Diagnosed Type 2 diabetes

You are an Enrolled nurse working in primary health care. A new referral to your clinic, Mr. McFarlane, has recently been diagnosed Type 2 diabetes.

As part of your role, you are working with a Registered Nurse to assess the client and develop a care plan appropriate for the client with both short- and long-term objectives and goals.

Character Briefs:

Mr. George McFarlane. Male aged 53 years. Married for 5 years with 3 children.

Mr. McFarlane’s background includes:

• Second marriage – first wife died of cancer 8 years previously
• Occupation – Long haul truck driver
• Earns good money
• Away from home a lot – not there to support the family
• Overweight – 135kg
• Hypertension
• Uses watching television and beer to cope with stress
• Smoker
• Diet preferences are Australian. Often has a poor diet when on the road for work including ‘fatty food from truck stops’
• Has a 26-year-old son from his first marriage who has severe depression and uses illicit drugs, he visits on occasion (very disruptive when he does visit)
• Unknown social support and external interests
• Has osteoarthritis in (L) knee
• Reliant on their wife, Yu Yang does all domestic duties as he is not self-sufficient.

Mrs. Yu Yang McFarlane is Mr. McFarlane’s wife. She is 38 years old.

Mrs. McFarlane’s background includes:

• Came to Australia as a university student
• Fell pregnant at the age of 19 – did not marry
• Married George 5 years ago
• Has 3-year-old twins at home
• One twin has a developmental disorder
• The English language is good
• Was/Is isolated with no extended family
• Her issues will be those of isolated immigrant
• Prefers to cook Asian food
• Needed help with raising a child and so she invited her Chinese mother to come to Australia to help out
• Needed help with raising a child and invited a Chinese mother to Australia to help out

Questions.

1. Mr. McFarlane has recently been diagnosed with Type 2 diabetes. Discuss the pathophysiology of Type 2 diabetes.

Include in your response:

1. Your understanding of Type 2 diabetes
2. Possible causes of Type 2 diabetes
3. Possible risk factors for Mr. McFarlane

2. Discuss the difference between Type 1, Type 2, and gestational diabetes.

Include in your response:

• anatomy, physiology, and pathophysiology of each type

3. Consider each of the following potential problems associated with diabetes:

1. hypoglycemia
2. hyperglycemia
3. ketoacidosis
4. Hyperosmolar non-ketonic coma

4.  Discuss your understanding of each of these potential problems.

Include in your response:

1. Signs and symptoms of each potential problem
2. What assessments/ examinations would determine if the client is suffering from the potential problem
3. Possible treatment options including any emergency care required
4. nursing care of a client