Evidence Based Nursing Practices for Type 1 Diabetes Patient

This study discusses evidence-based nursing practices for a 12-year-old patient with type 1 diabetes, including assessment, nursing diagnosis, planning, implementation, and evaluation. It also analyzes the involvement of multidisciplinary teams and potential comorbid complications.

Evidence Based Nursing Practices

Contents
Introduction...........................................................................................................................................2
Management..........................................................................................................................................2
Assessment........................................................................................................................................2
Nursing diagnosis..............................................................................................................................3
Planning.............................................................................................................................................4
Implementation..................................................................................................................................5
Evaluation..........................................................................................................................................6
Involvement of Multidisciplinary team..................................................................................................6
Potential Comorbid complication and extended care education.............................................................7
Conclusion.............................................................................................................................................8
References.............................................................................................................................................9
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Introduction
The term evidence signifies all sorts of medical documents and nursing signifies taking care.
Thus, evidence-based nursing states a nursing procedure that is developed with various
medical tests and their documents. Evidence-based nursing is a process that that enables the
healthcare officials to care for their patients using technology and tests for the effective
outcome of the patient. It includes the design of care plans, understanding the medicine-
related interactions and review of pathophysiology. This study will decode the nursing
process of a 12 years old patient who is affected by type1 diabetes (Ackley, Ladwig & Makic,
2014). Therefore the entire study will discuss the assessment process, the nursing process, the
planning process, the implementation process and evaluation process to diagnose the patient.
Moreover, the importance of the involvement of the child and family care centre will be
analyzed based on C &FCC model. An analysis of potential complication will also be
discussed followed by a certain conclusion.
Management
Assessment
Assessment should be done properly by the nurse so that the diagnosis of the patient can be
performed in the right manner. Sarah and her mother are from a remote community so during
the assessment of the patients' health language can be barrier so proper stress should be given
to that. According to the case Sarah has pain in her abdomen so a complete pain assessment
should be done to map the exact details of the pain. The conversation must be done with
Sarah so she could open up and can express her difficulties. Since Sarah has hyperglycemia
immediate blood test should be done for the proper assessment of the sugar level. Sarah is
afraid of needles so test might be done by the use of electronic testing kits which has a
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negligible syringe that causes no distress (Butler & Grobbelaar, 2017). Sarah is at a tender
age of twelve so she should be handled delicately with empathy.
The fluid assessment should also be done. Patient with Hyperglycaemia often has the
tendency to be dehydrated. If the proper fluid assessment is not done then the amount of
saline that should be given to the patient cannot be calculated. Proper assessment of ketone
acidosis should be done be done by the measurement of the ketone bodies in the blood. The
Assessment is mainly performed by an advanced level glucose measuring device or urine
strip can also be used to determine the ketone bodies present. Proper assessment is necessary
or else it can cause the fatal result to Sarah. The Assessment of the Ketone body is important
because the Proper dose of insulin should be set by the doctor according to the assessment of
ketone body inside the blood level. It is very much necessary to explain the overall situation
of Sarah to her mother in an understandable language (Chaska, 2001). This will calm the
nerves of her mother. The pediatric assessment is also necessary so that the proper condition
of the child should be comprehended.
Nursing diagnosis
The main problems diagnosed in the case of Sarah are the Hyperglycemias, low blood
pressure level, abdominal pain and the high amount of the ketone bodies present in the body.
The nursing diagnosis should be done according to the condition of Sarah. Since Sarah has
low blood pressure as suggested by the report immediate saline channel should be made so
that proper fluid system can be restored in the body. If proper Blood pressure is not
maintained then the patient can collapse. The pain in the abdomen can be caused due to the
problem of the catheter. The Pain should be investigated properly. If the pain is caused due to
ketone body formation then medication or insulin should be provided immediately, if proper
medication is given it will lower the abdomen pain which will reduce the stress of Sarah
(Tucker, 2017).
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Since Sarah is suffering from the hyperglycemias proper diet should be given as per
diagnosis. The main reason of type1 diabetes is low secretion of insulin and improper diet. If
a Child develops the habit of taking a high-calorie diet or imbalanced diet then she is at risk
of developing hyperglycemia. A balanced diet is one of the essential components to cure
diabetes in the long run. The real problem is to make the child understand the situation and to
implement the proper diet. Since diabetes can cause a problem in the excretory system so the
kidney and the urinary system should also be checked (Cheng, 2011). Creatinine test is
performed to diagnose the condition of the kidney. A routing diabetes monitoring test is also
performed to see the fluctuating level of diabetes. Thorough monitoring helps to set the
insulin level which results in a proper diagnosis of Sarah.
Planning
Planning should be done keeping in mine Specific, measurable, achievable, realistic goal in a
particular time frame.
Specific goals- There should be some long-term and some short-term specific goals set so
that improvement can be made to the overall holistic health of Sarah. At first, the present
situation analysis should be done and a short-term plan should be made to the patient can
have some relief. Like proper medication and fluid for fluid maintenance. Insulin dose should
be set so that the sugar level reduce instantly (Chowdhury, 2017). These goals are realistic
and achievable in all sense.
The long-term specific planning should be done so that the disease can be cured. These
planning should be done by discussing with Sarah and her mother. They should be awarded
of the proper monitoring of the glucose level by the device. The technique should be taught
and demonstrated to them (Sutton, Liao, Jimmieson & Restubog, 2011). Proper diet chart
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should be done so that she can receive all the nutrients which are necessary for the body and
will also maintain the glucose level of the body.
After going out of the hospital the blood sugar level should be monitored and documented on
a regular basis for three months.
Timeframe
The proper diet, insulin intake, and monitoring should be done regularly twice a day for three
months. After that analysis should be made on the records of the test reports. Further
treatment should be done according to the condition. Besides that, another important factor is
the performing daily exercise which is essential for patients with high blood sugar. Regular
exercises that may be jogging is essential twice daily for at least for half an hour (Clarke &
Forster, 2015).
Implementation
The implementation of this action plan should be done by Sarah with help from her mother.
Implementation is the most important step. After performing the exercises and taking healthy
diet it is expected that blood sugar level will slowly get into the normal figure. During
Implementation, it should be remembered that during use of insulin the measurement of the
blood glucose level is essential (Conron & Denton, 2016).
Evaluation
Critical evaluation of the action plan and its implementation is necessary. The insulin level
which is set for the patient during the stay in the hospital may not be needed after a few
weeks due to maintaining a proper diet and physical exercise. The insulin level should be
considered and the condition of the patient should be evaluated properly. The evaluation
process must be done by proper monitoring and documentation of the blood sugar level and
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the creatinine level so that it could be inferred that the level of insulin is working properly for
the patient or not. Critical adjustment to the diet or insulin level of the patient should be done
after evaluation of the health of the patient (Evans & Lang, 2004).
Involvement of Multidisciplinary team
The task of the members of the multidisciplinary team is to take care of each patient comes to
the healthcare organization. The members of the interdisciplinary team are the practitioner
nurse, the doctor of podiatric medicine, the anesthetist nurse, the registered dietician, the
therapist, the clinical psychologists and the pharmacist (Schoenly & Knox, 2013). In this
case study, as per C&FCC model the child specialist doctor, the registered dietician, and
clinical psychologist are the influential members of the child management care. The child
specialist would take regular check-up of the child's blood sugar level and blood pressure
level (Grossman, 2011). The dietician would check the medical reports regularly and would
advise the types of foods that can be hygienic for the patient.
Potential Comorbid complication and extended care education
As per the case study, the child health care organization must advise Sarah's parents to take
effective care of Sarah's medication, food habits and wounds. They would be advised not to
give Sarah sweet food and consult with a doctor soon if any unusual urinal problem is
identified (Potter, 2003). Moreover, the parents must care about any kind of physical wound
of Sarah. Because bleeding from any kind of wound can be dangerous for Sarah’s health.
They must keep Sarah well away from any kind of alcohol consumption and alcohol
consumption promotes type1 diabetes. The food timing must be fixed for Sarah. She must be
given breakfast, lunch, and dinner in a specific time and as early as possible (Mazurek
Melnyk, 2007). Early to bed is must for Sarah.
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The discharge plan and consideration from child health care in the remote community are:
 Evaluation: The health of the patient must be evaluated by any specialist if any further
issue arises.
 Discussion: discussion would be done with the parents of the patient. As per this case
study, the child health care staffs must discuss the future tasks with Sarah’s parents.
 Planning: The child health care then advice the patient either to go home or refer to
any better place for further treatment.
 Determining: the caregivers of the child healthcare determines to whatever any
assistance is required
 Referrals: The caregivers of the child care organization refer to any healthcare
agency or care organization of the particular community of the patient so that the
patient can be assured about the treatment process (Mazurek Melnyk, 2007).
 Arranging: The healthcare staffs then advices the patients' family for any further test.
Here, Sarah must be advised to take insulin and a regular blood and urinal test.
Conclusion
The study has discussed several aspects of evidence-based nursing which includes several
medical checkups and medical advice. In this study, a blood test is done as soon as Sarah was
admitted to the child care organization. This helps them to measure the blood sugar level of
Sarah. Then insulin was injected for quick treatment. Thereon, the management assessed the
symptoms, diagnose the symptoms, plans for Medicare, implemented the Medicare plans and
then evaluated the Medicare process. Therefore, the study analyzed the involvement of the
disciplinary team, a potential comorbid compilation which includes several medical advice
before discharging Sarah. Thus, evidence-based nursing is the most effective way to treat
critical disease accordingly.
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