Unit 7 Assignment Diabetes is a chronic and serious illness that can cause complications such as nerve damage, blindness, renal failure, cardiovascular disease, the difficulty of hearing and strokes. It can be leading to foot amputations. But Which a good patient education and lifestyles changes, diabetic patients can prevent these complications and lead full, productive lives. (Williams, Hopper 2015) The environmental issues I come up with in Mrs. Kent include social isolation. The death of the patient husband lead her alone or the lioness is a risk factor and at the same time contribute to the progression of diabetes. The second risk is the lack of eating healthy foods, the fact that Kent works as a server proves that she does not earn enough money to put healthy food on her table or the nutrition is primordial to the management of diabetes even though it is the most critical aspect in the treatment of the disease (Williams, Hopper 2015). The Lack of insurance and transportation can push Shelly to the old practice remedy which can cause other complications. The major factor, in this case, is obesity.The pathophysiology of type 2 diabetes mellitus occurs when blood sugar levels become high. It is characterized by peripheral insulin resistance, altered regulation of hepatic glucose production, and decreased beta cell function, ultimately leading to beta cell failure. ()Because diabetes affect a different part of the body a nursing care plan may benefit. The nurse needs to consider several areas of education and resources. Shally the patient has been diagnosed with type 2 diabetes and hypertension and she is taking medication for that. First, at all, she needs a lifestyle changes because of her weight and for that resources can be provided to her for future education. The nurse should begin by the dietary education as well as the benefit of a regular work out which should be included prior to help the patient to get better. For the patient, the diagnosis of diabetes can be overwhelming with an intervention, planning, an education plan, and evaluation as well. The nurse should be started by The First step of the nursing care plan which is the data collection. The assessment is the principal way for the nurse to collect objectives and subjective data and develop a therapeutic relationship with the patient, the nurse should start the Assessment via an opened ended interview for a complete nursing history and a physical examination. The manner in which the nurse conducts herself during her interview with her patient has a therapeutic effect on the patient. During the interview, the nurse must behave professionally and in addition, she must use compassion, be understandable, not judgmental and especially good listener because the first impression says everything to the patient. Objective Data Shelly is a 64-year-old widower who comes in with a diagnosis of diabetic type 2. The patient fasting blood sugar was 280 mg/dl. The patient is on accuchecks and Glucophage’s 500mg twice a day. The nursing goal is to decrease Shally blood sugar at 70-100 per physician order. Mrs. Kern the patient weighs 190 lbs. for five feet, four inches in height. The nurse should first ask the patient about the diabetes type 2, what she knows about the progression of the disease, and figured out if the patient can be able to check her blood sugar by herself and interpret the results. If she knows about the effects of increasing blood sugar and about her diet regimes.Nursing Diagnosis is: Ineffective health maintenance related Deficient knowledge of diabetes management as evidenced by blood sugar above normal.Risk for infection related by high blood glucose levels Imbalanced Nutrition: More than Body Requirements related to lioness as evidenced by weight gain and eating unhealthy food.Nursing Outcomes: The patient will maintain blood glucose between 70 to 130 mgdl. The patient will verbalize how many times she needs to take her diabetes medication and when she needs to do her accucheks. The patient will verbalize the diet regimes she needs to follow to meets her diabetic needs. The patient will demonstrate properly how to her accuckecks and read the result. The patient will verbalize how to reorder a supply of testing strips and glucometer after 30 days Nursing Interventions The nurse will demonstrate to the patient how to her accuchecks and read the results. The nurse will teach the patient on the diet menu she needs to follow to balance her blood sugars. The nurse will make to teach the patient how to get rid of lancets after each accuchecks Monitor blood glucose levels and provide simple carbohydrate, as indicated ()Evaluation: After 4 to 8 hours after the intervention shally will demonstrate how to checks her blood sugar and how often it needs to be done.The client has been prescribed a Glucophage (metformin) 500mg by mouth twice a day. Glucophage is in a class of drugs called biguanides. It is an appropriate choice because its action is to lower hepatic glucose and the absorption of intestinal glucose. Side effects of Glucophage (metformin) are Anxiety, fast or slow breathing, upper chest seizures, and blurred vision, shortness of breath, muscle pain, difficult urination, and stomach discomfort, sleepiness, a decrease in blood pressure, and a decrease in heart rate. It is safe for the patient to take both Metropol and Glucophage together because they have no interactions.Patient teaching The nurse will educate the patient to take the drug at the same time every day.The nurse will teach the patient that the medication doesn’t treat diabetes but helps to balance the blood sugars levels the nurse teach the patient to take the drug with food. The nurse will educate the patient about the risk for lactic acidosis and the need to stop taking the med if diarrhea, dehydration, and infection occurs. Nursing Implications Monitor for signs and symptoms of lactic acidosis: fever, dehydration, and diarrhea, and drowsiness drop of the Blood pressure drop of heart rate Monitor for blood sugars and observe for signs of hypoglycemia. Monitoring of blood glucose blood pressure, cholesterol levels, and lifestyle changes is primordial to prevent diabetes complications.