Case Study: Diabetes Type 1 - Nursing Care and Family Impact

This case study presents a comprehensive analysis of a Type 1 diabetes case, exploring the physiological mechanisms behind the disease, including the role of insulin and the impact of hyperglycemia. It details the various symptoms associated with the condition, such as increased thirst, frequent urination, and weight loss, and explains their underlying causes. The case study further examines the critical aspects of nursing care, including the validation and safe administration of insulin, patient assessment, and post-administration monitoring. It also delves into the emotional and physical impact of Type 1 diabetes on a child and their family, highlighting the importance of supportive care and education. The study concludes by addressing the adaptation of nursing care to accommodate a patient's intellectual disability, emphasizing the need for clear communication and health literacy.

Running head: CASE STUDY FOR DIABETES 1
CASE STUDY FOR DIABETES 1
Name of the student:
Name of the university:
Author note:

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CASE STUDY FOR DIABETES 1
High blood glucose level
There are certain specialized cells called beta cells of Islet of Langerhans that are present in the
pancreas. They are responsible for the secretion of insulin. Insulin help in entry of the glucose
form the blood to that of the cells of the body. Within the cells, glucose is broken down in
presence of oxygen to produce energy. However, in case of diabetes 1, the beta cells are not
being able to work properly. They produce little or no insulin at all for which the glucose form
the blood cannot be entered in the cells. These results in increase of blood glucose level which
causes hyperglycemia (Zaccardi et al., 2015).
Glucose in the urine:
When a person suffers from Diabetes 1, the beta cells of the islets of Langerhans cannot produce
enough insulin which is required to make the glucose absorbed by the cells. In such a scenario,
glucose level rises in blood. If left untreated, the glucose level becomes o high, that even kidney
fails to make the blood free form the glucose and some amount of glucose gets leaked in urine.
As a result, glucose is found in urine in many individuals who are suffering from diabetes 1.
Increased urination:
When glucose levels increase in blood, the kidney tries to take the sugar from the blood and
make it go back to the system and the urine is prepared to release out. However the kidney feels
pressurized in such a scenario as they have to work overtime to filter and absorb the excess
glucose. Often the kidneys fail to keep up and glucose get released into urine. These causes
dragging of extra fluids form the tissues which trigger more frequent urination that often leave
the patient dehydrated. As they drink more fluid to meet their thirst, they are subjected to
produce more urine.

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Increased thirst
As the excessive level of glucose in the blood grows up due to inappropriate secretion of insulin
form the beta cell of Langerhans in pancreas, some amount of glucose gets released in the urine,
this is mainly because the kidney cannot work properly to remove the excess amount of glucose
in the blood. When some amount of glucose is leaked in urine it pulls more fluid form tissues
resulting in more urination (Ozogou et al., 2013). Due to this factor, the individuals get
dehydrated and as a result they often have the feeling of drinking more water. This causes
increased thirst.
Increased appetite:
In case of Diabetes 1, the beta cells of the islets of Langerhans fail to produce enough insulin that
can remove the glucose from blood into the cell. As a result the cells do not get glucose and
therefore they cannot oxidize the glucose in presence of oxygen. Therefore energy is not
profuced by the cells which is important for conducting various activities. As the body cells do
not get glucose, the feeling of hunger occurs in the individuals, as the body thinks that more food
s required producing glucose in the blood but failing to understand the main reason that leads to
such condition. This lack of energy causes the individual patient to feel hungry.
Ketones in the urine and blood:
Body cells are unable to get glucose form the blood as the patients who is suffering form
Diabetes I do not produce enough insulin. In such a scenario, they cannot get substance to
oxidize them to produce energy which is required to conduct different physiological activities. as
the cells do not get energy they try to burn the fat in order to produce energy. The liver is mainly
responsible for converting fatty acids in ketones which are then released in the blood stream.

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These are helpful in deriving energy from fat. In patients who are suffering from this disorder,
have high levels of conversion which leads to high production of ketones in blood as well as in
urine. It enters in urine when levels get high in blood resulting in leakage form urine (Kahn et al.,
2014).
Weight loss:
As the cells are unable to produce energy due to absence of glucose in them during diabetes 1,
the cells try their best to gain energy from other sources. The fat and muscles is often burnt for
production of energy. As a result the individual starts losing body weight due to los of stored fat
and muscles.
Question 2:
Prior to administration
Validate the medication order
When using apart insulin, the nurse should be sure that it is provided about 5 minutes before the
meal of the patient. They are to be provided in association along with other intermediate or long
acting insulin. The number of units would be divided by 24 so that the nurse can obtain the basal
rate in units/hr (Leslie et al., 2016).
Have comprehensive knowledge of the medication
The medication is mainly used to treat type 1diabetes in order to control the amount of sugar in
blood. It also helps the patients to get rid of chances like heart disease, kidney problems, stroke,

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eye problems and also nerve damage. This mainly comes at a solution in liquid form and as
suspension which has liquid with particles that settle on standing. They are usually injects
subcutaneously that is under the skin.
Prepare the medication safely
The dose of the insulin to be provided will depend mainly on metabolic needs a swell as frequent
monitoring of the blood glucose level. The total daily insulin requirements are between 0.5 to 1
unit/kg/day. Usually 50 to 70 percent insulin will be provided with that of the prefilled syringe
containing this 100 units/Ml. this will contain 3mL Novolog Flexpen or Flex touch. Proper hand
hygiene will be maintained and the all ethical considerations during flex pen use to be
maintained (Fulcher et al., 2014).
Assess the patient
The patient will be assessed that whether the patient is having any episode of hypoglycemi a or
whether the she has taken any pills of diabetes management. Moreover as the patient is a child,
the usp units taken will be based on the results of blood and urine glucose tests which should be
carefully individualized to optimal effects.
During administration
Administer the medication safely
The hands should be washed first. Then the label should be checked. Pen cap should be pulled
off. The rubber stopper will be rubbed by alcohol swab. Protective tab form needle should be
pulled and then screw it onto flex pen tightly. The air shot should be conducted. If no drop

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appears, the needle should be changed. With the turning of the dose selector, the dose can be
corrected by the nurse (Clemens et al., 2017). One should not push the push button until injecting
the needle. Then the needle should be injected in skin and kept there for 6 seconds and at that
time the push button should be kept pressing at until the needle has been pulled out from the
skin. Then by detaching the needle, the pen should be kept by the cap tightly closed.
After administration
Document nursing care
Proper documentation of the medication provided should be done by writing the ways of
administration and the time of administration. The response of the child observed by the nurse
should also be noted which would help in case of delegation.
Ensure patient safety
The patient safety should be ensured by properly disposing the needle in proper ways and at
proper sits so that she does not get harmed by the sharp object. Moreover, she should e also
protected from symptoms of hypoglycemia as that may have fatal effects on the child (Perez et
al., 2015).
Monitor the patient
After the administration of the medication, the nurse should not immediately leave. Nurses have
to observe the patient to ensure that the insulin administration is rightly taking place and any the
child is safe from any chances of hypoglycemia or other effects.

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Question 3. The potential impact of type 1 diabetes on Briana and her family.
Emotional:
As Briana is a little child, it would be emotionally painful for her parents to see her go through
such critical treatments at such a tender age. Not only that, this sudden information of their child
being ill with diabetes 1 may also have severe impact on them for which they suffer from severe
symptoms of depression (Vanstone et al. 2015). They may get anxious about their daughters
health and will have very hard time in accepting their child’s ill health (Chiang et al., 2014).
Moreover, Briana herself will be agitated or may be depressed as her lifestyle will never be
simple like that of the other children. In such a tender age of immaturity, she may not understand
the main reasons of her disorder and might feel herself unlucky which will have negative impact
of her emotionally
Physical:
She is a young child and it might be difficult for her to be as much disciplined as like adults and
therefore her parents have to be always with her to protect her from negative outcomes. This will
increase the work burden of the parents and hence they will be also physically weak as the caring
and treatment procedure will also drain them physically (Wong et al., 2014). Briana may suffer
from symptoms like with loss, polyuria, hunger, thirst, lack of energy and many others; therefore
her parents have to keep proper care for her.
Question 4:Adaptation of nursing care to accommodate Tom’s intellectual disability.
Tom is not accustomed to medical terms and therefore he had become quite anxious about the
condition of her daughter. He was not being able to understand what was going on with her

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daughter. Therefore in such situation, nurses have the responsibility to educate the patient as well
as the patient’s family about the entire situation. However, in doing so the nurse should be
careful that she does not sue any sentences or words which are not possible for ordinary people
to understand. Health literacy for Tom would mainly include the nurse describing the events in
simple languages so that he can at least understand what is happening with her daughter. She
should not use any jargons (White et al., 2016). After making him understands, she should ask
tom to describe what he has understood. This will ensure the nurse that Tom has correctly
understood every part properly (Al Sayah et al., 2013). She will also make a proper plan of
treatment that he and his wife has to follow to keep her daughter free form any danger. This will
in turn make tom resolve his anxiousness and make up his mind to take h responsibilities that he
have to take from now on with his wife.

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References:
Al Sayah, F., Majumdar, S. R., Williams, B., Robertson, S., & Johnson, J. A. (2013). Health
literacy and health outcomes in diabetes: a systematic review. Journal of general internal
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Chiang, J. L., Kirkman, M. S., Laffel, L. M., & Peters, A. L. (2014). Type 1 diabetes through the
life span: a position statement of the American Diabetes Association. Diabetes
care, 37(7), 2034-2054.
Clements, J. N., Threatt, T., Ward, E., & Shealy, K. M. (2017). Clinical Pharmacokinetics and
Pharmacodynamics of Insulin Glargine 300 U/mL. Clinical pharmacokinetics, 56(5),
449-458.
Fulcher, G. R., Christiansen, J. S., Bantwal, G., Polaszewska-Muszynska, M., Mersebach, H.,
Andersen, T. H., & Niskanen, L. K. (2014). Comparison of insulin degludec/insulin
aspart and biphasic insulin aspart 30 in uncontrolled, insulin-treated type 2 diabetes: a
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Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Pathophysiology and treatment of type 2
diabetes: perspectives on the past, present, and future. The Lancet, 383(9922), 1068-
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Leslie, R. D., Palmer, J., Schloot, N. C., & Lernmark, A. (2016). Diabetes at the crossroads:
relevance of disease classification to pathophysiology and treatment. Diabetologia, 59(1),
13-20.
Ozougwu, J. C., Obimba, K. C., Belonwu, C. D., & Unakalamba, C. B. (2013). The pathogenesis
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Pathophysiology, 4(4), 46-57.
Perez-Nieves, M., Jiang, D., & Eby, E. (2015). Incidence, prevalence, and trend analysis of the use of insulin
delivery systems in the United States (2005 to 2011). Current medical research and opinion, 31(5), 891-
899.
Vanstone, M., Rewegan, A., Brundisini, F., Dejean, D., & Giacomini, M. (2015). Patient
perspectives on quality of life with uncontrolled type 1 diabetes mellitus: a systematic
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White, R. O., Chakkalakal, R. J., Presley, C. A., Bian, A., Schildcrout, J. S., Wallston, K. A., ...
& Rothman, R. (2016). Perceptions of provider communication among vulnerable
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Wong, C. K., Wong, W. C., Lam, C. L., Wan, Y. F., Wong, W. H., Chung, K. L., ... & Fong, D.
Y. (2014). Effects of Patient Empowerment Programme (PEP) on clinical outcomes and
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matched cohort study. PLoS One, 9(5), e95328.

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Zaccardi, F., Webb, D. R., Yates, T., & Davies, M. J. (2015). Pathophysiology of type 1 and type
2 diabetes mellitus: a 90-year perspective. Postgraduate medical journal, postgradmedj-
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