Diet and Exercise in Diabetes, Research Paper Example

The importance of diet and exercise can be the foundation of almost any illness. We are living in the couch potatoes American lifestyle age. According to Academy of Otolaryngology (2014),”Lack of exercise can increase the risk of diabetes, heart disease, and stroke. The CDC estimates that about 112,000 deaths are associated with obesity each year in the United States”.

Americans are spending too much time on computers and not enough exercise.There are several nursing diagnosis that can be contributed to a lack of exercise and diet. According to the Mayo Clinic(2014), there are complex reasons for patients developing High blood pressure(HBP), however, a poor diet can lead to overweight that causes your heart to work harder and the lack of exercise can lead to patients with HBP to have heart attacks. A patient weight, race, and medical history contribute to HBP, but the diet and lack of exercise can lead to serious clinical complications such as diabetes. In once example by WebMD (2014), the patient was a male 52 years old with severe urinary tract infection (UTI) and diabetes. According to Diabetes.uk.com (2014),”Urinary tract infections can be a particular problem for people with diabetes as sugar in the urine makes for a fertile breeding ground for bacteria”.

The patient worked over 60 hours per week while sitting down all day. The patient admitted does not exercise and 150 pounds overweight with poor eating habits. However, in the nursing intervention the patient only complained of fatigue and being diabetic. According to Yeastinfection.com(2014) indicated that contributing factors yeast infection for women is high stress lifestyle combines with poor eating choices along with inability to exercise because of fatigue. A recent report from the National Center for Health Statistics concludes that 35 percent of adults exercise regularly (more than 6 of 10 don’t), and nearly four in 10 aren’t physically active” Academy of Otolaryngology, 2014, pg1). In a study by Vroomen-Durning(2014), indicated that women with diabetes 2 are at risk to contract yeast infection because their bodies have more sugar.

The best definition of evidence based intervention and medicine by nursing was describe by a well-known and respected Registered Nurse.

Kathleen Stevens, RN (2013) published an excellent journal article the stated evidence based medicine is the well thought-out usage of the most up-to-date evidence in making good decisions concerning the care of patients. In addition, to integrating the patients medical history along with clinical proof and the best external clinical evidence from the process of methodical research (p.33).

Nursing Interventions (HBP)

The priority medical diagnosis is high blood pressure(HBP). The medical problem was chosen because it is a common nursing intervention the nurses may face during the care of patients. The client centered goals/outcome is to ensure the patient takes the HBP medication while educating the patient on the side effects of other diabetic prescriptions. The secondary client centered/outcome is ensure that the patient takes the medicine in the presence of a nurse, to ensure the patient is not experiencing any negative side effects. The nursing intervention would be evaluated based on several of the following factors: (1) the physicians being notified about the patients diabetic conditions. The hospital clinical medical notes must clearly show the nurses intervention involving the physician in the process.(2) The monitoring of the patients’ blood pressure every hour to ensure the medication does not have any side effects. The nurses must documentation must show the recording of patients’ blood pressure and notes concerning any indication of mixing of other drugs with diabetic insulin or any other negative effects.(3) The nursing industry has a set of standards that measure the performance of nurses.  (4) The final step to measuring the nurse’s performance is utilizing the national standardized performance measures. These measures are common used the nursing industry to measure the nurses quality of patient care in an acute environment. Including check the patients sugar levels due to diabetes.

Nursing interventions are specific treatments for different diagnosis that required the nursing to use her knowledge, experience and skills. The nurse uses this intervention/monitoring to determine which interventions is best action for patients with diabetes. One the most important priority diagnosis is patient with “High Blood Pressure”(HBP) complicated by diabetes.Nurses that work in the hospital and clinics will encounter this priority nursing diagnosis of diabetes during their careers.

The situation is based on a sick patient that was transferred to the hospital because of HBP. Ms. Williams has been admitted to the hospital by ambulance. She is a 79-year-old elderly female with a dangerous blood pressure results of 230/120. Ms. Williams is making complaints of severe headaches and she is dizzy because did not take her insulin.The patient has admitted she has a poor diet and she never exercises. The nurse can respond with three difference actions: independent, dependent and interdependent.

Independent

The nurse can take the Independent action based on the HBP diagnosis: Ms. Williams has been provided a new prescription by the physician for her high blood pressure. The patient is very concerned about the possible side effects because she is unable to exercise and because she is on insulin for diabetes. Ms. Williams refuses to take the medication from the nurse because things mixing other prescriptions with her insulin is deadly. The nurse intervenes by educating the patient on the purpose of the medication that will benefit the patient and addressing all the side effects and possible consequences including diabetic medicine.

Dependent

Ms. Williams’s blood pressure is rising with a continued reading of 200/110. The nurse relays on her years of experience that warrants immediate notification to the treating inpatient physician. The nurse takes another reading to ensure the blood pressure rate is rising and the nurse checks the patient’s feet for peeling and cracking.  The nurse once again confirms a reading of 210/110. The physician is contacted immediately about the patient’s diabetes. As a result, the physician makes the decision to treat the patient with an antihypertensive medication treatment plan along with the nurse watching the reactions with the insulin. The nurse takes the dependent action to give the patient the oral medication as ordered. In addition, the nurse request for dietician, Endocrinologist and physical therapist treatment plans. The patient weights over 400 pounds.

Interdependent

The interdependent method utilize by the nurse requires the involvement of numerous supporters of the medical team. Ms. Williams provides the information to the nurse that she has a diet of high sodium.The nurse intervention is documenting the patients file and requesting a diet consultation to ensure the patients meals meets the patient’sneeds. In addition, the nurse request the support of the dietician, and Endocrinologist at the facility to help education the patient and how to control high blood pressure with diet. In addition, the nurse contacts the physician concerning a proposer diet program along with the dietician.

Nursing Interventions (Urinary Tract Infection) UTI

The priority medical diagnosis is urinary tract infection (UTI). The medical problem was chosen because it is a common nursing intervention that a nurse may face with an elderly male patient. The client centered goals/outcome is to ensure the male patient is responding to treatment of UTI with antibiotics while checking the patient for urine is healthy. The secondary client centered/outcome is ensure the patient blood pressure and comfort levels reflect a patient that is responding positively to the antibiotics along with diabetes medicine. The nurse’s intervention at this point is critical because the negative effects of antibiotics that are notice too late could result in the patient’s death. The nursing intervention would be evaluated based on the following factors: (1) the physicians being notified about the patients diabetic conditions and if the patient’s urine changes. The change in discoloration could be adverse or positive effects from the antibiotics. The nurse’s intervention rationale for monitoring and assessing the urine output provides valuable information for the treating physician. Including the health of the patients feet due to diabetes. The characteristics noted by the nursing has implications such as the urine being concentrated which means the patient is not receiving enough bodily fluids. If the urine is cloudy means the patients still has an infection and if the urine has a foul order means the patient infection is still present. (2) The monitoring of the patients urine must be notated and monitored to ensure the medication is working or the existence of anegative side effects. The nurses must documentation must show the recording of the patient’s reaction to the antibiotics because the physician can determine whether to send the patient home with the correct prescription. In addition, the patient would be consulted by dietician, Endocrinologist and physical therapist (3) the nursing industry has a set of standards that measure the performance of nurses.  (4) The final step to measuring the nurse’s performance is utilizing the national standardized performance measures. These measures are common used the nursing industry to measure the nurses quality of patient care in an acute environment.

Nursing interventions are specific treatments for different diagnosis that required the nursing to use her knowledge, experience and skills. The nurse uses this intervention/monitoring to determine which interventions is best action for that specific patient with diabetes complications. One the most important priority diagnosis is patient with “Urine Tract Infections” (UTI). Nursing will encounter this priority nursing diagnosis such as diabetes during their careers.

The situation is based on a sick patient that been admitted with severe UTI and diabetes. Mr. Cranker has been admitted to the hospital by ambulance. The patient was overweight and fatigued. He is a 65 year-old elderly female with UTI with complaints of difficultly urinating and his feet are cracking and peeling. Mr. Cranker is making complaints of severe pain during urination and bad odor when urinating. The nurse can respond with three difference actions: independent, dependent and interdependent.

Independent

The nurse can take the Independent action based on the HBP diagnosis and diabetic complications: Mr. Cranker has been provided a new prescription for antibiotics for URI along with constant checks for insulin levels. The patient is very concerned that the new prescription with upset their stomach. Mr. Cranker is afraid to take a new prescription with insulin.The nurse provide the patient with information about antibiotics while educating them on the possible side effects. The nurse is educating the patient and involving them with the taking of the antibiotics while discussing the impact of the patient’s weight and diabetes.

Dependent

Mr. Cranker’s UTI is putting off a stronger order and the patient is complaining of itching. The nurse relays this information to the physician who determines the itching means the patient is allergic to that antibiotics. The nurse immediately takes the patient off the current medication changing to the new IV prescribe by the physician. As a result the physician changes from oral medication to an IV treatment plan. The nurse takes the dependent action to give the patient the IV treatment as ordered. However, the diabetes medicine especially the insulin is monitored.

Interdependent

The interdependent method utilize by the nurse requires the involvement of numerous supporters of the medical team.Mr. Cranker provides the information that his stomach is still aching. The Endocrinologist will be consulted for diabetes. The nurse intervention is documenting request prescription to sooth the patient stomach and request the assistance of the gastro physician to ensure the patient stomach pains are not something severe.  In addition, the nurse request the support of the Urologist to run some more test to ensure the new IV was helping the patient.

The third nursing intervention is yeast infection. The treatment plan is very similar to the UTI treatment plan. The primary difference in the nursing intervention would be monitoring would be different while UTI is looking for order, yeast infection may not have an order and the yeast infection will be itchy just like UTI but itchiness for yeast infection means they are still infected and not a result of a negative reaction. The patient shares with the nurse she is an actor and dancer but suffers from diabetes. As result, the nurse decides to provide the patient with additional education such as no feminine sprays or tampon deodorant that may cause additional infections. Do not were wet swimsuit, thus stay away from swimming until they have healed. The patient was advised to not where tight fighting cloths such as tight jeans. The independent action would be educating the patient, the dependentwould be showing the patient how to clean the infection. The interdependent would requesting the help of the physician that is a dermatologist to show the patient how to care for her skin in that sensitive area and a Gynecologist to examine the patient before leaving the hospital to ensure no other problems exist. These example show a great need for evidence based intervention.

In the last decade there has been a concentration of research to improve the healthcare system and the quality of patient care. The greater emphasis has been on utilizing evidence based nursing interventions to find the best evidence for the best treatment methods. According to Courtney &McCuthceon (2010), the inclusion of evidence based nursing intervention can reduce the indecision in clinical care. There is quantitative and qualitative evidence that evidence based nursing intervention can only improve the quality of patient care. There is evidence the evidence based nursing intervention can usher in a new innovate way to improve the quality of patients with diabetes into the new millennium.

Reference

Academy of Otolaryngology (2014).Diet and exercise tips. Retrieved from https://www.entnet.org/content/diet-and-exercise-tips

Beers criteria for potentially inappropriate medication use in older adults. MedSurg Nursing, 21(3), 129

Courtney, M. & McCutheon, H. (2010).Using evidence to guide nursing practice. National Library

of Cataloging. Retrieved from https://www.us.elsevierhealth.com/media/us/samplechapters/9780729539500/Courtney_Sample_Chapter.pdf

Diabetes.uk.com. (2014).Urinary tract infections: Diabetes. Retrieved from http://www.diabetes.co.uk/diabetes-complications/urinary-tract-infections.html

Mayo Clinic. (2014).High blood pressure (HBP). Retrieved from http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/risk-factors/con-20019580