Assignment on Chronic Care

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Added on 2020-10-23

Assignment on Chronic Care

Added on 2020-10-23

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Chronic care

INTRODUCTIONClinical reasoning cycle consist of using knowledge, intuition and thinking for analysingthe patient's situation and to take decision as per the clinical circumstances of the patient(Koivisto & et.al., 2016). The report will analyse the decision making through clinical reasoningfor the given case study of a diabetic patient. MAIN BODY Marcel is 70 years old and was fatigued recently. The age related factors and past medicalhistory of hypertension are also important element in correct identification of the problem.Considering the present situation of the patient though extreme critical situations are notobserved but the lack of suitable intervention and diagnosis can lead to serious implicationswhich are often neglected with age factor. Marcel was commenced Metformin and after 3months his medication was changed to combination of Metformin/GLibenclamide. Further, forcontrolling his BGL Lantus 10 units was given until his BGL was within normal range. For theinsulin control Marcel uses insulin pen. On collecting various cues it is observed that Marcel is obese and also has family historyof type 1 and type 2 diabetes. Thus, there is high risk that patient may have diabetes. In oldpeople most of the time fatigue is assumed to be associated with hypertension, however it can bealso be the result of diabetes. Further, Marcel has been a heavy smoker. Thus, it is also requiredto consider this aspect. From the lab findings it has been found that patient has hyperglycaemia.After retirement sedentary life style and excessive weight gain due to sub-nutritional diet hascaused insulin imbalance in the body. Due to the enormity of diet and life style routine Marcel isconcerned about its diagnosis and thus needs proper understanding of diabetes management. The hyperglycaemia events occurs as HBA1C level of patient was more than 7%.However, the dosage of metformin/Glibenclamid resulted in side effects in the form of diarrhoea.Thus, it can be interpreted that Marcel may need insulin addition. The patient also informed thatdue to stiffness of hands he will prefer insulin pens for the regulation of insulin. The patients facedifficulty in vision thus there eye vision, blood pressure, skin integrity must also be checkedregularly. The life style and weight management is one of the key concern and thus insulin dosageare important for maintaining the sugar level of patient (Turpin & Higgs, 2017). Marcel is theonly member of family who drives and thus for avoiding hyperglycaemia events during driving1

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