Care Plan and Reflection Report: A Case Study on Diabetic Patient Care

This report provides a comprehensive overview of a nursing care plan and reflection centered on a 19-year-old patient, Joseph Okojie, diagnosed with diabetes. The report begins with an introduction to care plans, emphasizing their role in organizing patient care and promoting holistic well-being. It includes a detailed nursing care plan, outlining interventions to manage Joseph's diabetes, alongside an analysis of the pathophysiology of his clinical deterioration, specifically addressing the potential for diabetic coma. The report also explores the application of a person-centered approach in Joseph's case, highlighting the importance of patient involvement and tailored care. Furthermore, it incorporates a reflection component, likely using Gibbs' reflective cycle, to analyze the care provided and identify areas for improvement. The report concludes by synthesizing the key findings and recommendations for effective diabetes management and patient-centered care.

Care plan and Reflection
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Table of Content.
INTRODUCTION...........................................................................................................................1
Nursing care plan.........................................................................................................................1
Pathophysiology of clinical deterioration....................................................................................4
The case in relation to one person-centred process.....................................................................5
Reflection.....................................................................................................................................7
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10
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INTRODUCTION
The concept of care plan within healthcare is generally the presentation of data which can
easily illustrate the care services as well as can encourage being provided to a person. The care
plan must be put collaboratively as well as agreed with the person which they concentrate on
through the process of care planning as well as review. In addition to this, a care plan can aid the
healthcare professionals and care nurses to organize aspects of the vulnerable patient care
according to a timeline. It is mainly a tool for healthcare professionals to effectively think
critically as well as holistically in a manner which can empower the physical, social,
psychological as well as spiritual care of a vulnerable patient (Spear et. al., 2021). In this report,
it will cover a case study of Joseph Okojie who is 19-years-old and is diagnosed with diabetic.
Along with this, the report will cover a nursing care plan that can involve all the care
interventions which is essential for Joseph Okojie to overcome his illness. In addition to this,
there is a discussion about the pathophysiology of the care clinical deterioration of the patient
about what exactly the cause of his illness. Furthermore, there is also a discussion about the
person-centred approach and its implementation in the case scenario of Joseph Okojie such that
he can overcome his diabetes with time and can stay healthy as well.
Nursing care plan
DIAGNOS
IS
INFERENCE NURSING INTERVENTION EVALUATION
Possible
infection
of
urinary
tract.
Urinary
frequenc
y and
pain on
voiding.
U/A
express
Diabetes mellitus is generally a chronic
metabolic illness that is mainly caused
by a relative or absolute deficiency of
insulin, an anabolic hormone. The
diabetes type 1 generally occurs at any
of the age group and is typically
identified by the marked as well as a
advanced inability of the pancreas to
effectively secrete insulin, it is because
of the autoimmune devastation of the
beta cells. Diabetes illness can occur
among the children, with having a fairly
Independent:
Supervise the orthostatic
blood pressure alterations.
Supervise the respiratory
patterns such as
kussmaul's respiration and
an acetone breath.
Supervise the temperature,
colour of skin as well as
moisture as well.
Effectively assess the
peripheral pulses, skin
Goals are met. Joseph Okojie was able
to exhibit reduced signs of being a
diabetic patient.
Resolves the Urinary tract infection.
Decrease in urinary frequency and pain
as well.
RATIONALE: The hypovolemia can be
evident by the hypotension and
tachycardia.
Reflective of an inflammatory
process/infection, need evaluation and
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large
leukocyt
es and
blood
and
positive
for
nitrites.
The
airways
are
obstruct
ed, his
respirato
ry rate is
12,
having
SpO2
value
ranges
between
84%.
The
volume
of fluid
deficien
cy
generall
y linked
with
osmotic
abrupt onset, therefore, the newer test
of the antibodies have enable for the
identification of diabetes. The
hypoglycaemic episodes are also linked
with diabetes such that the blood
glucose levels can vary all over the day,
mainly depending on what Joseph can
eat, how active he is, and many more.
In this, the hormonal fluctuations which
can make influence over the blood
glucose levels. In addition to this, some
of its symptoms of hypoglycaemia are
mainly caused by the lack of supply of
glucose to the brain. On other hand, the
hyperglycaemia can effectively
damages the vessels which can supply
the blood to the vital organs, that can
enhances the developing risk of stroke
and cardiovascular illness, kidney
illness, nerve issues and many more.
turgor, capillary refill and
a mucous membrane.
Must supervise input and
output.
Enhance the intake of
fluids such as water. Must
ensure about an effective
antibiotic care treatment
by determining organism.
Enhances the volume of
urine to effectively
decrease the pain and
flush the bacteria out.
Improves the Joseph 's
understanding about
decrease anxiety as well
as improves a shared
intervention plan.
PLANNING: After the eight
hours of nursing care
interventions, the patient
will exhibit an adequate
hydration.
care treatment.
Encourage the ventilation of entire lung
segments and can help in mobilizing
the secretions to prevent pneumonia.
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diuresis
from the
hypergly
caemia.
Pathophysiology of clinical deterioration
Clinical deterioration is the condition where the patient experiences an acute onset of a
serious physiological disturbance and is also the state of physiological decompensation. Joseph
OKOJIE was first hospitalised with conditions - slurring words, and high blood glucose level.
Indicators of clinical deterioration in Joseph's condition were pale colour, unconsciousness, loss
of movement, obstructed airway, and choking.
The symptoms observed in Joseph's clinical deterioration were similar to the symptoms
of diabetic coma. Diabetic-coma is a life-threatening condition of dilemma occurring either due
to high blood glucose levels or low blood glucose levels. People with insulin dependent diabetes
mellitus on clinical progressions are most likely to get affected with either diabetic keto acidosis
or Hypoglycaemic coma. In present case, Joseph had three episodes of hypoglycaemia in past
seven years (Artingstall et. al., 2019).
Diabetic keto acidosis develops when body does not have enough of the insulin that
further thickens the blood and produces acids called ketones. Ketone bodies are strongly acidic
whose build up cause the blood to become acidic and the high level of which poisons the body.
Eventually causes unconsciousness, high blood sugar level, dehydration, and shock (Diabetic
Coma, 2021).
Hypoglycaemia induced coma results from the dangerous low level of blood sugar levels,
mainly occur when the person is sleeping and shows symptoms like unconsciousness, weakness,
sweating, nausea, fast breathing, and low blood glucose level (Diabetes- Related Coma, 2020).
Joseph's condition eventually progressed into diabetic-coma during intensive care,
referred as clinical deterioration. The reason lying could be the uncontrolled blood glucose
levels, either too high or too low.
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The case in relation to one person-centred process
A person-led approach is generally where a person is generally empowered to lead their
own care as well as are treated as a person first. The concentration is on a person as well as what
they can do, not their conditions or a disability. Encouragement should be concentrated on
accomplishing a person's aspiration as well as be tailored to their required and unique
circumstances. In this, a person-led approach can encourage a person, at the middle of the care
service to be effectively involved while making the care decisions about their life. It can also
take into account that the life experience of every person, such as age, gender, heritage, culture,
language, identity and beliefs. The person-led approach can specifically need the care services as
well as support to suit the wishes of a person and their priorities as well. The approach is
generally based on strengths where the people are effectively acknowledged as an expert in their
life with a concentration on what they can do first as well as any aid they generally need a
second. A person-centred approach must encourage as well as allow a person to improve and
keep control over their life. It is generally a humanistic approach which can deal with how a
person can perceive themselves, instead than how a counsellor may analyse them via the
subconscious notions. In this, there are enhancing numbers of old age people as well as the
people who are living with a long-term condition and disabilities. At the similar times, the well-
being and social care budgets are under elevating pressure (Wallace et. al., 2018).
In person-centred care, the well-being and social care professionals can work
collaboratively with the person who can utilise the care services. The approach mainly
encourages the people to enhance the skills, knowledge as well as confidence which they
generally need to more efficiently manage and can make an informed care decisions about their
own well-being and care. It is generally coordinated as well as tailored to the requirements of a
person. And essentially, it ensures that a person can always be treated with all the compassion,
dignity and respect as well. In context with case scenario, the person-centred care is generally a
prominent as well as an evolving well-being care reform efforts that are structured to give a
respectful as well as preferential care which can align with the personal values while making
effective decision. Having a person-to-person can specifically seek to enhance the functioning of
the well-being care organization, and can typically enhances the well-being results of the non-
communicable illness like diabetes. The person-centred approach can involve the four main wide
areas such as partnerships, effective communication, well-being promotions as well as a physical
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care as well. provided the necessity of the self-care behaviours in maintaining the glycaemic
control as well as the restricting complications, these such findings can recommend a
requirement for the enhancement of quality of care as well as an intensive patient-centred efforts
within the patient with the significant risk profiles. It is quite essential to determine the potential
barriers as well as the obstacles that are generally being practiced by the vulnerable patient’s
when integrating the self-care into their normal routines. It is known that the person-centred care
is mainly linked with the better self-management behaviours which are being encouraged by the
evidence from the earlier research. within a study, using the computer-assistive interventions to
effectively enhance the person-centred diabetes care by simply enhancing the autonomy, it is
found that the care interventions outcomes in an enhanced results of self-managing the diabetes
illness. In this, the behaviours of self-care consisting the adherence of medicines, blood sugar
testing, diet as well as the foot care are generally imperative for an effective management of
diabetes type II. Hence, the positive relationship among the person-centred care as well as the
self-care behaviours is generally promising. an enhanced patient-provider relationship and an
enhanced patient education as well as knowledge about the diabetes, can encourage the care
providers as well as the social networks and participation generally nurtured by person-centred
care are more likely to subsidise towards an enhanced awareness as well as observance to the
self-care (Amato et. al., 2021).
In addition to this, the quality of life is also equally essential when it comes to the care
treatment methods. Both the mental as well as physical components must be taken into
reflections. Within the investigation to access whether the participation of the vulnerable patient
such as Joseph is linked with the advanced satisfaction and empowerment, there has been found
a positive relationship among being satisfied, involved as well as empowered. The above
findings can significantly recommend that the participation of the vulnerable patients can
specifically offers an opportunity to improve the results like support and satisfaction as well.
while studying the case scenario of Joseph, the person-centred care is generally positively linked
with the mental component, but are negatively linked with the physical quality of life. The
person-centred care generally involves a potential to effectively enhance the satisfaction with
care, enhances the medical or clinical as well as the behavioural results, as well as can decrease
the underuse as well as overuse of the care clinical services within the chronic illness, consisting
the diabetes which can need a comprehensive care plan treatment. It is identified that Joseph
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provided in the case scenario is gradually becoming more interesting in receiving the well-being
information to effectively serve as a partners within the care and the collaborators within the
care treatment decision making, therefore, it can need the care provider to effectively understand
the Joseph preference as well as their perspective of being participating in the personal care as
well as to consider which the that the knowledge of the patient, their skills as well as the
experience s can also vary greatly specifically.
Reflection
Gibbs is generally one of the most famous cyclical models of the reflection that can lead a
person from the very six stages to explore an experience such as description, feelings, evaluation,
analysis conclusion and an action plan. Reflection is usually a main key part of both the personal
as well as a professional development which the care providers are needed to undertake to
maintain the pace with the altering nature of the care practice. The reflection can specifically
help the care provider and can ensure an effective and safe evidence-based care by simply
enabling the care providers to constantly enhance their skills. In this, the Gibbs generally
advocate its use within the ongoing situations, but the stages as well as the care principles can
apply more equally for the single experiences too. The stages of Gibbs reflective cycle that
involve six stage that are as detailed below:
 Description: There is a discussion about the patient Joseph who is 19 years old and
having a medical history of episodes of hypoglycaemia which results in diabetes.
Diabetes is a severe illness that can sometimes affect the functioning of brain as well. the
patient also facing challenges such as he involves slurring words and this is the result
elevated blood sugar levels in his body. To overcome his challenges, as a care nurse, I
have planned an effective care for the patient so that he can effectively plan a care to
improve his well-being.
 Feelings: while providing care to the 19-year-old patient, it was quite challenging for me
to foster an effective care service to Joseph. While furnishing care services, I need some
effective skills such as communication skills, empathy, integrity, self-confidence and
many more to effectively enhance his care. It is because, while delivering care for patient,
there is something lack in my care such that which can impact over his well-being
outcomes and due to this, I have to improve my care providing skills as well so that I can
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able to effectively deliver a quality care to Joseph to improve his diabetic condition more
appropriately.
 Evaluation: while providing care to Joseph, it is evaluated that he is having his illness
from the past seven years. And he is now become used to of it. In the beginning, I was
trying to provide the care treatment which does not work well and this cannot help him
well. due to my ineffective skills such as poor communication with patients and lack of
self-confidence and many more that can worsen his conditions. But, through enhancing
my skills towards patients, I can able to deliver a quality care services to the patient to
improve his conditions well.
 Analysis: In this, I think that the reason that the initial division of work went well
because I had effectively enhanced my skills like build self-confidence, empathy,
effective communication such that it can aid the patient well. With having effective and a
skilful communication, I can able to establish a relationship with the patient such that he
can share his feelings and emotions which can trouble him the most. It is also analysed by
me that having a skilful communication with patient can also aid me to provide a care
treatment as per his needs to effectively improve is health and can able to reduce the
effects of diabetes on his body.
 Conclusion: from the above all the case scenario, it is concluded by me that for an
effective care treatment and results of enhanced well-being, they generally need some
effective skills such as the care nurses must have a skilful communication, must show
empathy, integrity and many more, these such skills can effectively improve the well-
being conditions of the vulnerable patients (such as Joseph in the provided case scenario).
While fostering the care treatment plan to Joseph, I have learned various essential things
that can help in my future care practices as well.
 Action Plan: The action plan here includes that if this type of situation arises in the future
prospect, then I would know what exactly I have to do to improve the conditions of my
patient efficiently. In order to develop the skills which, I need to deliver the care
treatment or services, I will develop my skills through having sessions on building
confidence and empathy as well. these such things can help me to make effective
relations with the patients so that they can able to share their emotions and feelings.
Establishing an effective relationship can also aid me because I can able to deliver the
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care as pre their needs. I will definitely try my level best to use the effective skills in my
future care practice to enhance the health of all the patients with respect and dignity as
well.
CONCLUSION
From the above discussion, it is concluded that planning care is quite important for a
person to receive a care. the planning of care can effectively ensure the consistency of the care.
In this, if the robust care plan is in the place, the care staff from the various shifts, the visits can
effectively use the information to provide the same quality of support and care as well. in
addition to this, it can enable the patients to receive high level of effective, safe as well as a
responsive care within the service that is well-led. Furthermore, the report also includes a
reflection, in which as a care nurse I have analysed that having effective skills can help me a lot
in providing the care treatment to Joseph so that I can able to improve his health conditions more
appropriately.
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REFERENCES
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