Nursing Medication Management

This article deals with the case study of the Marcel and in this article clinical reasoning cycle will be applied to support the patient with his self and medication management regarding diabetes.

Running head: NURSING MEDICATION MANAGEMENT
NURSING MEDICATION MANAGEMENT
Name of the Student
Name of the University
Author’s Note:

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This article deals with the case study of the Marcel and in this article clinical reasoning
cycle will be applied to support the patient with his self and medication management regarding
diabetes. Marcel is a seventy years old male who migrated from Spain in his childhood years
with his family. Marcel is second generation sugar cane farmers living in the northern
Queensland. He is married and has three grandchildren from his two children. At present, he is
retired and he sold his farm three years ago at the time of the retirement. Presently, the patients
has been feeling very fatigued in his daily activities and had to get up at night to go to the toilet.
Being worried about his condition, Marcel decided to visit and general practitioner and made an
appointment.
The patient’s height is 180.5 cm with a weight of 116 kg. He has a very high Body Mass
Index or BMI of 35.6 and can be classified in the group of obese. During the initial assessment
Marcel has reported that his family has a history of Type 1 diabetes as well as Type 2 diabetes.
Additionally, he has a history of the hypertension and he was a heavy smoker during his whole
work life. Along with that the patient has also reported that the he has been spending a sedentary
life style over the past years and as a direct consequence of this kind of lifestyle, he has gained
14 kg over the course of last 9 months.
The patient’s Body Mass Index or BMI of 35.6, family history of Type 1 diabetes as well
as Type 2 diabetes, patient’s own history of hypertension, and heavy smoking habits puts him
under high risk of diabetes. Consequently, the laboratory test of the patient’s has been positive
for hyperglycemia which is the most defining characteristics of diabetes. Along with that patient
does not perform lot of physical activity due to his sedentary life style which also adds another
risk factor to the patient condition. The reasons behind the patient’s appointment with the general

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practitioner were feeling of fatigue and frequent urination. These are also the symptoms of Type
2 diabetes and therefore the patient, Marcel, is in high risk from suffering diabetes mellitus.
Form the lab report, it has been found out that the patient, Marcel, has Type 2 diabetes
mellitus. This diagnosis is in line with the suspected diagnosis presented for the patient in the
above paragraph. The patient was concerned about his diagnosis and he was very concerned
about the situation as this condition led his uncle to amputation in his knees.
To control and mitigate the harmful effect of chronic illness like diabetes (Chang &
Johnson, 2017), physical activities and dietary conditions of the patient has to be managed. There
is no optimal management system for every single patient and a management plan has to set up
according to the patient’s physical and medical conditions (Lewis et al., 2014). In order to
achieve that, a set of goals need to be set up for the patient. The goals that were established for
this patient were:
i. The patient will lose 1 kg in every week for the next month and overall goal is to reduce
body mass index by 10 % (Middleton, Moxham & Parrish, 2016).
ii. The patient will join in a fitness program at the local community center.
iii. The patient will partake in a balanced diet.
iv. The patient will walk for at least 30 minutes every day.
v. The patient will be administered with diabetes lowering agents or medication.
vi. The patient will be aware of the basic understanding of the diabetes and its management
plan
vii. The patient will be vaccinated against diseases like hepatitis and influenza (Celik &
Celik, 2019).

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viii. The patient will be able to monitor his blood glucose level by himself.
ix. Changes in lifestyle like cessation of smoking in a step by step manner and driving cars.
In order to achieve the goals set up in the above section, several actions will be taken for the
support of the patient. The patient will be refer to a dietician to for proper nutrition, so that he
can maintain a balanced and nutritional diet. The diet will be according to the ‘Australian Dietary
Guidelines’.
The next step that will be considered according to the clinical guidelines is to provide
education to the patient about his ‘Medication Management’. Medication management is really
important for the patients as error related to the medication intake is one of the leading cause of
the re- hospitalization or hospitalization (Roland & Paddison, 2013). Studies have suggested it is
particularly evident among the older patients with more than 2 – 3 medicines (Tannenbaum et
al., 2014). Marcel is a seventy years old man who currently takes lots of medicine and therefore,
education related to the medicine management is really important to him. Marcel will be clearly
directed about the harmful effects of taking a wrong medicine or not taking a medicine for his
condition (Tannenbaum et al., 2014). Additionally, his medication will be dispensed in separate
containers with color coded for better identification. His medication will also be marked clearly
to avoid confusion and mistakes. Furthermore, Marcel will be enrolled in a tele- outreach
program conducted by nurses to check that he is taking accurate medication and no error has
been made by him in this regard (Darvish et al., 2014). He will also be advised to contact
immediately to the nurses or medical practitioner if he has any doubt his medication. In addition,
his immediate family will also be notified about his medication so that they can help and correct
any mistakes which might occur.

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Evaluation process of the patient management will be performed after three months. In the
evaluation process, the parameters like blood glucose level, weight loss will be measured. For
example, if ‘Metformin’ is not able to reduce the level then combination of drugs like
‘Metformin/Glibenclamide’ can be employed. If the patient is not able to achieve his weight loss
target, then exercise time might be improved. Additionally, an interactive session will be
conducted to evaluate whether the patients has adequate knowledge regarding diabetes and
monitoring his blood glucose level correctly.
Findings of the evaluation process will be analyzed and further implementation and change
of management plan can be modified based on the findings of the evaluation process.
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References:
Celik, E., & Celik, M. (2019). Vaccination Recommendations for Patients with Diabetes. EC
Endocrinology and Metabolic Research, 4, 19-64.
Chang, E., & Johnson, A. (Eds.). (2017). Living with Chronic Illness and Disability: Principles
for Nursing Practice. Elsevier Health Sciences.
Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing
informatics on promoting quality of health care and the need for appropriate
education. Global journal of health science, 6(6), 11.
Lewis, S. L., Bucher, L., Heitkemper, M. M., & Dirksen, S. R. (2014). Clinical Companion to
Medical-Surgical Nursing-E-Book. Elsevier Health Sciences.
Middleton, R., Moxham, L., & Parrish, D. (2016). Diabetes, older people and exercise:
recommendations for health promotion programs. Australian Nursing and Midwifery
Journal, 23(9), 32.
Roland, M., & Paddison, C. (2013). Better management of patients with
multimorbidity. Bmj, 346, f2510.
Tannenbaum, C., Martin, P., Tamblyn, R., Benedetti, A., & Ahmed, S. (2014). Reduction of
inappropriate benzodiazepine prescriptions among older adults through direct patient
education: the EMPOWER cluster randomized trial. JAMA internal medicine, 174(6),
890-898.