Comprehensive Nursing Care Plan: Managing Diabetes for Patient S.J

This nursing report presents a comprehensive care plan for an 86-year-old patient, S.J., diagnosed with diabetes. The plan focuses on ensuring effective and safe insulin treatment to manage high blood glucose levels and A1C, aiming to prevent micro and macrovascular complications such as retinopathy and foot ulcers. It also emphasizes the importance of a tailored anti-diabetic diet, low in sugar, carbohydrates, and fats, while considering the patient's African-American cultural values, emotional well-being, and life expectancy. The diet plan aims to reduce cardiovascular threats and promote wound healing, ultimately improving the patient's overall quality of life. The report references studies supporting the importance of blood glucose control, dietary regulation, and individualized care in diabetes management.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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NURSING
Plan of Care
1. Ensure effective and safe treatment for S.J on insulin.
Rationale: The fasting glucose level of S.J is 204 mg/dL (normal level 100 to 125
mg/dL) and A1C is 8.4% (normal: below 6.5%) (Siu, 2015). Thus, it can be easily gauzed
that his blood sugar level is alarmingly high. Moreover, Kontopantelis et al. (2015) are of the
opinion that high level of glucose in the blood tends to lower level of good cholesterol within
the body (HDL: high-density lipo-protein) while increasing the level of triglycerides and bad
cholesterol (LDL: low density lipo-protein). As per the case study, S.J is has high level of
blood cholesterol and is on statin medication. Increase in the blood cholesterol level with
further increase the cardio-vascular threat of S.J (S.J already has cardio-vascular disease and
myocardial infarction). So in order to reduce the fetal threat, periodic monitoring of the blood
glucose and the blood cholesterol level of S.J is important. Proper monitoring of the blood
glucose level will help in ascertaining the dosage of insulin administration. Inzucchi et al.
(2015) stated that subcutaneous administration of the artificial insulin helps in immediate
lowering of the blood glucose level. The decrease in the level of the blood glucose will help
S.J to recover from vision problems, wound healing complication along with pain or
numbness in the feet. Siu (2015) argued that high level of blood glucose for the prolong time
leads to the development of the micro and macrovascular complications of diabetes. The
micro and marco-vascular complications of the diabetes is associated with the development
of the diabetes retinopathy (dual vision or blurred vision) and diabetic foot ulcer whose initial
stages deals with pain or numbness in the feet. Thus, effective control of the blood glucose
level will help to improve the overall quality of life of S.J.

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2. Making proper diet plan for S.J
As per the case study, S.J lives alone and is never on specific diet. Lately he is feeling
excessively and tend to feed eat out a lot. According to Doménech et al. (2014), effective
regulation of diet plays an important role in controlling the level of glucose in the blood. The
diet plan for S.J must be anti-diabetic, free from sugar or any other sources of glucose and
low on carbohydrate and fat. Doménech et al. (2014) stated that restricted or zero intake of
sugar through diet helps in the effective regulation of the blood glucose level. Apart from
sugar, the intake of carbohydrate must also be taken under consideration, as carbohydrate
eventually gets broken down to glucose. However, the diet plan for S.J must be designed in
such a way that it upholds his African-American values. Moreover, S.J is 86 years old with
life expectancy less than 5 years thus while designing his diet plan; his emotional, cultural
and spiritual well-being must be taken under active consideration in order to improve his
mental health and well-being. Mediterranean can be suitable for reduction of the 24 hours
ambulatory blood pressure and thereby helping to reduce the cardiovascular threat and at the
same time promote proper healing of wound.

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NURSING
References
Doménech, M., Roman, P., Lapetra, J., García de la Corte, F. J., Sala-Vila, A., de la Torre,
R., ... & Toledo, E. (2014). Mediterranean diet reduces 24-hour ambulatory blood
pressure, blood glucose, and lipids: one-year randomized, clinical
trial. Hypertension, 64(1), 69-76.
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... &
Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a
patient-centered approach: update to a position statement of the American Diabetes
Association and the European Association for the Study of Diabetes. Diabetes
care, 38(1), 140-149.
Kontopantelis, E., Springate, D. A., Reeves, D., Ashcroft, D. M., Rutter, M., Buchan, I., &
Doran, T. (2015). Glucose, blood pressure and cholesterol levels and their
relationships to clinical outcomes in type 2 diabetes: a retrospective cohort
study. Diabetologia, 58(3), 505-518.
Siu, A. L. (2015). Screening for abnormal blood glucose and type 2 diabetes mellitus: US
Preventive Services Task Force recommendation statement. Annals of internal
medicine, 163(11), 861-868.