PEKKA CASE by

PEKKA 59 yrs

katariinakoistinen4 — 2016-09-26 11:23:36 UTC

- overweight (175cm /107kg) --> LOSE WEIGHT, HOW? RIGHT KIND OF NUTRITION, EXERCISE
- stressed out, long working hours--> MORE EXERCISE, CUT DOWN WORKING HOURS
- irregular smoking--> QUIT SMOKING!
- tiredness (6 months) --> MENTAL OR PHYSICAL? MORE EXERCISE, DEPRESSION, PSYCHIOLOGICAL HELP?
- pain in the legs--> NEUROPATIA? EXAMINE THE FEET, GOOD CARE OF THEM, EXERCISE, GUIDANCE TO SELF-CARE.
- poor exercise--> MORE EXERCISE, HOW TO MOTIVATE?
- poor eating habits--> NUTRITION, MOTIVATION
- drinks every day, weekends more--> CUT DOWN ALCOHOL
- father & mother both suffered from DM2--> FAMILY HISTORY, HIGH RISK!!
- father died from heart disease at year 60
- high blood pressure 160/95--> should be under 140/80--> EXERCISE AND MEDECIN ACE
- glucose tolerance test later BECAUSE HIGH RISK PATIENT

RISK FACTORS

katariinakoistinen4 — 2016-09-26 11:24:01 UTC

Pekkas` lifestyle:
-Smoking
-Alcohol
-Obesity
-No exercises
-Stressful job
--> can affect

Family burden:
-Both parents suffer from DMII --> cant`t affect

-All these together increase the risk of getting diabetes

Smoking:
-Raise the heart rate --> heart load
-Constricts blood vessels
-Cause lack of oxygen --> ischemic in myocardium
-Increase blood coagulation --> risk of embolism
-Degrade cholesterol
-Cause inflammation in the blood vessel wall

Alcohol:
-Raise blood pressure --> risk of stroke, heart disease and vascular disease
-Often causes weight gain

Obesity:
-Major risk factor for metabolic syndrome --> diabetes
-Can raise the heart rate --> heart load

No exercises:
-Cause weight gain
-Fall mood
-Weakens the heart and blood circulation

Stress:
-May cause weight gain
-Fall mood
-Raise blood pressure
-Weaken the immune system
-Feeds the other risk factors

WHAT IS DIABETES:

katariinakoistinen4 — 2016-09-26 11:45:00 UTC

- chronic life-long health condition
- Body can't product enough insulin
-> causes high levels of sugar in the blood.

THERE ARE 2 MAIN TYPES OF DIABETES:
Type 1 Diabetes
- Usually diagnosed in childhood, but can appear in any age.
- Treated with insulin (injection), exercise and diabetic diet.

Type 2 Diabetes
- The most common diabetes type in adults.
- May be prevented by healthy lifestyles and regular exercise
- Treated with weight control, insulin or oral medication and exercise.
- pancera can't make enough insulin to keep blood glucose level normal.

Insulin is the hormone produced by the pancreas that allows glucose to enter the body’s cells, where it is used as fuel for energy so we can work, play and generally live our lives.

LABORATORY TEST

katariinakoistinen4 — 2016-09-26 11:45:37 UTC

-Pekka`s lifestyle affect his laboratory result

-fP-Kol: 7 ( fP-LDL: 3, fP
-HDL: 0,7, Trigly: 3)
-fP-Gluk: 7,2 mmol/l

HbA1C: 53mmol/mol (7,0 %)

Should be:
- Total cholesterol <5
- "Good" cholesterol >1
-fasting plasma glucose 4-6 mmol/L

NURSING ARTICLE:

katariinakoistinen4 — 2016-09-26 11:54:00 UTC

http://prhsj.rcm.upr.edu/index.php/prhsj/article/viewFile/1067/712

Standards of medical care for patients with diabetes mellitus

ROLE OF NURSE IN HEALTH PROMOTION

hanna_klinga — 2016-10-08 14:23:52 UTC

- patient education
--> goals
primary (1.) prevention
--> risk factors
--> nutrition
--> personal hygiene
secondary (2.) prevention
--> early diagnoses
--> prompt treatment
tertiary (3.) prevention
--> restoration and rehabilitation

ADVICING PEKKA

hanna_klinga — 2016-10-08 15:06:43 UTC

- lifestyle counseling and self-care
- family disease
- personal treatment goals (short-term (welfare) and long-term (prevention of other diseases) --> retinopatia, nefropatia, skin diseases, CAD, thrombosis...)
- regular monitoring especially right after diagnosis

HEALTH PROMOTION

2016-10-09 01:14:55 UTC

· Physical

Weight loss -> Exercise and diet. Steady mealtimes.

Physical activity -> Exercise should last at least 30 min per day, 5 days per week.

Diabetic diet -> Food triangle and nutrition’s that can be found from low glycemic foods. Think what you eat and how much.

Medical care-> Check blood glucose and keep it in target range. Learn from it.

· Mental
Emotional processing -> Anger, stress, loneliness, depression. Talk about it!

· Social
Family guidance and knowledge, doesn’t restrict social life of the patient (Even if it could feel like it).

· Spiritual
Commitment to treatment. Acceptance of the condition.