She was diagnosed with Type 1 diabetes mellitus and began treatment management of her glucose levels by administration of frequent insulin injections throughout the day on a basal bolus regime. Initially, this included 19 units of Novorapid throughout the day before meals and 6 units of Insulin Glargine (Lantus) at night time. This managed the patient’s glycaemic level
Diabetes being one of the chronic conditions with a lot of comobidties is of interest in this discussion. It is a major of cause of heart disease and stroke among adults in the United States. Also, coupled with lower extremity amputations, blindness and kidney failure. Comprehensive models of care such as the original chronic care model advocate for evidence- based health care system changes that meet the needs of growing numbers of people who have chronic disease. CCM was initiated to provide patients with self- management skills and tracking systems.
The flow chart may also serve as a reminder of crucial events of medical care that may effect the overall patients health. The particular sample of a flow chart I chose would be a great reference for the onset of diabetes, yet I do not feel that the form would be a good reference tool for prolonged diabetic care. If I would have created this flow sheet I would have done it on graph paper or an excel spread sheet to allow for numerous date entries of data across the flow sheet. This way a Physician would be able to see at a glance what progress has been made on the care and control of the patients diabetes. If the chart shows little or no improvement or even a worse scenerio worsening of diabetes and its overall side effect the the Physician will know that either the patients diet and or medication will need to be adjusted
3.3 11/17/15 PP: Have the patient count his carbs for each meal he receives in the hospital for practice and correct patient PRN by 11/18/15. 1.1. EBN: Learning ability and readiness varies with each patient and changes according to the situation the patient is in. The nurse is the patient advocate and spends the most time with the patient, so the nurse is able to most accurately assess the patient’s learning readiness. 1.2.
Make sure to assess the cardiac and respiratory status for dyspnea, crackles, cough, weight gain, and edema. Pulmonary toxicity happens when prolonged therapy of drug. Another important thing to look for is bone marrow depression but monitoring for bleeding of gums, bruising, petechia, guaiac stool, urine, and emesis.
Within the journal article, a chart on page 11-12 highlights: “Comprehensive Congestive Heart Failure Patient Education,” mentioning daily weights, with a teaching tip, providing the value of patient comprehension connection to “increased water weight and congestive heart failure”(2001). Explaining further increases of 3-5 pounds from previous examination by provider indicates attention needed due to underlying pathophysiology of CHF. In addition, to the topic of daily weight tracking, an explanation to how the evidence of weight tracking allows providers to titrating medications appropriately to manage CHF comprehensively by having the accurate daily weight measurement data. The middle section of the chart focuses on what key patient behaviors or actions correspond to the topics in managing CHF. For example, with “daily weight”
Goals for Type II Diabetes The HgbA1C optimal values for most patients with type 2 diabetes is seven percent or lower, which parallels to an average blood sugar of one hundred and fifty milligrams per deciliter. Until the patient A1C level is at seven or below, he should have his lab checked every three months until the correct adjustments have been made in his medication (American Diabetes Association, n. d.). With these results, the nurse practitioner can better adjust the treatment regimen of the patient. This test can also give the nurse practitioner a better idea of the likelihood that the patient can develop many other complications such as kidney failure, blurred vision associated with retinopathy, or many different types of neuropathies just to name a few (Grossman & Porth, 2013). Lipid density levels for patients should be below one hundred milligrams per deciliter.
A very common test for heart disease in general is an electrocardiogram or EKG. It measures electrical currents in the heart to see if they’re moving regularly, or if any parts are overworked. Another common test is cardiac catheterization. By running small tubes, called catheters, through the veins and injecting contrast dye, doctors can determine the blood pressure and blood flow levels inside the heart. A third usual test is an Echocardiogram where doctors take an ultrasound of the heart.
Major Political Actors Bill AB 1124 was approved by Governor Jerry Brown on 6th October 2015. The bill stipulates that the administrative director should create a drug formulary before 1st July 2017 to be in the medical treatment schedule regarding medications prescribed to workers in the compensation system (Perea 2016). The important bill was introduced by democrat Henry Perea with the goal of preventing the overutilization of numerous drugs and opioids. Also, the bill aimed at saving taxpayer’s money for other important ventures while still meeting worker’s requirements for medication within the system. Henry Perea’s decision to sponsor the bill was informed by a study that revealed the numerous savings states like Washington and Texas were making by adopting formularies.
LET YOUR CHILD 'S HEALTH CARE PROVIDER KNOW ABOUT: Any allergies your child has. All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines. Previous problems your child or members of your family have had with the use of anesthetics.
Then utilizing the results the clinic can drill down to the patients receiving beta-blockers, diabetes (eye & kidney exam) to determine if the correct interventions were being provided by the health care physician and identify gaps in treatment and then ensure the physician receives reminders on preventable measures to close quality care gaps and improve the quality of care provided to patients (Eddy, Pawlson, Schaff, Peskin, Shcheprov, Dziuba & Eng, 2008). I completed a chart audit of over 200 med advantage patient records this week utilizing CPT codes,ICD-9, progress notes, and lab results for HEDIS measures for HgbA1c (9 every 3 months), Diabetic Eye Exams (yearly), Colonoscopy Exam (every 10 years-unless indicated otherwise), Mammograms (yearly after age 50), BP (controlled < 100), and medication adherence (beta blockers, ACE/ARB, cholesterol, diabetic, etc) and my findings would be reported to BCBS, Humana, Clear River, Health Springs and NCQA. The yearly eye diabetic eye exam can detect retinopathy and help ensure early treatment to prevent blindness, control of BP can reduce MI infraction while yearly colonoscopy and mammograms can detect early signs of cancer and HbbA1c can help detect and identify gaps in diabetes
To develop objectives, you need to define the outcomes you and the patient expect from the teaching-learning process. Unlike goals, which are general and long-term, learning objectives are specific, attainable, measurable, and short-term. For example, for a newly diagnosed diabetic patient, the overall learning goal may be to learn how to maintain blood glucose levels between 70 and 150 mg/dl at all times. Reaching such a goal may be overwhelming unless it’s broken down into specific, short-term behavioral objectives that lead up to the overall goal. For this patient, an objective such as “After this session, the patient will be able to list five symptoms of hypoglycemic” is one step on the way to the larger goal.