Causes and Nursing Care for Diabetes and Heart Failure

This essay discusses the causes and nursing care for diabetes and heart failure, focusing on a case study of a patient suffering from both conditions. It explores the symptoms, initial health history, and recommendations for lifestyle changes. The essay also highlights the importance of client education and provides information on referrals needed for discharge.

Essay

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
Introduction aetiology of diabetes and heart failure....................................................................3
Possible causes of these mentioned conditions relating to the case study...................................4
Initial health history required.......................................................................................................4
Nursing care on admission...........................................................................................................4
Discussion of the things happened and the things which did not happen...................................5
Client education regarding diabetes.............................................................................................5
Recommendations for changing life............................................................................................6
Ways to provide the information.................................................................................................6
Referrals needed for discharge....................................................................................................7
Things which can help in staying independent............................................................................7
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................9

INTRODUCTION
Diabetes is considered to be a disease which occurs when the blood glucose also known as
blood sugar in the individual becomes too high. The glucose is considered to be the main source
of energy and it basically comes from the food eaten by the person. Insulin is a hormone which is
made by pancreas which helps the glucose to enter in the cells for using it for energy. Heart
failure is also known as congestive heart failure which mainly occurs due to the improper
working of the heart muscle which is responsible for pumping blood. This can be caused by
conditions such as narrowed arteries in heart or high blood pressure which weakens the heart for
pumping efficiently (Atherton and et.al., 2018). The essay will focus on the case study of Ms.
Aamira who is 66 years old and also having various language issues and suffering from diabetes
and heart failure. She is facing various symptoms like shortness of breath, persistent cough, lying
flat, swelling in legs and feet etc. This essay will mainly highlight the reasons which led to these
diseases and will also provide nursing care which can be given to her for improving the condition
and minimising the symptoms in Aamira.
Introduction aetiology of diabetes and heart failure
Diabetes is considered to be a metabolic disease which leads to high blood sugar. If the
high blood sugar is not treated then this can also damage eyes, nerves, kidneys or other organs.
There are basically 4 types of diabetes including type 1, type 2, pre-diabetes and gestational
diabetes. Each type of diabetes has different symptoms as well as causes. For the type 1 diabetes,
the main cause is that the immune system attacks and disturbs the insulin producing beta cells in
the pancreas. The main causes of type 2 diabetes include combination of genetics, lifestyle
factors, being obese, carrying extra weight in belly etc. This mainly occurs due to sharing of
genes among family members. Gestational diabetes is caused by hormonal changes and this
mostly occurs at the time of pregnancy (Al-Omary and et.al., 2018). This is because women gain
a lot of weight during pregnancy. Heart failure mainly develops after the conditions which
weakened the heart or stiffness comes in the heart. The main thing is that the heart becomes
unable to pump blood efficiently and effectively throughout the body. This can be due to high
blood pressure. It can include the left side, right side or both the ventricles of the heart.
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Possible causes of these mentioned conditions relating to the case study
The main cause which can be identified in the case study of Aamira is that no one was
there to take care of her so her diet intake is not monitored. She also is not involved in doing any
sort of exercise which is why her weight is also increased and made her obese. She has shortness
of breath which restricts her to do any kind of exercise. She also does not drink sufficient water
and also has a moderate appetite. The woman also does not take care of her health and diet which
is why the sugar intake is not evaluated. Because of the tensions regarding many diseases such as
gall stones, long term ulcer, osteoporosis, hypertension and many other things, she was having
high blood pressure which is why her heart is becoming weak and stiff to perform its functions
efficiently (Davis and et.al., 2018). She was also alone as no one was there who could listen to
her symptoms and get her treated. These caused diabetes as well as heart failure in Aamira.
Initial health history required
In order to treat Ms. Aamira, there is a need for assessing the history of the women which
caused these diseases and disorders. The woman was widowed and no one was with her to share
her problems which caused hypertension in the women. She was also suffering from osteoporosis
because of her age, her bones became so weak such that she can even fall if she coughs or bends.
Earlier, her niece visited her three times in a year bit due to the pandemic of COVID-19, she also
didn’t visit. This is why; the woman was feeling helpless and faced the symptoms of
osteoporosis. Also, at home she is using the community nursing services but she was also
diagnosed with gall stones because her diet was not balanced and she could have eaten the foods
including fried foods, high fat dairy products etc. (Yashadhana and et.al., 2020). Along with this,
she is also having long term ulcer which could be caused due to diabetes and poor circulation.
This is how; these disorders contributed towards the diseases like diabetes and heart failure
which were not identified earlier.
Nursing care on admission
The proper nursing care must be given to Aamira who was suffering from diabetes as
well as heart failure. The nurse tries to communicate effectively with the patient so that they feel
free to share their problems they face. Behavioural nursing interventions are used which can help
in supporting the patient to stop those things which worsens their condition. They must also
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monitor and manage the condition of the patient by providing information to the family members
or the patient (Caughey and et.al., 2017). Community interventions can also be used for focusing
on public health initiatives such as education programs. As soon as the patient got admitted, the
nurse must try to make good and loyal relations with the patient so that they can express their
views regarding symptoms and personal problems. In case of heart failure also, communication
can play a major role and along with that the focus of the nurse must be to change the unhealthy
diet and administer the medications accordingly. Advising them to adapt good practices such as
reducing weight, eating healthy diet, maintaining healthy weight etc. can prove to be helpful in
minimizing the symptoms of diabetes and heart failure.
Discussion of the things happened and the things which did not happen
The major thing which happened to Ms. Aamira is that she resettled in Australia but does
not know English speaking which is why she had to be depended on the Sudanese community
who translated everything to her. She had no one with her, neither her husband as he died nor her
children. This is the major reason she was facing so many medical issues and was unable to share
them with anyone. The thing which does not happen to her is the direct symptoms of diabetes
and heart failure in the earlier days if there is any issue regarding these diseases. She never got
her tested as she didn’t know she can have these issues. She was having the other symptoms such
as wheezing hard, laboured breathing, short of breath, bilateral oedema of calves, increased
urination etc. But she ignored by considering them the symptoms of other diseases including gall
stones, long term ulcer, PTSD etc. She does not have any type of allergies at this old age of 66
also. Therefore, the major thing which happened to her so early was the separation of her from
her family members which increased the risks of mental disorders and blood pressure which
increases hypertension and its symptoms along with diabetes (Al‐Omary and et.al., 2018). The
thing which does not happened to her fortunately that she has not lost her senses and at the age of
66 also she was able to understand everything which is spoken to her which can make easy for
the registered nurse to provide proper intervention.
Client education regarding diabetes
Diabetes is an incurable disease which creates a need for considering various factors
including exercise, proper use of medications, attention to diet, blood glucose levels etc. the
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patient need to bring various lifestyle changes in order to manage the diabetes. The nurse need to
convey the complete information to the patient regarding what diabetes is and what precautions
need to be taken. Ms. Aamira does not understand English so the information must be shared in
her understandable language. The patient must be conveyed the importance of therapeutic
interventions and follow the treatment plans. If they will not control this disease, then it can
control them. The nurse must also establish effective communication while sharing the
knowledge regarding the monitoring of the blood sugar levels, keeping the vaccines up to date,
heart diseases, eating and weight maintained, proper lifestyle which includes exercises, hygiene
etc., time to call physician, meal planning, managing stress, minimising infections, preserving
heart and kidney functions etc. (Cui and et.al., 2019). They must know the time when the
physician needs to be called. In case of heart failure also, the patient must know the significance
of quitting tobacco or alcohol, taking medicines, adhering to exercise program, managing diet,
follow up care, analysing the symptoms and must know when to call the registered nurse.
Recommendations for changing life
It must be recommended to Ms. Aamira that she must choose variety of foods in her diet
which are fibre containing such as fibre rich cereals, legumes, vegetables, fruits, whole grain
products etc. because these help in gaining minerals, vitamins and other substances which are
proved to be helpful for good health. They must engage in some sort of exercises on regular basis
which will help in maintaining the body weight and will also improves the circulation of blood.
These will help n improving the symptoms of diabetes as well as heart failure (Aune and et.al.,
2018). They must also get their cholesterol and blood pressure checked frequently and must
ensure that it is normal. Various regular physical exams must be scheduled so that if any disease
is damaging any part of body, it is cured before doing any manor loss to any organ.
Ways to provide the information
There are various ways in which information regarding the disease and its cure can be
conveyed to the patient. The first thing which the registered nurse needs to create is the loyalty
and trust between the patient and themselves. They must introduce them self and makes the
patient feel that you are the one who can cure them completely. They must also explain their role
in the complete care of them. The RN’s must also review the medical record and then ask some
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basic questions so that they can link themselves to the same. Rapport can be made regarding the
same. Making eye contact with them will make them feel more comfortable and they will not
hesitate in sharing any kind of information and also listening to the information. It must be
conveyed in Sudanese language as she does not know how to understand and speak English. The
information must also be noted or recorded for her so that she does not need to remember she can
just go through it and remember it.
Referrals needed for discharge
The major referral needed in case of Ms. Aamira is a social worker or a nurse who can
understand the needs of the patient for some time and then they can take care of them after some
days. Along with this, the patient must be told about the ways in which they can take the blood
glucose lowering tablets and also manage the consistent eating patterns. They must also know
about the ways in which syringes and needles are used and disposed daily. The name of the
treating physician must be known and the ways to communicate in case of any emergency or
issue (Trankle and et.al., 2019). This is how; various informations need to be conveyed at the
time of discharge to prevent many future problems.
Things which can help in staying independent
These things can include staying fit by exercise which can improve balance, preventing
health conditions, keeping the bones strong etc. Ms. Aamira must stay balanced so she could
easily analyse any wring thing happened to her body. Removing hazards can be another ways for
instance if she feels any issues try to contact the nurse or physician (Davis and et.al., 2018). She
must engage in the good things at this age like social work, listening to spiritual songs etc. She
must also know when to ask for help and when to not.
CONCLUSION
The above essay concluded about the disease of diabetes and heart failure. It shed light on
the causes of both and the symptoms which helps in diagnosing these diseases. The essay shed
light on the case study of Aamira who was suffering from diabetes and heart failure but is
unaware of the same. The initial history of the patient was described along with the nursing
admission for her. The other factors like client education and recommendations were also
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involved in the same. It also evaluated the ways in which information must be conveyed to the
patient at the time of treatment and after the discharge. The essay concluded about taking proper
food and doing regular exercise can help in treating many diseases.
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REFERENCES
Books and Journals
Al-Omary, M.S. and et.al., 2018. Mortality and readmission following hospitalisation for heart
failure in Australia: a systematic review and meta-analysis. Heart, Lung and
Circulation. 27(8). pp.917-927.
Al‐Omary, M.S. and et.al., 2018. Outcomes following heart failure hospitalization in a regional
Australian setting between 2005 and 2014. ESC heart failure. 5(2). pp.271-278.
Atherton, J.J. and et.al., 2018. National Heart Foundation of Australia and Cardiac Society of
Australia and New Zealand: Australian clinical guidelines for the management of heart
failure 2018. Medical Journal of Australia. 209(8). pp.363-369.
Aune, D. and et.al., 2018. Diabetes mellitus, blood glucose and the risk of heart failure: a
systematic review and meta-analysis of prospective studies. Nutrition, Metabolism and
Cardiovascular Diseases. 28(11). pp.1081-1091.
Caughey, G.E. and et.al., 2017. Understanding 30‐day re‐admission after hospitalisation of older
patients for diabetes: identifying those at greatest risk. Medical Journal of
Australia. 206(4). pp.170-175.
Cui, X. and et.al., 2019. A nurse-led structured education program improves self-management
skills and reduces hospital readmissions in patients with chronic heart failure: a
randomized and controlled trial in China. Rural and remote health. 19(2). p.47.
Davis, W.A. and et.al., 2018. Prevalence of diabetes in Australia: insights from the Fremantle
Diabetes Study Phase II. Internal medicine journal. 48(7). pp.803-809.
Trankle, S.A. and et.al., 2019. Integrating health care in Australia: a qualitative evaluation. BMC
health services research. 19(1). pp.1-12.
Yashadhana, A. and et.al., 2020. Trust, culture and communication: determinants of eye health
and care among Indigenous people with diabetes in Australia. BMJ global health. 5(1).
p.e001999.
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