disabilities, syndromes, and diseases. To discuss about the chronic illness in context to Australia, it has found that diabetes is one of the biggest health problems in Australia. It has observed that more than 11 million Australians, face health issues as having 1 out of 8 chronic diseases past few years. The chronic disease or illness for this essay taken is as ‘diabetes’ and the related symptoms, and aspects of prevention. Adults aged ‘45-64’ are taken into consideration as the patient group to study about the chronic disease in Australia, as the most diagnosed age group includes which both men and women (Agard, Ranjbar & Strang, 2016).

 

Diabetes mellitus, also known as diabetes is defined as group of metallic disorders, in which there are high blood sugar levels (blood glucose), over a long period of time. It may occur due to inadequate production of insulin, or because the cells of the body do not respond properly to the insulin or both as the cause of illness.  Diabetes is considered as a long-term condition, which leads to the high levels of blood sugar in the body. There are mainly three types of diabetes or diabetes mellitus, Type1 diabetes, Type 2 diabetes, and Gestational diabetes. In the cases of Type 1 and Type 2, the body does not produce enough insulin, and 90% of the cases, are found with the Type 2 diabetes around the world. The cause for the occurrence of the Type 1 DM is  currently not known, includes symptoms such as excessive excretion of urine (polyuria), thirst, constant hunger, weight loss, changes in the vision, and fatigue or tiredness in the body. Type2 DM previously called as non-insulin dependent or adult-onset results from the ineffective use of insulin in the body. It is the most commonly found diabetes in people, as it generally results from the lack of physical exercise and excessive body weight. Gestational diabetes is another form of diabetes, which occurs in the cases of pregnant women who develop higher blood sugar levels, without any previous history of diabetes. This type of diabetes occurs usually after the birth of the baby, and affects 3-9% of the pregnancies (Chatterjee, Khunti & Davies, 2017).

Diabetes is a chronic illness, as it is a long-developing syndrome, which may lead to the health issues like asthma, and others. Adults with the diabetes, are at a greater risk of strokes, and heart attacks, and considered as the leading cause of kidney failure. According to the research on the subject of chronic health conditions, diabetes mellitus is categorised as metabolism disorder. Metabolism refers to the way or process human body uses the digested food for the energy and growth. All types of the diabetes are preventable and must be diagnosed properly on time. A person with any type of diabetes must ensure proper diagnosis and treatment to reduce the impact of the chronic illness on their health and wellbeing (Sav et al., 2015).

Pathophysiology refers to the convergence of pathology into physiology, and it defines about the functional changes that occur in the body which results from a disease or injury to the person. Normal pathology of the human body, which discusses about healthy people, states that the pancreas, an organ situated behind the liver and stomach secretes digestive enzymes and the hormones, insulin and glucagon into the bloodstream, controlling the glucose of the body. Release of insulin in the body reduces the level of blood-glucose, by allowing glucose to enter the cells of the body, where it is metabolized (World Health Organization, 2018).

To discuss about the pathophysiology of the disease diabetes or diabetes mellitus, it can be stated that diabetes mellitus is a syndrome with the disordered metabolism and inappropriate hyperglycaemia which may be due to the deficiency of the insulin secretion. It may also be a combination of the inadequate insulin secretion and the insulin resistance in the body of an individual. It has been studied that diabetes can lead to serious complications, which may result in numerous diseases, and disorders leading to premature death of the person. Type 1 diabetes mellitus, and Type 2 mellitus, and the insulin resistance. As these terms have been described in the above description, it has been found that the Type 1 diabetes is usually diagnosed in children and young adults. It develops in the body when the immune system destroys the pancreatic beta cells, which are the only cells responsible to hormone insulin to regulate the blood glucose in the body. According to the statistics, only 5% people are diagnosed to have the type 1 diabetes, therefore they must be given insulin through the injection or pump. The pathophysiology also states about the prevalence of the type 2 diabetes, which is the most common type of diabetes. The causes of type 2 are multifactorial which include both genetic and the environmental factors that affect the beta cells (Inzucchi & Sherwin, 2011).

The occurrence of the type 2 diabetes can be prevented through adopting a healthy lifestyle, which includes healthy eating habits, regular physical exercise, avoiding smoking, or alcohol, and maintaining a healthy body-weight. These are some of the ways a person can prevent or delay the onset of the diabetes over a period of time. In context to the country Australia, it has found that the diabetes is the chronic condition, which is increasing at a higher rate than other diseases, cancer, and the heart diseases. Therefore, it shows that the prevalence of the diabetes in Australia has increased many folds, that is found higher in the men than the women (Zaccardi et al., 2016).

Some of the facts, which relate to the prevailing condition of the health of people in Australia describes that around 280 Australians develop diabetes every day, in every 5 minutes.  All the types of diabetes are prevalent in the country at different rates, i.e. Type 1 diabetes accounts for 10 % of all the diabetes, and are increasing continuously. In addition, Type 2 diabetes is found to be the 85% of all the diabetes and increasing constantly and similarly, gestational diabetes is prevalent amongst women in Australia. It has been stated by the researchers that if the diabetes continue to increase at the current rate, then the Australians over the age of 40 will develop severe health issues in the coming years. The federal government has declared diabetes as the National health priority back in the year 1997. The policy aimed to initiate programs to monitor and improve the diagnosis, prevention, treatment, and management of diabetes in Australia (O’Reilly et al., 2016). 

 


Chronic conditions or illness has complex and multiple causes, which are generally long-term and persistent with the lives of people. Diabetes leads to the impairment, ill functioning, and disabilities in people, thereby affecting the quality of life.  Diabetes has a considerable influence on the health and the functional status of Australia affecting the life expectancy and quality of life as well. It is a chronic condition, which leads to a major impact on the health and the status of wellbeing of individuals. According to the research, the relationship between the components of disability and diabetes in Australia has been found largely in the recent years. Complications due to diabetes lead to the conditions of disabilities, which include foot complications, eye disease, kidney related disease, and cardio-vascular diseases. It has been analysed that as per the population of Australia, disabilities are found to be more prevalent in the older age groups, i.e. people aged 40 and above. The signs and symptoms of diabetes affect an individual’s life by hampering their health and state of wellbeing. An individual with multiple health issues or diseases will automatically have negative impact on the quality of his or her life. People with diabetes in Australia, especially men are found suffering with the problems of high blood pressure, stroke, depression, kidney failure, heart diseases, loss of vision, and several others (Mustapha, Hossain & O’Loughlin, 2014).  

 In addition, as per the survey conducted by some of the researchers in Australia, diabetes is considered as the 6th  leading cause for deaths in the country, and also responsible for the personal and economic burden on the person significantly. The symptoms or effects of diabetes, such as fatigue or tiredness in individuals, this leads to an economic burden on the country, as the people, both men and women retire and stop working at an early age. This leads to the higher rates of absenteeism and lower employment in the country thus, low levels of income that ultimately affects the living standards of people in Australia (Fenwick et al., 2018). 

After discussing the symptoms, causes, and the impacts of the chronic conditions of people in Australia it has been analysed that there are some of the needs of the individuals or patients dealing with such health problems. A nurse in a healthcare plays an integral role in identifying and responding to the changing needs of the diabetic patients. The tool used to determine the needs of such patients is referred to as Outcome and Assessment Information Set (OASIS) (Bodenheimer & Bauer, 2016).  Needs of such patients may include living arrangement, support systems, and the potential therapy needs of the patients. They require proper medication management by their health professionals or carer in the hospitals as well as their homes. There are some age-related changes, which must be responded by the nurses in the healthcare, dealing with the patients who are 40 or above in age. Home care nurses have the opportunity to review the patient’s home settings and thereby make a record of all the medications the patient might be taking at that time, and which are required to be added. Here, as the patient group is taken, ‘adults’ in Australia, primary care is considered to be essential as the first level of medical care. It refers to the care that patients receive for their minor health issues, illness, or injuries along-with their preventive medical procedures   (Smolowitz et al., 2015). 

The patient needs in such illness, includes changes in the lifestyle, and the medications to improve their status of wellbeing. Nurse’s role is effective in treating the patients with diabetes, and other chronic conditions (Coventry et al., 2015).

The occurrence of diabetes can be prevented by maintaining a normal body weight, engaging in physical activity and consuming healthy diet. Physical activity for around 60 minutes a day reduces the risk of diabetes by 28%. In addition, changes in the dietary habits can be effective in prevention of diabetes at ease. Prevention of the diabetes is aimed at stopping the development of the diabetes, type 2 diabetes by adopting an adequate diet, healthy lifestyle, and proper medications (Henson et al., 2016). It is observed in the Australian population that by focusing on early interventions through intensive lifestyle, changes in the people with the pre-diabetes at the rate of nearly 60%, over a period of three or more years. At present, there is no prevention for the diabetes Type 1. For an instance, it has been analysed through the research that tight glycaemic control in diabetes type 1 may reduce the occurrence of the cardiovascular health problems, up-to 42%, and 50% reduction in the development of impaired kidney function (Dunbar et al., 2015).

In terms of clinical practices, the quality of care to be improved in the healthcare to prevent and treat diabetes in people. All the people with the high-risk score should be provided reference to the evidence based lifestyle behaviour change prevention services. Ensuring healthy food environments in Australia will also serve the purpose of prevention of the chronic health condition of people (Efraimsson et al., 2015). The primary prevention methods include maintaining improved food labelling which will enable the people in Australia to make healthier food choices. Reducing the promotion of the unhealthy food or food products in the country, so that people may emphasize adopting healthy eating habits, thus reducing the occurrence o such chronic diseases. In Victoria, there is a program called, the life!, focuses on the prevention of occurrence of the diabetes, stroke, and the heart diseases. The program has received until the time over 30,000 referrals and delivered intervention courses, in the groups that stated about an estimate rate of 30% reduction of diseases (Sapkota et al., 2015).

 


To discuss about the personal recovery or self-management of the chronic condition, diabetes in adults it has been found that the diabetes specialist nurses (DSNs), play a key role in providing effective patient care and self- management to such patients. Type 1 diabetes self-management for a longer period, requires an on-going support from an expert multi-disciplinary team. There are three fundamental aspects of chronic illness, which includes choices (Richardson et al., 2014).  Control and consequences that is equally applicable to an individual. Accordingly, it has been understood that the choices an individual makes each day, affects the outcomes largely, in comparison to the prescribed care by the health providers. The necessary interventions suggest that an individual’s attitude and beliefs towards the management and cure of the disease is essential besides the control of the external factors, i.e. care by professionals. Self-management refers to the process through which an individual involves with diabetes, working in the partnership with their carer, and other health professionals (Chrvala, Sherr & Lipman, 2016).

The chronic conditions like diabetes, personal recovery and self-empowerment implies an integral approach which enables the diabetic patients to recognise and influence the status of health and ensure sustained living. The patients must be informed properly about their health condition, due to which they will become knowledgeable enough to take effective decisions regarding diet, exercises, weight-control, blood-glucose monitoring, and the effective intake of the medications on time, which will control the other macro-vascular risk factors. Therefore, the role of self-management by patients dealing with the chronic conditions is essential along with the medications and healthcare services (Lawless et al., 2016).

Discussing the prevalence, symptoms, and the impact of the chronic illness, diabetes on the Australians it has been realised that there is a great influence of the primary nurse in the healthcare in prevention and treatment of the disease. The role of primary nurse care is to care for the patients with chronic illness and educating them about the disease self-management. Nursing staff in any healthcare have to perform a number of varied roles and responsibilities to treat patients with the diabetes (Griffey et al., 2015).

Nurses play an important role in early detection and diagnosis of the disease in the patients to ensure effective treatment and care to them. In addition, they must ensure checking the intake of proper nutrition, and identifying the food and drinks with the high sugar content. Reporting and informing them to follow a proper plan, if they are taking insulin and blood glucose lowering therapies. Thus, a nurse or RN in a healthcare perform duties of monitoring the intake of diet, urine monitoring, examining the level of blood glucose of the patient (Smolowitz et al., 2015).

 Understanding and taking the normal readings of glycaemia and reporting to the person and the health professionals or doctors outside the normal range. Concerning the chronic illness, nurses, as a diabetes educator must follow patient-centred care and ensure effective and open communication with their patients and family members (Dowell et al., 2018).  It will enable them in identifying and responding to the needs of the patients suffering chronic health condition, and identifying the patient stress and helping them to recover through using problem-solving strategies so that they can emphasize taking effective decisions towards the treatment of their illness (Burke, Sherr & Lipman, 2014).

Nurse practitioners in the healthcare are primarily involved in delivering effective care, health promotion, and prevention of the disease through patient education and counselling. More specifically clinical nurse specialists act as the leaders, managers, and collaborators, and their major contributions as providing psychological support to the patient and their family members along with the medications and therapies (Dunphy et al., 2015). 

The nursing interventions in respect to the diagnosis and treatment of the patients with diabetes include number of aspects along-with their rationale. The interventions in nursing include ensuring the availability of the proper information to the patient. The rationale behind this is to prevent the negative consequences due to lack of knowledge and to clarify the concerns and clarifications regarding the symptoms, their consequences on their health   (Butcher et al., 2018). Therefore, these interventions mainly include improving nutrition, teaching patients about insulin, improving the activity tolerance and informing them about the usage of oral ant diabetic agents, helping them to maintain the integrity of their skin as well as coping strategies. In this way, the primary care nurse role is significant to treat the patients with diabetes ensuring them effective and sustained health and wellbeing throughout their life   (Evert et al., 2014).   

 


To conclude the above discussion it has been analysed that diabetes is considered as the global health challenge in Australia, and Type 2 diabetes is known to be as life threatening. The essay described about the number of different causes, effects, and the treatment of the disease with respect to the chronic condition or illness. A number of serious impacts of the chronic diseases are found on the health condition of the individuals. It has been analysed through the National strategic framework that Australians encounter the maximum rates of the diabetes, especially in men. It causes a high burden on the personal and economic life of the people in the country, and leads to the severe impacts including disability, reduced life expectancy, increased cost of  resulting into deaths in every country. Thus, the role of primary care nurse is significant and contributes to improve and enhance the quality of care provided in Australia to the people suffering with the chronic conditions such as diabetes. Hence, an individual and the nurse/healthcare professionals must ensure proper care and prevention of their health from such diseases.  

 

References

Agard, A., Ranjbar, V. & Strang, S. (2016). Diabetes in the shadow of daily life: factors that make diabetes a marginal problem. Practical Diabetes, 33(2), 49-53.

Bodenheimer, T. & Bauer, L. (2016). Rethinking the primary care workforce—an expanded role for nurses. New England Journal of Medicine, 375(11), 1015-1017.

Burke, S. D., Sherr, D. & Lipman, R. D. (2014). Partnering with diabetes educators to improve patient outcomes. Diabetes, metabolic syndrome, and obesity: targets and therapy, 7, 45.

Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M. & Wagner, C. (2018). Nursing Interventions classification (NIC)-E-Book. United States: Elsevier Health Sciences.

Chatterjee, S., Khunti, K. & Davies, M. J. (2017). Type 2 diabetes. The Lancet, 389(10085), 2239-2251.

Chrvala, C. A., Sherr, D. & Lipman, R. D. (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycaemic control. Patient education and counselling, 99(6), 926-943.

Coventry, P., Lovell, K., Dickens, C., Bower, P., Chew-Graham, C., McElvenny, D. & Baguley, C. (2015). Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease. bmj, 350, 638.

Dowell, A., Stubbe, M., Macdonald, L., Tester, R., Gray, L., Vernall, S. & Raphael, D. (2018). A Longitudinal Study of Interactions between Health Professionals and People With Newly Diagnosed Diabetes. The Annals of Family Medicine, 16(1), 37-44.

Dunbar, J. A., Hernan, A. L., Janus, E. D., Vartiainen, E., Laatikainen, T., Versace, V. L. & Mc Namara, K. P. (2015). Challenges of diabetes prevention in the real world: results and lessons from the Melbourne Diabetes Prevention Study. BMJ Open Diabetes Research and Care, 3(1), 131

Dunphy, L. M., Winland-Brown, J., Porter, B. & Thomas, D. (2015). Primary care: Art and science of advanced practice nursing. United States: FA Davis.

Efraimsson, E. Ö., Klang, B., Ehrenberg, A., Larsson, K., Fossum, B. & Olai, L. (2015). Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care. European clinical respiratory journal, 2(1), 27915.

Evert, A. B., Boucher, J. L., Cypress, M., Dunbar, S. A., Franz, M. J., Mayer-Davis, E. J. & Yancy, W. S. (2014). Nutrition therapy recommendations for the management of adults with diabetes. Diabetes care, 37(1), 120-143.

Fenwick, E. K., Rees, G., Holmes-Truscott, E., Browne, J. L., Pouwer, F. & Speight, J. (2018). What is the best measure for assessing diabetes distress? A comparison of the Problem Areas in Diabetes and Diabetes Distress Scale: results from Diabetes MILES–Australia. Journal of health psychology, 23(5), 667-680.

Griffey, S., Piccinino, L., Gallivan, J., Lotenberg, L. D. & Tuncer, D. (2015). Applying national survey results for strategic planning and program improvement: the National Diabetes Education Program. Evaluation and program planning, 48, 83-89.

Henson, J., Dunstan, D. W., Davies, M. J. & Yates, T. (2016). Sedentary behaviour as a new behavioural target in the prevention and treatment of type 2 diabetes. Diabetes/metabolism research and reviews, 32, 213-220.

Inzucchi, S. E. & Sherwin, R. S. (2011). Type 2 diabetes mellitus. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier.

Lawless, M. E., Kanuch, S. W., Martin, S., Kaiser, D., Blixen, C., Fuentes-Casiano, E. & Dawson, N. V. (2016). A nursing approach to self-management education for individuals with mental illness and diabetes. Diabetes Spectrum, 29(1), 24-31.

Mustapha, W., Hossain, Z. S.  & O’Loughlin, K. (2014). Management and impact of diabetes on quality of life among the Lebanese community of Sydney: A quantitative study. J Diabetes Metab, 5(329),  2.

O’Reilly, S. L., Dunbar, J. A., Versace, V., Janus, E., Best, J. D., Carter, R. & Ebeling, P. R. (2016). Mothers after Gestational Diabetes in Australia (MAGDA): a randomised controlled trial of a postnatal diabetes prevention program. PLoS medicine, 13(7), 1002092.

Richardson, G. C., Derouin, A. L., Vorderstrasse, A. A., Hipkens, J. & Thompson, J. A. (2014). Nurse practitioner management of type 2 diabetes. The Permanente Journal, 18(2), 134.

Sapkota, S., Jo-anne, E. B., Greenfield, J. R. & Aslani, P. (2015). A systematic review of interventions addressing adherence to anti-diabetic medications in patients with type 2 diabetes—components of interventions. PLoS One, 10(6), 128581.

Sav, A., King, M. A., Whitty, J. A., Kendall, E., McMillan, S. S., Kelly, F. & Wheeler, A. J. (2015). Burden of treatment for chronic illness: a concept analysis and review of the literature. Health Expectations, 18(3), 312-324.

Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C. & Wood, L. (2015). Role of the registered nurse in primary health care: meeting health care needs in the 21st century. Nursing Outlook, 63(2), 130-136.

World Health Organization. (2018). Diabetes. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/diabetes

Zaccardi, F., Webb, D. R., Yates, T. & Davies, M. J. (2016). Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year perspective. Postgraduate medical journal, 92(1084), 63-69.

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I am writing to inform you that I have received my grades for Human Growth & Development. They are as follows: Assignments 8 & 4 = 100%. Thank you for such professional services rendered! I am looking forward to a continued relationship in the futu...

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User Id: 452606 - 11 Jul 2020

Australia

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