การส่งเสริมการจัดการตนเองของผู้ป่วยสูงอายุเบาหวานที่มี ภาวะไฮเปอร์ออสโมลาร์ไฮเปอร์ไกลเซมิก: กรณีศึกษา

Kallapungha  Chosivasakul; Sangthong  Terathongkum; Yomporn  Sakdanupab; Pathamaporn  Thongterm

Authors

Kallapungha Chosivasakul Boromarajonani College of Nursing Bangkok, Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health
Sangthong Terathongkum Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Yomporn Sakdanupab Bo Phloi Hospital
Pathamaporn Thongterm Boromarajonani College of Nursing Bangkok, Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health

Keywords:

promoting self-management, diabetic mellitus, elderly people, hyperosmolar hyperglycaemic state

Abstract

Introduction: Diabetic elderly patients with continuously uncontrolled blood sugar levels usually develop hyperosmolar hyperglycaemic state (HHS leading to acute complications. The common symptoms of this state are dizziness, palpitation, tiredness, and nausea; however, kussmaul breathing, dyspnea, and acidosis are not presented. A high blood sugar level over 600 mg/dL, and serum osmolality over 300 mOsm/L are used to define HHS.

Objective: To promote self-management of the diabetic elderly patients with HHS during the period of treatment at hospital and home health care.

Key issues: HHS is a common life-threatening emergency among the elderly with uncontrolled blood sugar levels. Nurses need to assess and analyse factors influencing high blood sugar levels to formulate a comprehensive nursing care plan to decrease complications and mortality rate among these patients.

Conclusion: Nursing care for the diabetic elderly patients with uncontrolled blood sugar levels is complicated; therefore, the nursing care should be formulated for individual patient during treatment, referring, and home health care focusing on family involvement with self-management and patient center.

Implication: Nurses should analyze causes of high blood sugar levels to prevent HHS leading to healthcare system improvement. Nurses should also promote self-management among the diabetic elderly patients and family involvement to decrease blood sugar levels in a long term.

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