Chronic Care in Lifespan B

This document discusses the medication management and self-management strategies for chronic care in older patients with diabetes. It explores the nursing interventions and provides strategies to evaluate the outcomes of these interventions.

Running Head: Chronic Care In Lifespan B
Chronic Care in Lifespan B

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Chronic Care In Lifespan B
Introduction
Chronic care must be provided to older patients with diabetes as it helps them to stay fit as well
as healthy. Clinical reasoning cycle is being applied throughout the discussion, in order to
assess provided case study. In this study, the case of Marcel Lever is being considered. This 70
years old man is suffering from type 2 diabetes mellitus. Production of insulin has been reduced
and blood cells are not responding effectively to insulin. Glucose is being accumulated in blood
and due to this reason; Marcel is suffering from type 2 Diabetes mellitus. In this task gathered
information is being processed in order to identify issues. After establishing goals medication
management is to be supported considering clinical reasoning cycle.
Identification and explanation of medication management of Marcel along with his self-
management
Marcel has reported all physical complexities to nurse and provided in-depth information about
impact of hypoglycemia on mental state of him. As opined by Kuramoto et al. (2015),
cooperation with medication helps to fight with diseases more efficiently. Medication
management of Marcel is mentioned below,
He has been asked to intake metformin in order to improve production of insulin. This
medication was supposed to maintain use of insulin by body. After 3 months, he has noticed
minimal change in his physical condition and healthcare professional have advised him to intake
combination of Glibenclamide and Metformin. The issue was that medication was not effective
and HBA1C level was higher than 7. He was suffering from diarrhea due to side effect of
medication. Healthcare provider has asked him to consume Lantus 10 units in order to reduce

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Chronic Care In Lifespan B
Blood Glucose Level (BGL) below 7 mmols. He was asked to continue taking metformin
500mg before dinner.
Self-management of Marcel
Marcel has quit smoking and he walked near about 45 minutes every day. He has joined local
fitness class and had taken annual flu vaccination. He was taken care of his foot and footwear
Description of nursing interventions and rationales for supporting Self-management
medication of Marcel
Nursing interventions are actions that need to be taken to help Marcel to fight against
Hypoglycemia. Interventions of nurse include educating Marcel about importance of a
balanced diet and proper medication. As suggested by Polonsky & Henry (2016), Marcel
needs advice of being enrolled in wellness activities for older person at local community
recreation center. He needs to be encouraged to check weight every 2 days in order to keep a
record of changes in his weight due to medication and self-management. According to Roumie et
al. (2016), information regarding manifestation, complications, and pathophysiology of
type 2 diabetes need to be provided to Marcel in order to help him to manage his health
condition. In addition, nursing interventions include making Marcel understand guideline and
impact of oral agents on hypoglycemia. Marcel must be encouraged to measure level of blood
glucose before driving in order to avoid condition of hypoglycemia (Munshi et al. 2016).
Nurses are liable to educate this patient to about the process to measure blood glucose level and
necessary action that needs to taken accordingly.

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Chronic Care In Lifespan B
Rationale of nursing intervention can help to understand goals of these interventions. These are
mentioned below,
Firstly, nursing intervention needs to encourage patient to lose near about 1 kg in single week
and it has to increase awareness in patient regarding disorder and available medication in
addition, it is liable to encourage service user to consult with expert dietician for gathering
knowledge about a balanced diet and it needs to influence patient for exerciser and medication
Strategies to evaluate outcomes of nursing interventions
Strategies to evaluate nursing intervention outcomes are mentioned below,
Measuring the weight of patient on regular basis is expected. According to Chrvala, Sherr &
Lipman (2016), this strategy can help to understand outcome of nursing intervention related to
weight loss. Marcel needs to check weight on regular basis in order to keep record of body
weight. Measuring level of blood glucose is essential and BGL needs to be checked on regular
basis in order to understand effectiveness of taking balanced diet (Ncbi.nlm.nih.gov, 2019).
Evaluation of physical fitness is an important expected outcome. As suggested by Pillay et al.
(2015), after joining fitness class, physical fitness of Marcel needs to be checked on frequent
basis. Assessment of mental stability of patient is required. Perception of patient after
implication of nursing intervention can be evaluated to understand mental status of him
(Pectrum.diabetesjournals.org, 2019).

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Chronic Care In Lifespan B
Figure 1: Strategies to evaluate outcomes of nursing interventions
(Source: Influenced by Pillay et al. 2015)
Conclusion
From the above discussion, it can be concluded that nursing interventions and self-management
have potential to help Marcel to stay fit as well as healthy. In this study, eight stages of clinical
reasoning cycle such as consideration of patient, collection of information, processing gathered
information, identification of issue, the establishment of goal, action is taken, evaluation of
outcome and reflection on learning have been applied throughout the overall discussion. Marcel
needs to listen to nurses and other health care professionals in order to fight against
hypoglycemia. Evaluation of Potential outcomes of nursing interventions helps to understand the
effectiveness of intervention. Hence, it can be concluded that self-management and medication
can help to fight with chronic disorders such as diabetes. On another hand, this study has
helped to understand process to provide chronic care to older people suffering from a chronic
disorder such as hypoglycemia.

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Chronic Care In Lifespan B
Reference list
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Ncbi.nlm.nih.gov. (2019). Special Considerations for Older Adults With Diabetes Residing in
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