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S R Michael

Publications and source records attributed to S R Michael.

9 recordsLinked to original sources

Nursing management of the diabetic patient receiving nutritional support.

The diabetic patient receiving nutritional support presents a particular challenge to critical care nurses and other members of the health care team. Typical protocols concerning TPN administration must be reevaluated given the special considerations associated with the pathology of diabetes mellitus. These patients are particularly susceptible to the development of acute complications including those associated with glucose metabolism abnormalities and electrolyte imbalances. In addition, diabetic patients receiving TPN have the added stress of an acute illness complicating a chronic illness. An understanding of the interrelationships between the pathophysiology of diabetes mellitus and the stress response will provide the nurse with the background information necessary to meet the challenges imposed by TPN administration. The critical care nurse will be able to recognize early signs and symptoms of complications and implement appropriate nursing interventions. An overview of primary nursing diagnoses, goals, and interventions has been presented and will apply to most patients receiving nutritional support. Individualized care plans can now be formulated as an extension of the basic plan, thus ensuring optimum nursing care to the diabetic patient receiving nutritional support.

Diabetes Mellitus

Management of the diabetic patient receiving nutritional support.

The diabetic patient receiving TPN presents a challenge to health care personnel. Usual protocols concerning TPN administration must be reevaluated given the special considerations associated with the pathology of diabetes mellitus. These patients are susceptible to the development of complications including those associated with glucose metabolism abnormalities and electrolyte imbalances. In addition, diabetic patients receiving TPN have the added stress of an acute illness complicating a chronic illness. An understanding of the interrelationships between the pathophysiology of diabetes mellitus and the stress response will provide the nutritional support team with the background information necessary to meet the challenges imposed by TPN administration. The health care team will be able to recognize early signs and symptoms of complications and implement appropriate interventions. Individualized care plans can be formulated as an extension of the basic plan that has been presented, thus providing optimum care to the diabetic patient receiving nutritional support.

Diabetes Mellitus

Treating hypoglycemia.

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Diabetes Mellitus

Drug therapy for the hypertensive diabetic patient: implications for the diabetes educator.

A variety of side effects associated with the use of antihypertensive medications may occur in any patient with diabetes mellitus. Also, some antihypertensive agents produce symptoms that would be insignificant to the nondiabetic patient but may be life-threatening to the patient with diabetes mellitus. Therefore, it is imperative to instruct patients to be aware of any changes they may notice after starting an antihypertensive medication or changing their antihypertensive drug regimen. With this increased awareness and an increase in glucose monitoring (when necessary), the patient is prepared to recognize subtle changes in blood glucose levels or other conditions related to diabetes mellitus--changes that might otherwise go unnoticed. As diabetes educators, being knowledgeable about the pharmacodynamics of various antihypertensive medications, their influence on diabetes, and any risks the drugs may impose on the diabetic patient gives us a sound base to intervene with patients and prevent potentially life-threatening complications.

Antihypertensive Agents

Photography as a tool in assessment and rapport development in clients with diabetes: research brief.

Certainly no major conclusions or generalizations can be made from a pilot study of this size. However, as is the nature of pilot studies, needed modifications in methodology have been discovered. Also, it is obvious that rapport development may be evaluated with the MISS, and the use of a camera has proven to be a worthwhile assessment and intervention tool. The results of this pilot study would certainly warrant continuation with a larger study. Rapport development has not been studied in diabetes. Perhaps rapport may be at risk because of the lengthy provider-patient relationship and the need for repeated physician reinforcement of required medical regimens and some associated life-style changes. In this study, rapport appeared to increase slightly in the experimental (camera) group and decrease in the control (non-camera) group. From the patients' perspective, use of photography communicates that the health care provider cares about them as individuals, is interested in their life-styles, and is seeking methods to best integrate the treatment regimen into their individual life patterns. However, rapport development may deteriorate over time with individuals who have a chronic illness (as indicated by some decrease in pretest/posttest mean differences in both groups), thus emphasizing the responsibility of health care providers to actively work to preserve rapport. The camera may be one method to accomplish this goal. When treating an individual with a chronic illness, health care providers tend to view the patient and problem as one entity rather than as two separate components. The camera may help to enhance this separation and promote understanding of the individual by means of rapport development.

Adult