Nursing Practice in Context (Case Study Sample)
some books should be used -understanding pathophysiology- Craft Gordon Tiziani -Lew's medical-surgical nursing- Edwards brown -Weber & Kelley's Health assessment in nursing- Peter Lewis and David Foley Please please use the criteria document to follow last time i order same paper but different scenario and i fail this subject. this my last chance and i would like to get 6 or 5 a least. Thank you.source..
Case scenario: Nursing Practice in Context 4
1] Current problem
Both Type 2 Diabetes, hypertension increase the risk of fractures, and in the case of hypertensive older patients, care should be exercised to ensure that they do not worsen the situation. According to (Solomon et al., 2011), antihypertensive may affect the bone metabolism in cases where there is decreased calcium absorption. Since hypertension likely affects the bone mineral density (BMD), and fracture risk, there is a need to understand how hypertension and type 2 diabetes. However, there are mixed results on the impact of antihypertensive drug exposure and fracture risk. For instance, thiazide diuretics and Angiotensin-receptor blockers have lower risk of fractures unlike calcium channel blockers, but other agents seem to have to impact on the fracture risk (Solomon et al., 2011).
Patients with increased body weight have high bone density, but some studies show that there is likely no association between type 2 diabetes and risk of bone fracture. The stress of operation may exacerbate diabetes, and there is a need to address the stressors and look at the behavioral responses to them (Lloyd, Smith & Weinger, 2005). Social and psychological support might improve the chance of Jensen coping with the situation, but his children and ex wife and live out of state. Hypertension and type 2 diabetes are comorbidities, since they are likely to take medications that may decrease the BMD or increase risk of falling (Lipscombe et al., 2007). Jensen is 65 years old.
Even though, the fractures were caused by the fall, there are various factors that may worsen the situation. After having undergone the operation, there is risk that without power management of diabetes, there may be more complications. This is because stress can cause a rise in blood sugar levels, as stress hormones increase blood sugar levels including cortisol and epinephrine. There are both pharmacologic and non-pharmacologic interventions that address the risk factors of further structures. The pathophysiology of fractures are mostly related to the bone strength including age, one quality, bone mass, and the nature of injuries (Melton et al., 2008). Understanding the risk factors to the fractures is the basis for identifying the most effective interventions.
To highlight the gravity of the problem is that as severity diabetes increases so does the risk of non traumatic(fragility) fracture, while the current prediction tools to detect the risk of fractures are not necessarily robust when dealing with diabetic patients (Fraser et al., 2013). To further compound the problem is that Mr. Jensen smokes 20 roll-up cigarettes per day, increasing the risk of hypertension. Since the blood pressure is 155/100, focusing on the benefits of healthy eating during and after recovery would minimize further complications from diabetes and hypertension. Brown & Edwards (2015), highlight that patients ought to taught to manage the BP levels and maintaining the goals as this makes it easier to use interventions.
Patients with diabetes mellitus are at a higher risk of complications after suffering fractures regardless of whether they are treated surgically or not (Craft et al., 2015). Fracture repair starts with inflammation that allows recruitment of mesenchymal stem cells, before there is cartilage formation, cartilage resorptiom and the secondary bone formation (Graves et al., 2011). However, for patients suffering from diabetes the condition affects wound healing for both soft and hard tissues, since there is accelerated loss of cartilage, the tissue level changes and there is risk if reduced cartilage formation (Graves et al., 2011).
Impaired fracture healing is a concern in patients with hypertension and diabe...
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