Nursing Practice Handover: Assessment of Type 2 Diabetes Management

This report provides an assessment of a 62-year-old male patient, Ivan, diagnosed with type 2 diabetes and a foot ulcer, who has been receiving care from a community nurse. The assessment follows the ISBAR framework, focusing on the patient's condition, reason for referral, and diabetes management. The report highlights the importance of monitoring clinical manifestations like polyuria and hyperglycemia, which can lead to complications such as foot ulcers due to lower extremity paresthesias. Key assessment steps include estimating glomerular filtration rate and checking the blood albumin to creatinine ratio. Emphasis is placed on effective wound dressing, pain management, blood glucose monitoring, and physiotherapy to restore mobility. The report references relevant studies on clinical handover and glucose-lowering drugs in type 2 diabetes management.

Running head: NURSING PRACTICE HANDOVER
Nursing Practice Handover
Name of the student
University name
Author’s note

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NURSING PRACTICE HANDOVER
Assessment of the patient condition
For the current assignment the Identity, situation, Background, Assessment and
Recommendation (ISBAR) framework have been taken into consideration. Here, we will be
dealing with the assessment portion (A) of the ISBAR.

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NURSING PRACTICE HANDOVER
Assessment:
Reason for referral-
As per the current case study, Ivan is a 62 year man who has been affected with type 2
diabetes. He has been visiting a community nurse for three weeks owing to an ulcer on his foot.
He only visited the community nurse after trying to manage his condition by self for two
months. The pain from the leg ulcer has affected his activities of daily living considerably as he
has not been able to manage cooking for him or keeping the house clean.
Type 2 diabetes management
The patient should be monitored for a number of clinical manifestations such as
Polyuria, hyperglycemeia, weight loss, blurred vision, lower extremity paresthesias, etc. As
mentioned by Manias et al. (2016), people with type 2 diabetes remain asymptomatic for years
which further results in the build of the symptoms.
In this respect, Ivan was found to develop foot ulcer which could be attributed to lower
extremity paresthesias. In hyperclymeia , the excess glucose is metabolised by the pylol
pathway into sorbitol. Excessive sorbitol deposition in the arterioles has been seen to attract
water diffusion though osmosis resulting the blood vessels rupture or become in effective.
Hence, owing to impaired sensations the wound development can go unnoticed. Some of the
major assessment steps which could be adopted for the management of the clinical condition of
the patient are estimation of glomerular filtration rate along with checking the blood albumin is
to creatinine ratio (Palmer et al., 2016). For the current case study, emphasis needs to be
provided upon effective wound dressing and pain management in the patient. One of the best
ways to control the rate of hyperglycaemia in the patient is through blood glucose monitoring
and giving effective physiotherapy treatments to the patient to restore mobility.

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NURSING PRACTICE HANDOVER
References
Manias, E., Geddes, F., Della, P., Jones, D., Watson, B., & Stewart-Wynne, E. (2016). Inter-
hospital ‘patient expect’calls of clinical handovers for expected patients transferred
from rural to metropolitan hospitals: A retrospective clinical audit. Collegian, 23(4),
373-382.
Palmer, S. C., Mavridis, D., Nicolucci, A., Johnson, D. W., Tonelli, M., Craig, J. C., ... &
Natale, P. (2016). Comparison of clinical outcomes and adverse events associated
with glucose-lowering drugs in patients with type 2 diabetes: a meta-
analysis. Jama, 316(3), 313-324.