As a student nurse, I am glad to have made it this far without having to be the bearer of bad news for a patient or family. It is often hard to say exactly how you will deliver bad news as a caregiver who wants everyone to simply "get better", although we know this is not a common reality in healthcare. Depending on the news I am to deliver along with the patient and family dynamics, these will definitely play a huge factor in how I would approach the situation. As Marcus states from his experience, it is human nature that when we are faced with these situations we want to make it sound as good as possible, but our patients can decipher through these attempts. In times of anxiety and anticipation, I believe our patients appreciate honesty more than anything. I hope that one day when I am faced with this situation; I will be able to handle it with honesty and compassion. When establishing rapport with my patients, I like to make general conversation with them and find out their interests, but not only that, also their concerns. We are privileged at this point to still be able to focus our attention on the patients we have and give them more time than their floor nurse may have to offer. More than we know, I believe simply taking time to listen to what they have to say makes them feel like they can trust you and appreciate your presence.
Interventions:: Teach patient not to share blood glucose monitoring equipment
R: Hepatitis B can survive in a dried state for 1 week. Infection can be spread by the lancet holder even when the lancet itself has been changed.
I: Assess skin integrity and healing status of any wounds
R: The diabetic patient is at risk for delayed healing of wounds and infections that may occur
I: Demonstrate and perform proper aseptic injection technique
R: Using aseptic technique will reduce the chances of acquiring infection and the injection site which could cause further complications
I: Frequently assess blood pressure and blood glucose levels
R: Aggressive control of blood glucose and hypertension in patients without microalbuminuira can help avoid nephropathy in the diabetic patient
I: Encourage yearly routine eye examinations
R: Diabetes causes poor retinal circulation, edema, and hard fatty deposits in the eye along with retinal hemorrhages which can lead to legal blindness
I: Monitor laboratory values, with special consideration to WBC
R: The client may be at increased risk of immunosuppression because the WBC do not function at optimum level when the blood glucose level is high
I: Help client implement regular and safe exercise regimen that is attainable for the patient
R: Regular exercise can decrease the risk for cardiovascular complications that are commonly seen among diabetic patients due to poor tissue perfusion, especially to the lower extremities
Medications that can cause hyperglycemia
Thaizide Diuretics- chlorothiazide
Antihypertensive- Carvedilol
Corticosteroids- hydrocortisone
Interventions:: Teach patient not to share blood glucose monitoring equipment
R: Hepatitis B can survive in a dried state for 1 week. Infection can be spread by the lancet holder even when the lancet itself has been changed.
I: Assess skin integrity and healing status of any wounds
R: The diabetic patient is at risk for delayed healing of wounds and infections that may occur
I: Demonstrate and perform proper aseptic injection technique
R: Using aseptic technique will reduce the chances of acquiring infection and the injection site which could cause further complications
I: Frequently assess blood pressure and blood glucose levels
R: Aggressive control of blood glucose and hypertension in patients without microalbuminuira can help avoid nephropathy in the diabetic patient
I: Encourage yearly routine eye examinations
R: Diabetes causes poor retinal circulation, edema, and hard fatty deposits in the eye along with retinal hemorrhages which can lead to legal blindness
I: Monitor laboratory values, with special consideration to WBC
R: The client may be at increased risk of immunosuppression because the WBC do not function at optimum level when the blood glucose level is high
I: Help client implement regular and safe exercise regimen that is attainable for the patient
R: Regular exercise can decrease the risk for cardiovascular complications that are commonly seen among diabetic patients due to poor tissue perfusion, especially to the lower extremities
Medications that can cause hyperglycemia
Thaizide Diuretics- chlorothiazide
Antihypertensive- Carvedilol
Corticosteroids- hydrocortisone