Nursing Care for Patient with Diabetes Mellitus: A case study

Abstract

Purpose of this case study aimed to study nursing practice in diabetes patient during acute and urgent conditions. Data obtained from this study was resource to develop nursing care plan to prevent patient from complications and alleviate disease severity moreover enable patient to perform daily activity. The case is married Thai man aged 60 years old with diabetes and hypertension in which treated at community hospital. History of chronic renal failure was given and treated at Sunprasitthiprasong hospital. Patient was admitted at male medicine ward during July 6th—12th, 2015. History of present illness was chronic epigastric pain for 20 days and two days before he experienced high fever with productive cough. He underwent physical examination at community hospital. After hypotension and hyperglycemia was diagnosed, patient was referred to Sunprasitthiprasong hospital. According patient history, physical examination, laboratory and X-ray examination, the patient was diagnosed with type II diabetes mellitus, hypertension, chronic renal failure, septic shock, pneumonia, hypokalemia, hyponatremia and dizziness. During hospitalization, patient was found complication of decreased cardiac output according to septic shock, hyperglycemia, abdominal pain, hypokalemia, fluid overload secondary to impaired renal function, decreased gas exchange from pneumonia. Risk of infection was increased by impaired immunity, invasive catheterization and hyperglycemia. Renal failure related anemia also presented in this case. Family member also concerned about patient’s condition and treatment. After nursing care intervention, patient had good conscious, responsive and no dyspnea. His vital sign, feeding condition and urine output were normalized but hyperglycemia remained unresolved. Patient was hospitalized for totally six days and follow up in next one week after discharged.
Conclusion: Nursing care in diabetic patient during acute and urgent condition needs intensive patient assessment including physical and mental conditions. Encouragement of patient’s knowledge and adherence to self-health care will improve their quality of life.