Integrated Nursing Practice | Assignment

Running Head: INTEGRATED NURSING PRACTICE
Integrated Nursing Practice
Name of Student:
Name of University:
Author Note:

Integrated Nursing Practice
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Answer 1:
The case study involves around Evelyn Hansen, a 65-year old elderly female who is obese.
The assignment is addressing morning shift of the case study.
The five patient issues identified of Evelyn Hansen by the nurse are:
 Hyperglycaemia
 Hyperosmolar Hyperglycaemic Syndrome (HHS)
 Impaired Kidney function.
 Depression
 Lack of diabetic education
These are the five health issues observed in the patient of which three high risk issues
include the hyperglycaemia, hyperosmolar hyperglycaemic syndrome and impaired kidney
function. This is because these health issues are life threatening and if not checked or kept
in the normal range it could lead to cardiovascular complications in the older adults. The
patient showed slight signs of depression that can be considered later on the basis of
priority of the health conditions that needs immediate attention. Physical well-being will
gradual promote the mental health of the patient. The patient has lack of education on
diabetes as she had doughnut and a bottle of juice and complained of blurred vision as
well. This can also be considered as not that high a priority as health issue because while
treating hyperglycaemia the patient will automatically learn about the ways to deal with
high blood sugar. The hyperglycaemia is the prevalence of high glucose level in the blood
that can lead to other comorbid factors and the main contribution is due to the impairment
of the beta cells of the pancreas (Dhatariya and Vellanki, 2017). The kidney impairment
also is the cause of malfunction in the kidney glomerular filtration. The infiltration can
lead to harmful health condition and the dehydration caused due to the hyperosmolar

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hyperglycaemic syndrome plays an important role in deteriorating the health condition of
the older adults. It mainly compromises the consciousness level of the individual
(Fayfman, Pasquel and Umpierrez., 2017).
Answer 2:
The top three health priorities of the case study include:
 Hyperglycaemia
Hyperglycaemia is the condition when the pancreatic beta cells become dysfunctional and
causes insulin resistance in the liver. It is a condition described as excessive amount of
glucose present in the blood (Dhatariya and Vellanki, 2017). Diabetes is one of the leading
chronic medically health compromised condition among the older adults who have other
vascular comorbidities like coronary artery disease, impairment of the physical and cognitive
function and the mortality (Fayfman, Pasquel and Umpierrez., 2017). This is the most
prevalent form of diabetes among the older adults. The risk of acquiring diabetes for older
adults is higher due to the combined effects of genetic factors, the lifestyle and the influence
of aging. It is further complicated by the occurrence of comorbid and functional impairments
that are associated with ageing. The pathology of the syndrome of hyperglycaemia is the
imbalance of the glucose production and the glucose uptake (Umpierrez and Korytkowski,
2016). And several factors contribute to this imbalance of the glucose distribution. With
increase in age the impairment of the beta cells of the pancreas also increases this acts as a
direct impact of pathophysiology of the disease in the older adults.
 Hyperosmolar Hyperglycaemic Syndrome (HHS)
This syndrome is a complication of the disease diabetes mellitus which is characterised by
high blood sugar that results high osmolarity without any significant ketoacidosis (Hirsch and
Emmett, 2018). The essential symptoms involve dehydration, weakness and leg cramps. It