Case study 2 - Mary
Mary is a 56 year old woman who has recently been diagnosed with type 2 diabetes. She is morbidly obese and has a body mass index (BMI) of 35. She is visiting a community health clinic for assessment and education for her newly diagnosed condition.
1. (a) Explain six (6) potential health issues Mary faces as a result of her obesity.
(b) In planning services for your client, you follow organizational requirements and obtain a urine test from Mary. You note that Mary's urinalysis shows that there is a moderate amount of protein present. Is this finding normal or abnormal? Justify your answer.
2. Name two (2) external and (2) internal factors that could be affecting Mary's health status.
3. What type of health education should nurses give this client to assist her with controlling her condition?
4. In your planning of services for Mary you identify that she needs to see a Dietician. What is the most likely impact of this intervention for Mary?
5. Identify the body systems that are affected by Mary's Type 2 diabetes.
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Cardiovascular system
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Nervous system
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Integumentary system
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Endocrine system
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Sensory system
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Urinary system
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6. Complete the table below with the health impact that diabetes can have on the body systems provided.
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Sensory systems, the eye
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Cardiovascular system
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Nervous system
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Cardio vascular system - Hypertension
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Urinary system
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Body System
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Potential effects of Diabetes
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Prolonged raised blood glucose can lead to atherosclerosis - hardening and narrowing of the arteries, and if affects the coronary arteries, it can cause coronary heart disease leading to heart attacks and angina
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Diabetes, obesity and a sedentary lifestyle are all risk factors contributing towards development of hypertension. Untreated hypertension can lead to heart failure, stroke and kidney damage.
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Atherosclerosis in the brain can cause an ischaemic stroke.
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High blood glucose damages small and large blood vessels throughout the body. In the kidneys the damage is referred to as diabetic nephropathy (Waugh and Grant, 2010, p 345). Glomeruli are progressively damaged allowing protein into the urine. Atheroma of renal arteries can lead to renal ischaemia, hypertension and eventually chronic renal failure.
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Microvascular complications of diabetes can impair eyesight or cause vision loss.
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7. Fill in the blanks regarding the impacts of health services in relation to the health issues experienced by Mary, refer to the example provided as your guide.
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Health Issue
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Health Service
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Impact of service on clients condition
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Example:
Peripheral neuropathy
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Podiatrist
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Minimise risk of potential ulcers/sores developing and becoming infected (Peripheral neuropathy causes decreased sensation to feet)
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Dietician
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Treat underlying depression/eating disorders
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General practitioner
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Manage blood glucose monitoring, and overall health and well-being of a client with a chronic condition
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Diabetic retinopathy
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Endocrinologist
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Monitors diabetes and insulin/medication regime and specialised treatments
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Textbooks:
- Brown & Edwards, 2012, Lewis's Medical-surgery nursing, assessment and management of clinical problems, 3rd edn, Mosby Elsevier, Sydney.
- Waugh & Grant, 2010 Ross and Wilson Anatomy and Physiology in Health and Illness, 11th edn, Elsevier, Australia.
Attachment:- Assignment.rar