Chronic Endocrine Condition: Diabetes

Running head: CHRONIC ENDOCRINE CONDITION: DIABETES
CHRONIC ENDOCRINE CONDITION: DIABETES
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1CHRONIC ENDOCRINE CONDITION: DIABETES
Introduction
For the case scenario of Marcel, a 70 year old retired farmer suffering from chronic
implications of diabetes, the nurse must actively incorporate patient centered care, collaborative
functioning and multidisciplinary principles for the formulation of an appropriate care plan for
Marcel (Sarr-Jansman & Sier, 2018).
Discussion
Nursing Priorities
Two of the primary priorities outlining Marcel’s care is the need to improve his
medication management and improve the existing levels of his self-management skills. The
significant progression and aggravation of Marcel’s diabetic symptoms to chronic conditions
form the underlying rationale for these (Chrvala, Sherr & Lipman, 2016). The nurse may be
required to design a specified medication plan due Marcel admitting to maintaining higher levels
of his blood glucose levels (BGL) for avoidance of hypoglycemia and his experiences with
hyperosmolar hyperglycemic state (HHS). Indeed, inadequate medication management not only
puts the patient at risk for subsequence BGL fluctuations and hypoglycemic shock but also
increases susceptibility of altered mental states (Chaudhury et al., 2017).
Secondly, for enhancing Marcel’s self-management, the nurse must prioritize educating
him on the need to monitor his BGL, administer his insulin as well as adhere to his care plan of
engagement in exercise, dietary and additional multidisciplinary interventions. Multidisciplinary
interventions coupled with patient centered approaches have been implicated to yield beneficial

2CHRONIC ENDOCRINE CONDITION: DIABETES
results in chronic diabetes management since it allows patient self-control, self-empowerment
and knowledge acquisition (Wang et al., 2016).
Nursing Interventions
For ensuring adequate medication management in Marcel the RN must work
collaboratively with a diabetologist or Marcel’s physician to formulate a specific medication plan
for Marcel to prevent any exacerbation of his symptoms. This must also be followed by
administering a patient centered approach and directly involve Marcel in the formulation of a
medication plan (Zullig et al., 2015). Timely adherence to medications at the correct dosages will
not only result in maintenance of stable but will also prevent complications such as HHS and
hypoglycemic shocks which may alter levels of consciousness and mental perception of the
patient (Krass, Schieback & Dhippayom, 2015). Likewise, it can observed Marcel’s previous
experiences with hypoglycemia compels him to maintain slightly higher levels of BGL. He also
wishes to utilize flash glucose monitoring devices. Hence, a key nursing priority here is patient
education and enhancement of patient health literacy. Hence, the nurse will utilize components
of therapeutic relationships and discuss patiently and empathetically with Marcel on the need to
maintain adequate BGL, the effects of resultant HHS and the inaccuracies associated with flash
glucose monitoring usage (Kim & Lee, 2016). The effects of altered mental state due to
mismanaged medications coupled with the inaccurate readings of flash glucose monitoring form
the underlying rationale of these nursing interventions (Reisi et al., 2016).
The nurse must educate Marcel, not only on fast glucose monitoring devices but must
also enlighten him on reference ranges for BGL and that he may still be required to perform
finger prick methods for more accurate BGL monitoring (Lee et al., 2017). Presence of adequate
knowledge on BGL monitoring results in positive health outcomes in the patient since he or she