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Prepared by: Mark Anthony L.

Yabres SN/SUCN

BSN IV (Surgery Rotation: SY 2012 -2013)

OBJECTIVES

Topic: Diabetes Mellitus Type II Date: July23, 2012 Venue: Silliman University College of Nursing Time Allotment: 2 hours Placement: Surgery Rotation, 1st semester, SY 2012-2013

Topic Description: This topic deals with concepts of Diabetes Mellitus, Type II and its related complications during the entire course of the disease process. It is geared towards providing the learners with the opportunities in acquiring adequate knowledge, desired skills and appropriate attitude through utilizing the information given which encompasses the psychosocial profile of the patient, the structure and function of the endocrine system, the pathophysiology of the condition, its medical and pharmacologic management, its functional health patterns and nursing care plan presentation.

Central Objectives:
At the end of 2 hour lecture discussion, the learners shall have a

comprehensive understanding of the condition, demonstrate beginning skills and manifest desirable attitude towards the care of a 73-year old person with Diabetes Mellitus Type 2 including the family during and after the disease process.

Specific Objectives: At the end of our 2 hour Case Presentation, the learners shall: Interpret the profile of the patient satisfactorily. Identify the anatomy and physiology of the endocrine system and other body systems that are involved in the disease condition. Analyze critically and trace the pathophysiology of the condition. Examine comprehensively the functional health patterns. Enumerate the medical and pharmacologic management of the condition. Formulate appropriate nursing care plan for the patient. Evaluate objectively and enjoy the case presentation as a whole.

DEMOGRAPHIC DATA:
Patients name: Mr. E.S. Age: 73 yrs.old Sex: Male Address: Baybay Galas, Dipolog City Religion: Roman Catholic Educational Attainment: College Graduate BS in Elementary Education Occupation: Government Employee Doctor(s) in charge: Dr. Nicolas Ramas Uypitching & Dr. Edna Alcantara Nationality: Filipino

Date & Time of Admission: July 27, 2012 ; 11:16:AM

Room & Bed No.: 234

Medical Diagnosis: Post Amputation of Right Toe secondary to gangrene

CHIEF COMPLAINTS: Infected Right Toe HISTORY OF PRESENT ILLNESS: Patient was a known diabetic (type

2) for 3 years & S/P amputation of the Right toe secondary to gangrene.
2 hours ago prior to admission noted right toe to have pus drainage before the admission. (-) infection.
GENERAL IMPRESSION OF CLIENT (APPEARANCE UPON FIRST

CONTACT): Received lying on bed awake, alert, and responsive, coherent, and oriented to date, time, place with #8 PNSS 1 L @ KVO, flowing and infusing well. Dressing intact with minimal discharges noted. Skin shiny and slight edema of the foot noted secondary to amputation.

FAMILY GENOGRAM
Lolo J DM Lola U Lolo H Lola A

Papa A DM, 86

Mama D
HPN, CVA 84

Bro J Colon CA, 65

Bro E DM, 56

Bro G Liver CA, 50

Sis L1 DM, 65

Sis L2 DM, 64

Wife E HTN

PATIENT DM, 73

Wife A A&W, 63

BBB S, Jr A&W, 41

BBB J A&W, 43

BBG MP DM, 45

BBG G A&W, 37

BBG A A&W, 32

BBG I Asthm a, 31

BBB R A&W, 30

Random Blood Sugar Monitoring (q6H)

400 350 300 250 mg/dl 200 150 100 50 0 11:00 5:00 11:00 5:00 11:00 5:00 11:00 5:00 11:00 5:00 11:00 5:00 11:00 5:00 11:00 5:00 11:00 5:00 11:00 5:00 AM PM PM AM AM PM PM AM PM AM AM PM PM AM AM PM PM AM AM AM

6/27

6/28

6/29
time

6/30

7/1

7/2

BIBLIOGRAPHY

ADA. (2002). American diabetes association complete guide to diabetes. 3rd. ed. US: American Diabetes Association, Inc. Bare, B., Cheever, K., Hinkle, J. & Smeltzer, S. (2010). Medical-surgical nursing.12th ed. Philadelphia, USA: Lippinott Williams & Wilkins. Black, J. & Hawks, J. (2005). Medical-surgical nursing: Clinical management for positive outcomes. 7th ed. Singapore: Elsevier Inc. Brown, D., Edwards, H. (Eds.) Lewis Meical-Surgical Nursing: Assessment and Mangement of Clinical Problems. Mosby, Australia. Copstead Lee-Ellen C. & Jacquelyn L. Banasik (2008). Pathophysiology. 3rd ed. Michigan. Fauci, A. et.al. (2008). Harrisons Principle of Internal Medicine. 17th ed. USA: McGraw-Hill Companies, Inc. Ignativicius Donna D. and M. Linda Workman (2006). Medical-surgical critical thinking for collaborative care. 5th ed. St. Louis, Missouri: Mosby Inc. Lewis, Rowland (2005). Merritts Neurology. 11th ed. Philadelphia, U.S.A.: Lippincott & Wilkins. Lewis, S.L. et.al (2007). Medical-surgical nursing: Assessment and Management of Clinical Problems. 7th ed. International Edition, Mosby, Inc., Elsevier Inc. McCance, K. & Huether, S. (2002). Pathophysiology: The biologic basis for disease in adults and children. 4th ed. St. Louis, Missouri: Mosby Inc. Monahan, Frances D. et al. Phipps Medical-Surgical Nursing: Health & Illness Perspectives. 8th ed. St. Louis Missouri. Porth, C. (2007). Pathophysiology: concepts of altered health state. East Washington square, Philadelphia: Lippincott-Raven Publishers. Sonksen, Peter (et al.). (1999). Diabetes at your fingertips, 4th ed. London: BarbHome Smeltzer, et.al. Timby, B.K. & N.E. Smith (2006). Introductory Medical-Surgical Nursing. 8th ed. U.S.A.: Lippincott Williams & Wilkins