Chronic Endocrine Disease Management

Running head: CHRONIC ENDOCRINE DISEASE MANAGEMENT
CHRONIC ENDOCRINE DISEASE MANAGEMENT
Name of the Student:
Name of the University:
Author note:

1CHRONIC ENDOCRINE DISEASE MANAGEMENT
Introduction
The following paper will focus extensively on the nursing case management of Marcel
using clinical reasoning cycle (CRC) as well as nursing quality practices of multidisciplinary
approaches, patient centered care and collaborative inter-disciplinary care.
Discussion
Priorities
Considering Marcel’s present disease severity nursing emphasis on patient’s medication
management along with education on skills of self management form the primary nursing care
priorities. It can be observed that Marcel’s diabetic condition has progressed and is resulting in
his symptoms of diabetic retinopathy (difficulty to read insulin values) and diabetic neuropathy
(loss of sensation in toes). Hence, the nurse may be required to administer timely and
appropriately dosed medications in Marcel and also design a strict plan of medication. A key
contributor of diabetes symptom escalation, is the lack of engagement in appropriate
pharmacological interventions – hence, necessitating nursing prioritization (Schwartz et al.,
2017).
Additionally, a key factor contributing to prevention of metabolic symptom severity is
patient knowledge acquisition on skills of self-management (Coppola et al., 2016). Hence, the
nurse must prioritize Marcel’s improvement of self management skills by educating him on BGL
self-monitoring, medication administration and encouraging Marcel’s participation in healthy
diet consumption and exercise performance. A multidisciplinary approach and patient education

2CHRONIC ENDOCRINE DISEASE MANAGEMENT
has been proven to be beneficial for patient empowerment and management of diabetes (Conca
et al., 2018).
Interventions and Rationale
The first priority involves ensuring adequate management of his medications. In order to
control hyperglycemic symptoms, adherence to a medication plan in adequate times and dosages
has been proven to be beneficial (Butt et al., 2016). Hence, the nurse can discuss with Marcel,
using patient centered approach, on his appropriate timing and food consumption schedule and
hence, accordingly, using inter-professional care, take help from a diabetologist to create a
specific medication plan. Adherence to a specific medication plan, has been known to not only
make it convenient for the patient to manage his medications but also ensures prevention of
metabolic severity in the future (Mayberry et al., 2015). Hence, Marcel’s present emergence of
retinopathy, neuropathy and hyperglycemic symptoms requiring strict pharmacological
adherence form the rationale for this intervention.
Marcel prefers fast glucose monitoring and attempts to maintain higher BGL levels to
prevent reoccurrence of hyperglycemia - which clearly highlights his unawareness on the
dangers of hyperosmolar hyperglycemic state and inaccuracies of fast glucose monitoring. A
diabetic education plan results in improved patient awareness and self-management. Hence, the
nurse must educate Marcel, using patient centered care on the need to learn self-monitoring of
BGL, the accuracies of finger prick testing and importance of maintaining healthy BGL to
further improve Marcel’s knowledge and his sense of confidence for disease management (Dube
et al., 2015). Marcel’s lack of awareness on accurate BGL monitoring strategies and BGL
maintenance resulting in HHS complications, form the rationale. Additionally, using
multidisciplinary collaboration with a diabetologist, optometrist, nutritionist and fitness expert,