Nursing Priorities for Diabetic Patients

This article discusses the nursing priorities for diabetic patients, focusing on the importance of lipid control and non-pharmacological treatment. It explores the impact of diabetes on elderly patients and the risks they face. The article also provides insights into the clinical reasoning cycle and its application in patient care. Overall, it emphasizes the need to improve the quality of life for elderly diabetic patients.

Running head: NURSING PRIORITIES FOR DIABETIC PATIENTS 1
Nursing Priorities for Diabetic Patients
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Nursing Priorities for Diabetic Patients
According to de Vries et al. (2016), the condition is prevalent among the elderly
populaces aged between 50 and 80 years old. The researchers warn that the prevalence of
diabetes is expected to undergo further increments due to the present lifestyle changes. Nadeau et
al. (2016) explain that diabetes exposes elderly patients to multiple socio-economic, medical and
human burdens. For instance, Magnan et al. (2017) explain that diabetes exposes patients to the
increased risks of acquiring physical disabilities, reduced quality of life, and increased risks of
readmission. Peter is a 52 year old male patient diagnosed with type 2 diabetes. The patient was
admitted in the medical ward and showed evidence of poorly controlled diabetes, sleep apnea
and obesity ventilation syndrome. Upon presentation to the GP, the client presented symptoms
such as high blood glucose, shakiness, breathing difficulties, multiple sessions of hunger and
diaphoresis. The current study seeks to undertake a critical analysis of priority care for Peter by
initiating lipid control and non pharmacological treatment.
Priority care for Peter will be aimed at initiating lipid control and non pharmacological
treatment. According to Grant et al. (2016), priorities of care targeting elderly diabetic patients
must aim at improving their qualities of life while promoting successful ageing. On the other
hand, Clemens et al. (2016) demystify that treatments aimed at reducing the blood pressure of
patients that depict prolonged conditions (more than 8 years after diagnosis) lead to a significant
decrease in their levels of micro and macro cardiovascular events.
Lipid control will be prioritized as a strategy of initiating weight management through
proper management of the levels of LDLc and cholesterol. The clinical reasoning cycle plays a
significant role in explaining the efficacy of ongoing healthcare interventions when dealing with
elderly diabetic patients such as Peter. The cycle adopts eight cyclical procedures that are

NURSING PRIORITIES FOR DIABETIC PATIENTS 3
identified as look, collect, process, decide, plan, act, evaluate and reflect. Grant et al.
(2017)explain that while each of the eight processes are presented as separate and distinct
entities, there is need for caregivers to uphold the fact that clinical reasoning applies dynamic
procedures and experienced professionals may be allowed to combine some phases. According
to Finer et al. (2018), the levels of LDLc and cholesterol tend to undergo a sharp increase as a
person attains the age of 50. However, the researchers explain that after the plateau phase is
attained, the patient experiences a gradual decrease in the levels of total cholesterol (TC), low-
density cholesterol (LDLc) and high density cholesterol (HDLc). Wittink et al. (2018) attribute
such variations to issues such as decreased physical activity, general health position of the person
under consideration and an increase in co-morbidities. Further, the scholars reveal that the
relationship between the total cholesterol of a person and cardiovascular mortality tends to
weaken as the age of the individual advances. de Vries et al. (2016) also reveal a similar
relationship between one’s levels of LDLc and the tendencies of acquiring stroke or myocardial
infarctions. Further, the relationship between total cholesterol and mortality is inverted in
instances where the patient under consideration is very old. Finer et al. (2017) attribute such a
position to the fact that elderly people are exposed to other chronic conditions such as
malnutrition, cancer and infections.
Considering the case of Peter, lipid control will be initiated as a technique of managing
his weight. Despite his present status, the patient describes himself as a “biggish guy” whose
normal weight sits at around 105kg. However, Peter explains that he has gained a significant
amount of weight particularly after he had lost his job. The patient is exposed to multiple
difficulties in his pursuits of finding employment based on his present status as an overweight
person. The patient’s medical history reveals that he is obese with a weight of 145kg. The

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patient’s weight status exposes him to multiple social difficulties. For instance, he faces fatigue
and is generally disturbed by his size. Such feelings expose Peter to social isolation. However,
Peter is motivated to lose weight and quit smoking considering the fact that he is at the prime of
his middle age. Statin therapy is recommended for Peter as a method of initiating proper lipid
control. Rees et al. (2017) explain that just like their younger counterparts, elderly diabetic
patients show positive results when exposed to statin therapeutic interventions with the exception
of the levels of mortality. The researchers explain that statin is aimed at minimizing he levels of
LDLc, TC and HDLc. On the other hand, Finer et al. (2017) explain that low HDLc levels acts as
a better indicator of positive response to statin therapy. Peter presents a wider array of
complications which include poor feeding and nutritional regimes, being a chain smoker and
obesity. As a consequence, statin treatments will be adopted as a way of controlling the patient’s
body weight.
Further, the treatment of Peer’s condition will be initiated through incorporation of other
non pharmacological treatments. According to Finer et al. (2018) non pharmacological
treatments aimed at fostering lipid control proceed by combining physical activity and initiating
proper dietary balance. The researchers explain that while these two treatment approaches could
be time consuming and resource intensive, their benefits are additive. Such a notion is attributed
to the fact that non pharmacological treatment regimes are not only effective in fostering lipid
control but also play an effective role in fostering functional independence, restoring and
maintain the patient’s muscle mass, minimizing blood pressure, fostering overall wellbeing and
increasing the patient’s tendency of attaining successful ageing.
Therefore, Peter will be taken through a dietary counseling session with the intention of
fostering proper attainment and maintenance of an adequate nutritional status. Nadeau et al.

NURSING PRIORITIES FOR DIABETIC PATIENTS 5
(2016) explain that while weight loss is one of the objectives of initiating dietary balances among
diabetic patients, it must be conducted with adequate care as it may impose adverse negative
effects on the levels of mobility and muscle mass of the patient under consideration. As a
consequence, exceedingly liberal approaches will be avoided when dealing with Peter. Similarly,
physical activity targeting Peter will be conducted in such a way that it is at par with his levels of
ability as a way of avoiding any form of motor or sensory incapability. As such, Peter will be
taken through a series of endurance training exercises.
Grant et al. (2017) explain that there is need for elderly diabetic patients to be taken
through a series of medical examinations to assess their levels of fitness when undertaking
physical exercises. According to Rees et al. (2017), elderly people that are diagnosed of diabetes
tend to be exposed to minimal chances of successful ageing, with an increase in the levels of
functional limitations. On the other hand, Finer et al. (2017) demystify that the low socio-
economic statuses depicted by these patients also imposes a negative impact on their autonomies.
In particular, the researchers demystify that such medical examinations must be conducted in
such a way that they audit the efficacy of the patient’s cardiovascular system in sustaining the
recommended exercises. On the other hand, Wittink et al. (2018) caution that particular emphasis
must be put on the importance of preventing injuries particularly on the patient’s feet. In Peter’s
case, resistance training will be initiated as a way of enhancing his muscle mass while reducing
his fat mass as an initiative of fostering weight control. As such, the patient will get multiple
benefits both in the lines of autonomy and quality of life.
To apply the clinical reasoning cycle in Peter’s case, the process will proceed by
considering his situation by describing his current situation. For instance, Peter suffers from type
2 diabetes, is obese, hypertensive, and presents sleep apnea and gastro esophageal reflux disease.

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To collect information, patient history, investigational results, previous medical assessments and
handover reports will be adopted. Further, patient assessment will be institutionalized to collect
new information. Information processing will be undertaken through interpretation and analysis
of medical reports. To identify Peter’s problem, the caregiver will synthesize the information,
facts and inferences provided to ensure that effective diagnosis is undertaken. This will be
followed with the establishment of the proper treatment goals based on the observations made. A
course of action is then taken by selecting the most suitable choice from multiple alternatives. In
Peter’s case, evaluation of outcomes is conducted by assessing the efficacy of the treatment
priorities in fostering weight management and levels of physical activity as indicators of the
patient’s quality of life. By considering the effectiveness of the treatment regimes and
interventions put in place, the caregiver will contemplate on the learning opportunities availed by
Peter’s case and the things that needed to have been conducted in a different way.
In conclusion, the clinical reasoning cycle plays a significant role in explaining the
efficacy of ongoing healthcare interventions when dealing with elderly diabetic patients such as
Peter. According to Gummesson, Sundén, and Fex (2018), the clinical reasoning framework
inculcates evaluation and reflection as its two key principles. The cycle adopts eight cyclical
procedures that are identified as look, collect, process, decide, plan, act, evaluate and reflect.
Grant et al. (2017)explain that while each of the eight processes are presented as separate and
distinct entities, there is need for caregivers to uphold the fact that clinical reasoning applies
dynamic procedures and experienced professionals may be allowed to combine some phases.
Priority care for Peter is aimed at initiating lipid control and non pharmacological treatment. The
priorities of care targeting elderly diabetic patients must aim at improving their qualities of life
while promoting successful ageing. On the other hand, lipid control will be prioritized as a

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strategy of initiating weight management through proper management of the levels of LDLc and
cholesterol.

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References
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depression care: a randomized controlled pilot trial. American journal of health behavior,
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Finer, S., Robb, P., Cowan, K., Daly, A., Robertson, E., & Farmer, A. (2017). Top ten research
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