Interpretation of the relation between Sharon’s diabetes and chronic kidney disease

Running head: BACHELOR OF NURSING
BACHELOR OF NURSING
Name of the Student
Name of the University
Author note

BACHELOR OF NURSING1
Table of Contents
Question 1- Interpretation of the relation between Sharon’s diabetes and chronic kidney disease.2
Question 2 – Comparison of Sharon’s blood glucose level to normal glucose level......................2
Question 3 – Addition of Glucovance 500mg/2.5mg to the current medication list of Sharon......3
Question 4 – Suggestion of two new medications to Sharon..........................................................4
Question 5 – Preparation of a nursing care plan..............................................................................4
Reference........................................................................................................................................6s

BACHELOR OF NURSING2
Question 1- Interpretation of the relation between Sharon’s diabetes and
chronic kidney disease
In the given case study, Sharon is an old female of 58 years of age. Her height is 170cm
and her weight is 120kgs. Her blood glucose level value is 8 to 11 mmol/L in the day and 7 to 8
mmol/L in the morning. Diabetes is the type of disease where the body cannot prepare enough
insulin. Because of diabetes, the small blood vessels of the body are injured so when the small
blood vessels of the kidney are injured, it becomes difficult for the kidney to clean the blood. So
the body of the diabetic patient will retain more water and salt than it is supposed to be. This well
lea to gain in weight and swelling of the ankle. Also the urine may contain proteins.
She is taking the medicine metformin Sandoz of 1000mg twice per day. Metformin an
anti-hyperglycemic medicine used to control type II diabetes mellitus. It is considered to be the
anti hyperglycemic drug because it lowers the glucose concentration in the blood of a diabetic
patient without causing hypoglycaemia. Metformin is the first line therapy for diabetes
throughout the world. The molecular mechanism is still not clearly understood (Markowicz-
Piasecka et al. 2017). Till now multiple potential therapy has been proposed. The mechanisms
include inhibition of the complex I of mitochondrial respiratory chain, activation of AMP-
activated protein kinase, inhibition of glucagon induced elevation of cyclic adenosine
monophosphate with reduction in the activation of protein kinase A (Morrissey et al. 2016).
Other mechanisms include inhibition of glycerophosphate dehydrogenase of mitochondria and
also an effect on the microbial flora of the gut. The net result of the mechanism is that it reduces
the procedure of gluconeogenesis which means the glucose production in the liver decreases. It
also has an effect of insulin-sensitization in the along with multiple actions in the tissues of liver,
skeletal muscle, adipose tissue, endothelium and the ovary (Hibma et al. 2016)
Question 2 – Comparison of Sharon’s blood glucose level to normal glucose
level.
BGL stands for blood glucose level and it represents the amount of glucose present in the
blood. Glucose is the simplest of all sugars and normally only 4gms of glucose should present in
a human of weight 70kgs. An increase in the amount of glucose lead to the condition of glucose
toxicity. This toxicity is so crucial that it leads to the malfunctioning of the cells of the body and