Developing a Nursing Care Plan for Mr. Joni's Type 2 Diabetes Risk

This presentation focuses on a nursing care plan for Mr. Joni, who is at high risk of developing type 2 diabetes. The presentation begins by identifying Mr. Joni's risk factors, including smoking, high blood pressure, obesity (indicated by a BMI of 32.2), and an elevated fasting BGL of 9.6mmol/L. It then explains the pathophysiology of type 2 diabetes, highlighting the body's insufficient insulin production or resistance to insulin's effects, and lists associated symptoms like fatigue and increased urination. The presentation further discusses potential complications affecting organs such as the heart, kidneys, eyes, and nerves. The core of the presentation focuses on interventions to reduce Mr. Joni's risk, emphasizing the importance of weight loss through lifestyle changes (diet and exercise) and healthy eating habits. Specific interventions include nutrition screening, nurse-led example setting, and the design of a nutrition care plan. References are provided for all sources cited.

Nursing
Name
Institution

Diabetes Type 2
 Individuals with excess belly fat are highly likely to suffer from type 2 diabetes.
 Additionally, high cholesterol levels are very common among patients with type 2
diabetes.
 Furthermore, fasting BGL above 7mmol/L increases the risks of type 2 diabetes.
 Finally, smoking and eating fast foods increases the risks of diabetes by 30-40%
(Chang, 2012).
 Based on the above it is evident that Mr. Joni is at a high risk of developing this
complication.

Evidence Showing Risk of
Complication
 From the provided case study we are informed that Mr. Joni smokes at least a pack of
cigarettes weekly.
 Smoking raises the risks of having type 2 diabetes by approximately 30-40%.
 The more the number of packets one smokes, the higher the risks of developing this
condition.
 Diabetic people who smoke have a problem controlling the disease due to trouble with
insulin (Chang, 2012). .

Cont…
 His blood pressure is very high at 142/96mm/Hg.
 Reports suggest that almost 80 percent of individuals with type 2 diabetes have high
blood pressure (ACCORD Study Group, 2010).
 Normal BMI should not exceed 30.
 From Joni's weight(93kg) and height(1.7m) his BMI is calculated as 32.2 which is an
indication of obesity.
 The risk of having type 2 diabetes is higher in obese patients (Eckel et al., 2011).
 Mr. Joni also has a fasting BGL of 9.6mmol/L which is extremely high.

Pathophysiology of Type II Diabetes
 The body either counterattacks the effects of insulin or produces insufficient insulin.
 Insulin is the hormone that controls the concentration of glucose in the cells.
 When insufficient insulin is produced by the body, it becomes difficult to maintain
normal levels of glucose (Kahn et al., 2014).
 Therefore, controlling diabetes becomes difficult.

Cont…
 Some of the symptoms of type 2 diabetes may include (Kahn et al., 2014):
 Fatigue
 Increased frequency of urination
 Unintended loss of weight
 Increased thirst
 Increased frequency of hunger and
 Infection

Cont…
 Diabetes can affect many organs in the body including the kidney, heart, nerves, eyes,
and blood vessels (Kahn et al., 2014).
 Mr. Joni may develop heart diseases and diseases related to blood vessels.
 This may be the reason he uses Metoprolol to control his blood pressure that may
increase due to tightened blood vessels.
 He may also experience neuropathy as a result of this complication.
 Kidney damage and eye damage are other potential consequences (Kahn et al., 2014).
He uses Allopurinol to for kidney stones that may develop.
 Joni may also experience some hearing impairment.

Reducing Risks of Having Diabetes Type 2
 The chances of having type 2 diabetes can be lowered by maintaining a healthy
lifestyle (Rawal et al., 2012).
 In the case of Mr. Joni, the following two goals can help reduce the risks of the disease.
 Firstly, he needs to lose weight because his weight and BMI are unhealthy.
 Secondly, he needs to eat healthy food and avoid the takeaways that he frequently
takes.

Interventions
 There are several interventions that can help Joni to lose weight. They include (Rawal
et al., 2012):
 Obtaining the patient’s history
 Lifestyle changes. This may include changes in diet and exercise patterns.
 Building confidence and motivation.
 Medication may also be required for some patients.

Cont…
 Healthy eating is also important in preventing obesity.
 Joni should avoid food rich in calories and fat and instead consume food rich in fiber.
 Interventions to ensure healthy eating may include (Rawal et al., 2012):
 Nutrition screening and assessment.
 A nurse leading by example.
 Designing a nutrition care plan.

References
 Chang, S. A. (2012). Smoking and type 2 diabetes mellitus. Diabetes & metabolism
journal, 36(6), 399-403.
 ACCORD Study Group. (2010). Effects of intensive blood-pressure control in type 2 diabetes
mellitus. New England Journal of Medicine, 362(17), 1575-1585.
 Eckel, R. H., Kahn, S. E., Ferrannini, E., Goldfine, A. B., Nathan, D. M., Schwartz, M. W., ...
& Smith, S. R. (2011). Obesity and type 2 diabetes: what can be unified and what needs to be
individualized?. The Journal of Clinical Endocrinology & Metabolism, 96(6), 1654-1663.
 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), 1068-1083.
 Rawal, L. B., Tapp, R. J., Williams, E. D., Chan, C., Yasin, S., & Oldenburg, B. (2012).
Prevention of type 2 diabetes and its complications in developing countries: a
review. International journal of behavioral medicine, 19(2), 121-133.