Clinical Reasoning Cycle for Medication Management and Self-Management in Type 2 Diabetes

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Contents
INTRODUCTION.................................................................................................................................2
CLINICAL REASONING CYCLE.......................................................................................................2
PROCESSING OF INFORMATION................................................................................................2
IDENTIFICATION OF PROBLEM..................................................................................................3
ESTABLISH GOALS.......................................................................................................................3
NURSING ACTIONS AND RATIONALE......................................................................................4
ISSUE 1 – POLYPHARMACY AND MEDICATION MANAGEMENT....................................4
INTERVENTION..........................................................................................................................4
RATIONALE................................................................................................................................4
INTERVENTION 2.......................................................................................................................4
RATIONALE 2.............................................................................................................................5
ISSUE 2 –SELF MANAGEMENT...................................................................................................5
INTERVENTION..........................................................................................................................5
RATIONALE................................................................................................................................5
EVALUATION OF OUTCOMES....................................................................................................5
REFLECTION...................................................................................................................................6
CONCLUSION.....................................................................................................................................6
REFERENCES..........................................................................................................................................7

INTRODUCTION
Type 2 diabetes is a chronic endocrine disorder associated with other limiting co-
morbidities such as kidney failure, lower extremities amputation, and diabetic retinopathy.
Obesity act as a risk factor for type 2 diabetes. Medication targeted towards lowering
glycemic index is the mainstay for diabetic’s symptomatic management and therapy. In the
case of older adults, current research suggests medication management is better achieved
through self-management (Iglay et al., 2016).
The present essay will address a medical case study on type 2 diabetes through Levett
Jones clinical reasoning cycle for facilitating optimal care with rationale and logical
validation. The essay will focus on medication management and self-management issues.
CLINICAL REASONING CYCLE
COLLECTION OF INFORMATION & PATIENT SITUATION
The current essay takes into account the case of Marcel (70-year-old male) suffering
from obesity condition and recently diagnosed with Type 2 diabetes. His medical history
shows hypertension and in the past a heavy smoker. Frequent urination has been noticed in
the case of Marcel.
PROCESSING OF INFORMATION
In type 2 diabetes, insulin resistance occurs at target cells (liver and skeletal muscles)
due to the involvement of low level of insulin receptors and reduced response by target cells
(Craft & Gordon, 2019). Type 2 diabetes has many implications, especially in older patients.
One of the significant implications in older patients is medications. Older diabetic patients
with obesity have multiple co-morbidities; therefore, warranting polypharmacy. Poly-
pharmacy can result in drug interactions, dose error, missed medications and wrong intake
(Lewis, Kollier & Heitkemper, 2017). In the present case study, Marcel is obese evident by