Chronic Care Report: Diabetes Management in Lifespan B, NUR2102

This report analyzes the case of Marcel Lever, a 70-year-old male with type 2 diabetes, applying the clinical reasoning cycle to his care. It describes the nursing implications related to older patients with diabetes, outlines optimal diabetes management strategies, and discusses the physical tasks and knowledge required for patient self-management. The report details Marcel's medical history, lab results, and medication, including Metformin. It also covers nursing interventions, rationales, and strategies for evaluating outcomes, focusing on supporting Marcel's self-management of his condition. The assignment addresses topics such as blood glucose monitoring, dawn phenomenon, lifestyle changes, and glucose-lowering agents. The report follows the guidelines provided in the NUR2102 assignment brief, including a focus on the nursing standards of practice.

Running head: 1
Chronic Care In Lifespan B
Student’s Name:-
Institutional Affiliation:-

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Introduction
The Clinical Reasoning Cycle is the backbone of good quality nursing. Patients spend
most of their time with nurses in wards and mainly engage in self-centred interactions. Patients
come from varying backgrounds and nurses are expected to provide good quality care without
any stigmatization or preconception. Nurses therefore need to employ the Clinical Reasoning
Cycle to ensure the problems of patients are solved to the best of their ability (Gruppen L. D.
2016). This essay seeks to describe how the Clinical Reasoning Cycle is applied in the diagnosis
of an individual patient known as Marcel Lever.
Marcel Lever is a 70-year old male who suffers from type 2 diabetes mellitus. He is 180.5
cm tall, weighing 116kg with a BMI of 35.6. He is regarded as obese. Since he retired, his
weight has been on the increase since he has attained 14kg within 9 months. He has a medical
history of hypertension and lineage history of Type 1 and II diabetes. Results from lab analyses
of his blood has indicated hyperglycaemia.
Hyperglycaemia is caused by reduced insulin production by beta cells of the liver which
brings about increased concentration of glucose in the blood. Body cells become less sensitive to
blood-borne glucose and fail to effectively utilize it in ordinary activities of the body. Marcel
experiences unordinary fatigue. His knowledge about Diabetes is reduced thus he fails to
understand his condition and cannot manage the disease well.
Priorities of Marcel’s medication management including his self-management.
According to Crasto & Pecker (2015), antihyperglycemic agents include insulin
secretagogues, insulin sensitizers together with drugs that slow down the absorption rate of
carbohydrate from the gut. Metformin is prescribed for Type 2 diabetes patients. It down-
regulates the production of glucose in the liver and pumps up the system’s sensitivity to insulin.

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Metformin would be a good remedy for Marcel since his blood glucose levels are abnormally
high.Metformin brings about nausea and diarrhoea but the effects can be evaded by taking the
drug together with food or once the body gets used to the drug.
Nursing interventions and rationales used to support Marcel in his medication self-
management.

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Strategies used to evaluate the outcomes of these nursing intervention.
Conclusion

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References
Crasto, W. & Packer, E. (2015).Type 2 diabetes: pharmacological management strategies. Royal
Pharmaceutical Society.