Care of a Client with Dm Type 2

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Cebu Normal University
College of Nursing
Osmeña Boulevard Cebu City 6000
254 – 4837 / cnucollegeofnursing@live.com.ph

A Case Study of a Patient with Diabetes Mellitus Type 2: Striving to Live Life worth Living

Taboada, Gwen Marie F.

Chapter 1
Introduction
Diabetes mellitus (DM) 2 or type 2 diabetes is more common than diabetes mellitus type 1 and is prevalent in people over 40 years old. The condition and its symptoms develop slowly over a period from weeks to months. In DM type 2, the patient’s body still makes insulin but the amount is not enough for the body’s needs. This condition is called “insulin resistance” where the body cells become resistant to normal levels of insulin or if there is inadequate production of insulin. With DM type 2, the patient needs more insulin to keep the blood glucose level down. The obese and those who have type 1 diabetes are at risk developing type 2 diabetes. Among all diseases, the number of deaths due to diabetes grew faster than other conditions between 1999 and 2005. From 9, 749 reported diabetes cases in 1999, 18, 411 cases were listed in 2005. Prevention and early treatment of diabetes are key elements in preventing the spread of this disease. Information on the early prevention of diabetes will help decrease the prevalence of the disease. Thus, this study aims to increase awareness and knowledge of the seriousness of diabetes, its risk factors, and effective strategies for preventing complications associated with diabetes and preventing DM Type 2 and to help people to live well with diabetes and effectively manage their disease to prevent or delay complications and may improve quality of life.

Physical Assessment
A comprehensive head-to-toe assessment was done with the following baseline data. Central Nervous System
During the time of care, the client’s level of consciousness was alert. She was pleasant and calm upon assessment. She has a congruent affect and displayed appropriate gestures to the situation offered. Her orientation was “x3” meaning she was oriented to place, person and time. She was also able to recall her recent, intermediate and remote memory. There were no unusualities noted with her sensorium.

In her sense of sight, she stated that she is using glasses and reported blurring of vision especially when reading. Her pupils on both eyes were both equally round and reactive to light and accommodation. Her taste buds were altered. She feels it when she is touched and has no unusualities on her sense of smell. She can also hear conversation at normal tone of voice. There was no slurring of speech noted. No aphasia noted during the interview. Cardiovascular System

Upon assessment, she had a irregular strong pulse ranging from 110-130 beats per minute. Upon auscultation, there were no extra sounds heard; only S1 and S2 were audible through stethoscope. Her blood pressure was slightly elevated usually at 130/90 mmHg. Her capillary refill time was 2-3 seconds and has pale nail beds. Respiratory System

Client has symmetrical chest and tachypnea noted with respirations at a rate ranging usually to 30 cycles per minute. Regular, shallow, abdominal breathing was observed with no presence of cough. There were no adventitious sounds heard upon auscultation during the time of care. Client has no respiratory assistive devices.

Gastrointestinal System
Client was on soft diet with aspiration precaution. Gag reflex is present. When feeding, client must be positioned in moderate high back rest to prevent aspiration. Her appetite was normal, however, she needs an assistant when feeding due to weakness on her left side of her body. Her lips were pink and moist. Client regularly defecates twice a day with semi-solid brown feces. His abdomen is flat and symmetrical with normoactive bowel sounds with 30-35 clicks per minute. No ostomies noted. Integumentary System

The client has a brown complexion and is warm to touch on the upper extremities and cold to...
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