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Case Study:

Cane is 20 and was diagnosed with Type 1 Diabetes at age 7. He is an apprentice mechanic and has recently moved out of home and is living with his girlfriend Julia who is also 20. Julia is studying to be an Enrolled Nurse. 

 

You are the Enrolled Nurse working in the Outpatient Diabetes Clinic. Cane is here for his yearly review with the Endocrinologist. You have only worked here for 2 weeks and have just finished your orientation. A holistic nursing assessment before Cane’s appointment with the Endocrinologist is required. 

 

Cane tells you that he sometimes doesn’t take his insulin at work because he “feels weird doing it” in front of other employees. He also has been avoiding taking his BSL through the day. Cane cannot answer questions about hypoglycaemia and does not know what to do if his BSL is 16 mmol. 

 

 

With Cane’s consent you invite Julia into the conversation. Julia tells you she doesn’t interfere with Cane and his diabetes because “that would just be too weird”

 

You have Cane check his BSL and you note that he takes his BSL from the middle of the pad of his thumb. The result is 19mmol. 

 

When you tell Cane that his BSL reading is high, he does not appear to understand. On further questioning he tells you that up until a month ago his mum managed his BSLs and his insulin dose and attended all appointments with him. 

 

Questions:

 

How would you identify the level of understanding and involvement in a person’s diabetic care by other stakeholders such as Julia or Cane’s parents?
What factors do you need to consider when preparing a care plan for Cane?
How would you identify the understanding of ongoing management of the person, their family or caregiver?
After you have evaluated and interpreted Cane’s blood and urine test results, how would you provide this information to interdisciplinary health team members?
Depending on the patient’s reaction to treatment and other factors the care plan may need to be modified in order to achieve the best outcomes for the patient, and this needs to be done in consultation with members of the interdisciplinary health care team. What types of modifications to the care plan would require consultation with the interdisciplinary team?
Evidence-based best practice requires records and research to establish benchmarks and or statistical guidelines to achieve the best outcomes for the patient. What methods would you use to evaluate your nursing interventions against existing evidence and best practice to determine the effectiveness of your nursing interventions for the patient?
Cane and Julia would not have been ready for education while he was unwell. When can/should you give education to patients? Provide three (3) examples of where an opportunity might present itself for you to provide information around diabetes and possible support services to Cane and Julia.
How would you evaluate Cane’s understanding of his own condition, treatment options, and self-management?
Provide an example of how you would promote/encourage Cane’s self-management of his condition, and how you would support him to involve Julia?
How would you know Cane had adopted your suggested strategies for self-management? b. How would you describe this in documentation or handover? (For this question you should consider yourself as an EN responsible for chronic management of diabetes eg. In primary care or in an Outpatient clinic)
SCIENCE
HEALTH SCIENCE
NURSING
NURSING HLTENN025

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