Type 2 diabetes mellitus - Symptoms and causes

Running Head: T2DM 0
T2Dm
[Document subtitle]
JANUARY 25, 2020

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Table of Contents
Task 1....................................................................................................................................................2
Task 2................................................................................................................................................3
Task 3................................................................................................................................................4
Task 4................................................................................................................................................5
References.............................................................................................................................................7

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Task 1
Luna Brown is the Maori women diagnosed with Type 2 diabetes mellitus. She has
been provided with the metformin and receiving palliative care. She also has an increased
level of LDL and augmented blood pressure and high levels of glycosylated hemoglobin. She
has been living alone after the death of her husband and developed psychological issues and a
lack of trust in the treatment procedure. She has been facing problems in managing daily life
works due to deprived body function and lack of visibility which increases the risk of falls.
There different nursing care needs that should be considered in the case of Luna as she has
developed mental issues like depression and stress. The nurses must provide emotional
support to the patient and reduce the pain as part of palliative care (DeFronzo et al., 2015). A
health care team for Luna will involve endocrinologists, nutritionists, pharmacists, social
workers, and nurse educators. Endocrinologist treats diabetes and other illnesses associated
with endocrine glands, which secretes the hormones that regulate bodily functions and which
the insulin-secreting is part of. This professional can help Luna learn to monitor her blood-
glucose intensities and can recommend and monitor medicines to regulate them. A
nutritionist or a registered dietitian is proficient in nutrition will help Luna understand the
association between diet and diabetes and support her create an ingestion plan that fir for her
and her specific lifestyle while captivating into account how bodily active she is. Pharmacists
receive professional training in an extensive variety of therapeutic conditions, medicines, and
treatments. If the patient has questions about her medication, for example, side effects, the
pharmacist can recommend Luna and her family members. Social workers, or psychologists,
can help Luna and her family address the emotional toll a long-lasting illness can take. A
nurse educator or diabetes nurse expert is a registered nurse with distinct training and
experience in caring for and educating individuals with diabetes (Jalilian et al., 2014). A
Nurse educator frequently helps the patient with the everyday aspects of living with T2DM.

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The nursing needs discussed above are the most important aspect in the treatment process,
however, there are other different aspects that must be considered while addressing the
patient's situation such as including Maori traditional medication in the treatment,
maintaining her LDL levels and performing assessment at a regular basis (Carpenter et al.,
2019). Providing emotional support is essential in the case of Luna as her husband died
recently and she is living with life-threatening health issues. Patient with type 2 diabetes
often experiences pain during the treatment process. Increase pain might affect the treatment
process and nursing care (Cheng et al., 2918). In the case of older people, it becomes
unbearable, therefore it must be assessed at regular intervals and should be reduced.
Including Maori traditional medication might develop a sense of belief and trust in the
healthcare setting as it enables the patient to think that she is being cared for and respected
(Klee & Perkins, 2015).
Task 2
Hypoglycemia is an important issue risk for numerous people. It is significant to
understand that the risk of hypoglycemia can alter and require to be evaluated frequently. The
hyperglycemia problem is not a benign illness (Zhao et al., 2017). It causes upsetting osmotic
symptoms for example thirst, urinary regularity, and lethargy, worsens pain, subsidizes to
delirium and misperception, diminishes mood, and impacts problem solving, the ability to
cope and quality of life (Tangvarasittichai, 2015). Dealing with hyperglycemia improves
comfort and might comprise more recurrent BG testing, liquid replacement, and insulin.
Some common problems faced by people receiving palliative care are Anorexia, cachexia,
and dysphagia (Azami et al., 2018). Furthermore, individuals with diabetes are frequently
deficient in important nutrients and are frequently anemic, particularly if they are receiving
metformin, which prevents absorption of vitamin B12 (Smith‐Miller et al., 2012), therefore
might require additional nutrients counting protein in the steady and unbalanced palliative

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period. Increased pain, which impacts appetite should be managed (Yuan et al., 2014).
Tolerable pain management is important and is usually well recognized in palliative care
plans. In the case of Luna’s pain Acetaminophen, aspirin, ibuprofen, or naproxen can reduce
mild to moderate pain. The self-management of symptom in type 2 diabetes mellitus is
essential as is support the treatment process (Dodds, 2017). Self-management involves the
person with diabetes working in partnership with their carers and health professionals so they
can: understand their condition and various treatment options contribute to, review and
monitor a plan of care (eg care plan) engage in activities that protect and promote health
monitor and manage the symptoms and signs of the condition manage the impact of the
condition on physical functioning, emotions and interpersonal relationships (Catherine et al.,
2014). To identify whether the patient self-managing her care or not, a nurse can monitor her
health condition regularly and assess her vital signs. A nurse can also ask some questions
related to self-management and guide the patient is she is doing something wrong and
identify barriers to self-management as it is important when developing a management plan
with the patient (Jalilian et al., 2014).
Task 3
As the patient reported that her condition is getting worse and she does not think that
the treatment s working for her. She has also developed mental health issues like stress and
depression. Therefore, the nurses provided culturally competent care to the patient (Daly et al.,
2018). The nurses managed to develop a therapeutic relationship with the patient and the
diseased person seemed happy and satisfied with the care being provided to her. Maori
culture is quite different from other non-Maori cultures. For example, most of the Maori
patient demands to keep spiritual and cultural things with them during her hospital stay (Kidd
et al., 2018). The hospital management allowed the patient to carry Tikanga, which is the
cultural customs that provide a wide range of care. The hospital management also allowed

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her to perform Karakia in the hospital which is the Maori prayer used to invoke spiritual
guidance and protection. Different Maori patient demands to have Maori traditional medicine
in the hospital, which is allowed in the hospital, this developed a sense of trust and being
cared. Maori people specifically discuss the significance of waiata (a song) in managing pain
and enabling the individual’s spiritual journey by making an association between the spiritual
and physical worlds. These specific cultural practices are an appearance of Māori principles
and values and frequently involved strengthening relational relationships (counting
spiritually) between the individual receiving palliative care and whānau members, and the
health care providers (Walker & Waterworth, 2017). The patient is also showed a positive
response on allowing the family member’s involvement in the decision-making process.
Task 4
Goals associated with the nursing care planning for Luna Brown include efficient
treatment to regularise blood glucose and reduction of complications by implementing insulin
replacement, a stable diet, and exercise. The nurse must stress the significance of obeying the
recommended treatment program. The nurses must tailor teaching to the patient’s
requirements, abilities, and developing stage (Richardson et al., 2014). They must also stress
the effect of blood glucose regulation on longstanding health. An efficient nursing care plan
comprises a regular assessment of the vital sign. The glucose level should be assessed before
and after meals (McGill et al., 2017). A nurse must also assess the patient for anxiety, tremors,
pain, and speech issues. The patient will learn how to measure her blood sugar and
understand the results. Her family members will demonstrate how to give insulin injections
using and other medicine. The patient will express how frequently and when she requires to
check her blood sugar. The diseased person will display how to self assess her deteriorating
condition. Luna will develop an everyday menu that encounters her diabetic requirements
(daCruz Vargas et al., 2015). The patient will also learn to self manage her psychological

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symptoms and report about the physical symptoms. The nurse will also educate the patient
and her family members on regulating her reparatory issues and reporting. After the
successful implementation of pain medication, she will experience a low intensity of pain and
her diabetic symptoms will be managed after a 30 days period. The patient will be educated
to take medicine on time and encouraged to adhere to the treatment. As the patient is
receiving palliative care she will be provided with emotional support. the patient will be
allowed to perform her traditional and spiritual activities such as karakia and take traditional
medicine during palliative care (Yuan et al., 2014). As the patient developed an unhealthy
lifestyle like eating outside food, she will be encouraged by the registered nurse to consume a
healthy diet and avoid alcohol and smoking.
Conclusion
Luba Brown is an old Maori lady suffering from type 2 diabetes mellitus. She has
increased levels of LDL, and high blood pressure, and developed psychological issues after
the death of her husband. The nursing care needs essential in Case of Luna includes
emotional support, advocacy, assessment of vital signs. She also developed low visibility
issues therefore she need assistance in performing routine tasks like walking. The healthcare
team for Luna will include, endocrinologist, nutritionists, pharmacist, social worker, and
nurse. Symptoms management is one of the main nursing care Luna needs while receiving
palliative care. Pain associated with her health condition should assessed and managed by
using medication like acetaminophen. The cultural needs should be considered by health care
providers. For example, Maori patient often demand for carrying their spiritual things and
include Maori traditional medicines in the treatment. Having information and respecting the
Maori value can help the nurses to develop healthy relationship. The action plan must include
care for both clinical and mental issues. It must consider involving the family in the decision-
making process.

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