Nursing Assignment: Medication Management and Patient Education

This nursing assignment discusses the importance of medication management and patient education in promoting recovery for a 70-year-old farmer with diabetes. It emphasizes the need for a person-centered approach and collaborative practice in devising a care plan for the patient.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student:
Name of the University:
Author Note:

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Introduction:
According to the case study, Marcel is a 70 year old farmer who has been suffering
from Diabetes and its uncontrolled symptoms. In order to promote recovery, the nursing
professional must adapt a person-centred approach and collaborative practice so as to devise
a care plan for the patient (American Diabetes Association, 2015).
Discussion:
Identification and prioritization of patient’s medication management:
In order to devise an effective care plan, it is important for the nursing professionals
to prioritize patient problems. Identification of patient priorities would help in assisting care
professionals to make use of care principles to promote effective recovery (Barrès & Zierath,
2016). Further, upon identifying the care priorities, the nursing professional would typically
adapt a person-centred approach in order to devise an appropriate care plan for the patient. It
should be noted in this context that the two nursing priorities for the patient would comprise
of teaching the patient self-management skills and promoting health literacy and improving
his medication management routine. On the basis of the case study analysis, it can be said
that the patient’s Diabetic condition had deteriorated on account of the identified care
priorities. Upon applying the principles of clinical governance, it can be said that the patient’s
health condition had significantly deteriorated due to poor lifestyle factors. Therefore, it can
expected that upon addressing the identified care priorities the patient’s condition could be
improved.
The nurse would typically make use of the clinical reasoning cycle in order to identify
and collect information related to the medication management routine of the patient.
Therefore, to address the nursing priority of managing the patient’s medication, the nursing
professional would need to draft a schedule for the medication dosage and timing of the

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patient. The routine would comprise of mentioning the dose level of insulin and other
diabetic medications. The rationale for managing the medication routine of the patient would
help in controlling the elevated blood glucose level of the patient (Brummel, Soliman,
Carlson & de Oliveira, 2013). This would help in preventing instances of hypoglycaemia as
has been reported consistent with his experience of hyperosmolar hyperglycaemic state
(Bowen et al., 2016). In addition to this, research studies report that improper medication
management in patients suffering from Diabetes could trigger an episode of hypoglycaemia
as well as altered mental state conditions resulting due to hyperosmolar hyperglycaemic state
(Kuntz et al., 2014). In addition to this, promoting health literacy to the patient is also
important as it would help in disseminating awareness about the need to optimize the blood
glucose levels in the body so as to avoid instances of skipping medication and consuming the
correct medication doses (Solomon er al., 2017).
Further, appropriate measures would be adapted by the care professionals to educate
and empower the patient about self-management skills. The care professionals would teach
the patient the process of monitoring his blood glucose level by using blood glucose test
strips (Van der Heide et al., 2014). The nursing professional would teach the patient how to
correctly use the blood glucose test strips by pricking of the finger. Further, the nurse would
also educate the patient about the risk factors that could potentially interfere with the
optimization of the blood glucose level. Also, the nurse would consult and involve a
multidisciplinary team or care professionals comprising of a dietician, ophthalmologist and a
physiotherapist who would practice collaboratively to ensure holistic management of the
symptoms of the patient (Barres & Zierath, 2016). In addition to this, the patient would also
be educated about the cause of diabetic foot ulcers and neuropathy (Watson & Dyck, 2015).
In order to alleviate the patient from the impact of Diabetic foot ulcer, the patient would be
encouraged to adapt precautionary measures to ensure Diabetic foot care. According to

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Soloman et al. (2017), disseminating self-management strategies have been reported to yield
empowerment and knowledge acquisition which subsequently promotes to accelerated
recovery.
Use of nursing intervention:
The nursing intervention would comprise of placing the patient at the heart of the care
and adapting a multidisciplinary approach to ensure that the patient’s medication is managed
optimally. This would include drafting a proper medication routine after consulting with the
physician. The medication along with the correct dose would then be obtained from the
pharmacist. A nurse would then be involved in the care process who would ensure that the
correct dosage of the medication is administered to the patient at the correct timings. It can be
mentioned here that upon ensuring proper medication management, the blood glucose level
of the patient would remain stable which would eventually prevent risks of suffering from a
hypoglycaemic shock (Kuntz et al., 2014). Further, the patient would be educated so that he
is able to make use of the flash glucose monitoring device, this would help him control the
presence of stiffness in his hands (American Diabetes Association, 2015). Therefore, the
nursing professional would make use of the principles of clinical governance and establish a
strong therapeutic relationship with the patient to make him appropriately use the flash
glucose monitoring device and monitor the blood glucose levels (Van der Heide et al., 2014).
The second intervention would include educating the patient about the normal range
of the blood glucose level and an in depth knowledge about the risk factors that could trigger
the worsening of his Diabetic symptoms. In addition to this, the nurse would explain the
patient about the correct procedure of using the glucose test strips by pricking his finger and
enlightening the patient about the symptoms of Diabetic foot and neuropathy (Watson &
Dyck, 2015). Further, on account of the information mentioned about problems with the

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vision, an ophthalmologist would be consulted (Solomon et al., 2017). Deteriorating vision or
diminishing visual perception is common in Diabetic patients as suggested by research
studies (Solomon et al., 2017). Further, the inclusion of dietician would help in customising
and monitoring the dietary intake of the patient. Also, a physiotherapist would be included in
the process of care so as to teach the patient a number of physical exercises which could help
the patient manage his body weight and control the blood glucose level.
Evaluation outcome:
Evaluation forms an integral aspect of the clinical governance cycle. In order to
evaluate the efficacy of the nursing intervention strategies, regular blood tests would be
conducted (American Diabetes Association, 2015). This would help in estimating the blood
glucose level. In addition to this, the body weight and BMI of the patient would be frequently
assessed so as to estimate the level of progress (Bowen et al., 2016). Also, the patient would
be interviewed in order to develop an idea about his experience of managing the symptoms
on his own. Based upon the results, necessary amendments could be made in the nursing
plan.
Conclusion:
Hence, to conclude it can be said that in case of the patient, it is extremely important
to educate the patient and adapt a multidisciplinary approach to control the symptoms of the
patient. Involving a multidisciplinary approach would help in catering to the holistic needs of
the patient which would subsequently promote an accelerated recovery.

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References:
American Diabetes Association. (2015). Standards of medical care in diabetes—2015
abridged for primary care providers. Clinical diabetes: a publication of the American
Diabetes Association, 33(2), 97. DOI: 10.2337/diaclin.33.2.97
Barrès, R., & Zierath, J. R. (2016). The role of diet and exercise in the transgenerational
epigenetic landscape of T2DM. Nature Reviews Endocrinology, 12(8), 441. DOI:
https://doi.org/10.1038/nrendo.2016.87.
Bowen, M. E., Cavanaugh, K. L., Wolff, K., Davis, D., Gregory, R. P., Shintani, A., ... &
Rothman, R. L. (2016). The diabetes nutrition education study randomized controlled
trial: a comparative effectiveness study of approaches to nutrition in diabetes self-
management education. Patient education and counseling, 99(8), 1368-1376. DOI:
https://doi.org/10.1016/j.pec.2016.03.017.
Brummel, A. R., Soliman, A. M., Carlson, A. M., & de Oliveira, D. R. (2013). Optimal
diabetes care outcomes following face-to-face medication therapy management
services. Population health management, 16(1), 28-34. DOI:
https://doi.org/10.1089/pop.2012.0023
Kuntz, J. L., Safford, M. M., Singh, J. A., Phansalkar, S., Slight, S. P., Her, Q. L., ... &
Hommel, K. (2014). Patient-centered interventions to improve medication
management and adherence: a qualitative review of research findings. Patient
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https://doi.org/10.1016/j.pec.2014.08.021
Solomon, S. D., Chew, E., Duh, E. J., Sobrin, L., Sun, J. K., VanderBeek, B. L., ... &
Gardner, T. W. (2017). Diabetic retinopathy: a position statement by the American

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Diabetes Association. Diabetes care, 40(3), 412-418.DOI:
https://doi.org/10.2337/dc16-2641
van der Heide, I., Uiters, E., Rademakers, J., Struijs, J. N., Schuit, A. J., & Baan, C. A.
(2014). Associations among health literacy, diabetes knowledge, and self-
management behavior in adults with diabetes: results of a Dutch cross-sectional
study. Journal of health communication, 19(sup2), 115-131. DOI:
https://doi.org/10.1080/10810730.2014.936989
Watson, J. C., & Dyck, P. J. B. (2015, July). Peripheral neuropathy: a practical approach to
diagnosis and symptom management. In Mayo Clinic Proceedings (Vol. 90, No. 7,
pp. 940-951). Elsevier. DOI: https://doi.org/10.1016/j.mayocp.2015.05.004