Nursing care of diabetic patients with hyperglycemia : A Case study

Abstract

Diabetes is a chronic disease that frequently to multiple system complications. The key to managing diabetes is the initial screening. Care for delay the occurrence of complications. To provide adequate guidance to achieve, learn and modify the appropriate health behaviour. A Case study of Thai female patients 65 years old, presented with fever, dizziness, numbness, A history of hypertension and diabetes for 15 years. Vital signs: T 38^oc pulse 95/min  RR 24/min  BP 175/80 mmHg. Lab investigation showed Urine Culture; > 10⁵ CFU/ml  Klebsiella pneumonia, Blood sugar 320 mg/dl, BUN 17 mg/dl, Creatinine 0.94 mg/dl, eGFR 55.11 ml/min/ 1.73 m² (Stage 3)  Diagnosis; DM, Hypertension, Urinary tract infection. Treatment; Ciprofoxazine 250 mg PO q 12 hrs*7days, Manidipine(20mg) 1tab OD pc, Metformin(500mg) 2 tab bid pc, Glipizide(5mg) 2 tab bid ac.

The nursing problem were 1) Patients with fever from urinary tract infection. 2) Patients with hyperglycemia because of inability to control blood sugar. 3) Risk of complications due to hypertension. 4) Diabetes control is ineffective. 5) Risk of diabetic foot ulcers. 6) Decrease in kidney filtration rate due to ineffective diabetic control. M-E-T-H-O-D concept used to Discharge planning. Follow up the patient one month after the appointment showed  the patients can foods selection that are good for the disease. FBS 197 mg/dl, BP  164/92 mmHg.   Comment ; providing advice and empowerment by diabetic patients in group activities, help the patients to view their own problems and adjust behavior better than knowledge only.