11. Discuss Briefly 3 factors experienced by Aboriginal and/or Torres Strait Islander people that may contribute to their higher rates of diabetes.
12. Discuss 3 issues relating to diabetic care delivery or services in Australia
Case study 2
You are the EN on shift at a multipurpose medical centre; your next patient to review prior to the doctor is Chloe aged 15 a Type 1 Diabetic in year 10 at school. While you are taking her vitals and BGL you ask her how she has been going, she makes the following comments during your conversation.
“Sometimes you’ll binge eat and you’ll feel disgusting and you’re like, ‘Well, I just won’t inject my insulin for it and it’ll kind of even itself out again’… it sounds screwed up.”
“I’m fat compared to Sara”
“Why do I have to have diabetes, why can’t I be normal, it’s so frustrating?”
13a. Outline 4 factors that can influence self-esteem in a young person
13b. As a nurse hearing these comments from Chloe, outline 4 nursing strategies you could help Chloe with, to build up her self-esteem
14b. Kerry has now been in hospital for 3 days the focus has switched from initial stabilisation of blood glucose levels to looking at strategies for how Kerry can be supported with adherence to a management plan
Part of the ENs role in conjunction with the interdisciplinary health care team is to collect data that is used to review and modify the care planning process.
You have completed a Nursing care plan as per above (Q14a) now you are to modify this into a management plan. In the table below outline 6 outcomes with interventions you can suggest to the team.
NURSING DIAGNOSIS: Risk for unstable blood glucose levels related to inadequate blood glucose monitoring and lack of adherence to diabetes management plan
PATIENT GOAL: Maintains a balance of nutrition, activity and insulin availability that results in stable, normal blood glucose levels
Desired Outcomes Interventions and Rationales Evaluation Statement
Example- Follows recommended diet
Example – Teach patient to use a food diary to record dietary intake for at least 2 days.
Example – Kerry will record her food intake in the diary for 2 days
14c. All nurses are required to undertake continual professional development; this is often undertaken in the format of in-services in the workplace.
You are a 1st year graduated EN and your Nurse Unit Management has asked you to present a short in-service to your colleagues in regards to evidence-based practice relating to Kerry’s outcomes as noted in the management plan in Q14b
Therefore to be able to present your in-service you need to choose one outcome (Q14b) and discuss how it is supported by evidence based practice.
15. You are on your vocational placement and involved in the care of Kerry, your facilitator has asked that you evaluate and interpret Kerry’s blood tests within this case study and report your findings to her and the other students during reflection time at the end of the day. What would you tell them? The following points will assist.
Normal range for both tests
What is the difference between each?
What is their significance in Kerry’s case
Ketones in Urinalysis or Finger-stick analysis with a ketone meter ?
16. Kerry’s situation raises many concerns regarding her health. In the table below outline the potential problems for each of the following conditions and 2 nursing interventions for prevention
Health issues Potential problems related to the condition Suggested 2 Nursing Interventions for each
Your answer should be in-depth and demonstrates specialised understanding.
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