The document provides an overview of type 2 diabetes, including:
1) Pathophysiology of type 2 diabetes involves insulin resistance and inadequate insulin production, leading to high blood glucose.
2) Nursing care involves educating patients on lifestyle changes, medication management, and monitoring for complications.
3) The case study illustrates the nurse assessing a newly diagnosed patient, addressing concerns, and providing education on self-monitoring and safety.
Coronary artery disease, also known as atherosclerosis, is the leading cause of death in the United States. It occurs when plaque builds up in the arteries and decreases blood flow to the heart, which can lead to chest pain, heart attack, or heart failure. Some major risk factors include smoking, high blood pressure, diabetes, and high cholesterol. Nurses play an important role in educating patients on modifying risks like diet, exercise, and medication adherence to help prevent cardiovascular events.
This document summarizes several common cardiovascular pathologies including heart disease, hypertension, hyperlipidemia, arteriosclerosis, and peripheral vascular disease. It describes their symptoms, risk factors, prevalence, and recommendations for prevention and treatment including lifestyle modifications like diet, exercise, and smoking cessation as well as medical treatments.
This document discusses angina pectoris, also known as stable angina. It defines angina as chest pain or discomfort that occurs due to decreased blood flow to the heart muscle. It then describes the different types of angina and their causes. The main causes are atherosclerosis, coronary artery spasm, traumatic injury, and embolic events which can all restrict blood flow to the heart. The document outlines the goals of treatment which are to prevent heart attacks and death while reducing angina symptoms. It then discusses the various pharmacological treatments used including nitrates, beta blockers, calcium channel blockers, antiplatelet agents, ACE inhibitors, and ranolazine. Non-pharmacological options like percutaneous coronary
Angina pectoris is caused by reduced oxygen supply to the heart muscle due to spasm or obstruction of the coronary arteries. There are three main types of angina - stable angina, variant angina, and unstable angina. The main causes are atherosclerosis and coronary artery spasm. Treatment goals are to reduce symptoms and mortality from coronary artery disease progression through lifestyle changes, drug therapy, and surgical methods when needed. Drug therapy includes nitrates, calcium channel blockers, beta blockers, and other vasodilators to relieve symptoms and reduce ischemia. Percutaneous coronary intervention and coronary artery bypass grafting are surgical options for severe cases.
This file contains information regarding the medical condition unstable angina, as well as a case study of an unstable angina patient in a soap format. Please go over all of the slides to get a complete picture of the situation.
If you have any queries or suggestions, you can drop down in the comments below.
Thank you!
Angina (an-JI-nuh or AN-juh-nuh) is chest pain or discomfort that occurs if an area of your heart muscle doesn't get enough oxygen-rich blood.
Angina may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.
Angina isn't a disease; it's a symptom of an underlying heart problem. Angina usually is a symptom of coronary heart disease (CHD).
CHD is the most common type of heart disease in adults. It occurs if a waxy substance called plaque (plak) builds up on the inner walls of your coronary arteries. These arteries carry oxygen-rich blood to your heart.
Plaque Buildup in an Artery
Figure A shows a normal artery with normal blood flow. The inset image shows a cross-section of a normal artery. Figure B shows an artery with plaque buildup. The inset image shows a cross-section of an artery with plaque buildup.
Plaque narrows and stiffens the coronary arteries. This reduces the flow of oxygen-rich blood to the heart muscle, causing chest pain. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow, which can cause a heart attack.
Angina also can be a symptom of coronary microvascular disease (MVD). This is heart disease that affects the heart’s smallest coronary arteries. In coronary MVD, plaque doesn't create blockages in the arteries like it does in CHD.
Studies have shown that coronary MVD is more likely to affect women than men. Coronary MVD also is called cardiac syndrome X and nonobstructive CHD.
Types of Angina
The major types of angina are stable, unstable, variant (Prinzmetal's), and microvascular. Knowing how the types differ is important. This is because they have different symptoms and require different treatments.
Stable Angina
Stable angina is the most common type of angina. It occurs when the heart is working harder than usual. Stable angina has a regular pattern. (“Pattern” refers to how often the angina occurs, how severe it is, and what factors trigger it.)
If you have stable angina, you can learn its pattern and predict when the pain will occur. The pain usually goes away a few minutes after you rest or take your angina medicine.
Stable angina isn't a heart attack, but it suggests that a heart attack is more likely to happen in the future.
Unstable Angina
Unstable angina doesn't follow a pattern. It may occur more often and be more severe than stable angina. Unstable angina also can occur with or without physical exertion, and rest or medicine may not relieve the pain.
Unstable angina is very dangerous and requires emergency treatment. This type of angina is a sign that a heart attack may happen soon.
Variant (Prinzmetal's) Angina
Variant angina is rare. A spasm in a coronary artery causes this type of angina. Variant angina usually occurs while you're at rest, and the pain can be severe. It usually hap
Angina also known as angina pectoris is a medical condition characterized by chest pain usually left sided due to inadequate blood supply (ischemia) to the heart muscles due to obstruction (like presence of blood clot), narrowing or contraction (vasospasm) of the supplying coronary arteries.
This study aims to describe the diagnosis and management of stable angina in India through a large prospective multicenter observational registry of 1000-1500 patients seen by 150-250 non-interventional physicians over 4 months. The study will describe the demographic and medical profiles of subjects with stable angina and evaluate current practices for diagnosis and treatment. Eligible subjects must have a provisional diagnosis of stable angina by the participating physician within the past 3 months, agree to data sharing, and cannot have a history of acute coronary syndrome, revascularization, myocardial infarction, or angina for less than one month.
Coronary artery disease, also known as atherosclerosis, is the leading cause of death in the United States. It occurs when plaque builds up in the arteries and decreases blood flow to the heart, which can lead to chest pain, heart attack, or heart failure. Some major risk factors include smoking, high blood pressure, diabetes, and high cholesterol. Nurses play an important role in educating patients on modifying risks like diet, exercise, and medication adherence to help prevent cardiovascular events.
This document summarizes several common cardiovascular pathologies including heart disease, hypertension, hyperlipidemia, arteriosclerosis, and peripheral vascular disease. It describes their symptoms, risk factors, prevalence, and recommendations for prevention and treatment including lifestyle modifications like diet, exercise, and smoking cessation as well as medical treatments.
This document discusses angina pectoris, also known as stable angina. It defines angina as chest pain or discomfort that occurs due to decreased blood flow to the heart muscle. It then describes the different types of angina and their causes. The main causes are atherosclerosis, coronary artery spasm, traumatic injury, and embolic events which can all restrict blood flow to the heart. The document outlines the goals of treatment which are to prevent heart attacks and death while reducing angina symptoms. It then discusses the various pharmacological treatments used including nitrates, beta blockers, calcium channel blockers, antiplatelet agents, ACE inhibitors, and ranolazine. Non-pharmacological options like percutaneous coronary
Angina pectoris is caused by reduced oxygen supply to the heart muscle due to spasm or obstruction of the coronary arteries. There are three main types of angina - stable angina, variant angina, and unstable angina. The main causes are atherosclerosis and coronary artery spasm. Treatment goals are to reduce symptoms and mortality from coronary artery disease progression through lifestyle changes, drug therapy, and surgical methods when needed. Drug therapy includes nitrates, calcium channel blockers, beta blockers, and other vasodilators to relieve symptoms and reduce ischemia. Percutaneous coronary intervention and coronary artery bypass grafting are surgical options for severe cases.
This file contains information regarding the medical condition unstable angina, as well as a case study of an unstable angina patient in a soap format. Please go over all of the slides to get a complete picture of the situation.
If you have any queries or suggestions, you can drop down in the comments below.
Thank you!
Angina (an-JI-nuh or AN-juh-nuh) is chest pain or discomfort that occurs if an area of your heart muscle doesn't get enough oxygen-rich blood.
Angina may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.
Angina isn't a disease; it's a symptom of an underlying heart problem. Angina usually is a symptom of coronary heart disease (CHD).
CHD is the most common type of heart disease in adults. It occurs if a waxy substance called plaque (plak) builds up on the inner walls of your coronary arteries. These arteries carry oxygen-rich blood to your heart.
Plaque Buildup in an Artery
Figure A shows a normal artery with normal blood flow. The inset image shows a cross-section of a normal artery. Figure B shows an artery with plaque buildup. The inset image shows a cross-section of an artery with plaque buildup.
Plaque narrows and stiffens the coronary arteries. This reduces the flow of oxygen-rich blood to the heart muscle, causing chest pain. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow, which can cause a heart attack.
Angina also can be a symptom of coronary microvascular disease (MVD). This is heart disease that affects the heart’s smallest coronary arteries. In coronary MVD, plaque doesn't create blockages in the arteries like it does in CHD.
Studies have shown that coronary MVD is more likely to affect women than men. Coronary MVD also is called cardiac syndrome X and nonobstructive CHD.
Types of Angina
The major types of angina are stable, unstable, variant (Prinzmetal's), and microvascular. Knowing how the types differ is important. This is because they have different symptoms and require different treatments.
Stable Angina
Stable angina is the most common type of angina. It occurs when the heart is working harder than usual. Stable angina has a regular pattern. (“Pattern” refers to how often the angina occurs, how severe it is, and what factors trigger it.)
If you have stable angina, you can learn its pattern and predict when the pain will occur. The pain usually goes away a few minutes after you rest or take your angina medicine.
Stable angina isn't a heart attack, but it suggests that a heart attack is more likely to happen in the future.
Unstable Angina
Unstable angina doesn't follow a pattern. It may occur more often and be more severe than stable angina. Unstable angina also can occur with or without physical exertion, and rest or medicine may not relieve the pain.
Unstable angina is very dangerous and requires emergency treatment. This type of angina is a sign that a heart attack may happen soon.
Variant (Prinzmetal's) Angina
Variant angina is rare. A spasm in a coronary artery causes this type of angina. Variant angina usually occurs while you're at rest, and the pain can be severe. It usually hap
Angina also known as angina pectoris is a medical condition characterized by chest pain usually left sided due to inadequate blood supply (ischemia) to the heart muscles due to obstruction (like presence of blood clot), narrowing or contraction (vasospasm) of the supplying coronary arteries.
This study aims to describe the diagnosis and management of stable angina in India through a large prospective multicenter observational registry of 1000-1500 patients seen by 150-250 non-interventional physicians over 4 months. The study will describe the demographic and medical profiles of subjects with stable angina and evaluate current practices for diagnosis and treatment. Eligible subjects must have a provisional diagnosis of stable angina by the participating physician within the past 3 months, agree to data sharing, and cannot have a history of acute coronary syndrome, revascularization, myocardial infarction, or angina for less than one month.
Hypertension, or high blood pressure, refers to persistently high arterial blood pressure that can damage organs if untreated. It is a major risk factor for heart disease and stroke. While hypertension often has no symptoms initially, over time it increases the risk of serious disorders like heart disease, stroke, and kidney failure. The causes are usually lifestyle factors like diet, obesity, smoking, excessive alcohol, as well as genetic predisposition. Treatment involves lifestyle modifications like diet changes, exercise, and reducing stress. Medication may also be needed to lower high blood pressure. Uncontrolled hypertension can lead to complications affecting the heart, brain, kidneys and eyes.
Angina pectoris, commonly known as angina, is a type of chest pain or discomfort that occurs when an area of the heart muscle is not receiving enough oxygen. There are two main types of angina: stable angina and unstable angina. Stable angina follows a predictable pattern and is brought on by physical exertion, while unstable angina does not follow a regular pattern and can occur at rest. Risk factors for angina include unhealthy cholesterol levels, hypertension, smoking, diabetes, obesity, and physical inactivity. Angina is usually caused by underlying coronary artery disease and physical exertion can trigger stable angina episodes, while unstable angina may be caused by blood clots partially or totally blocking an artery
Coronary artery disease and its resulting conditions of angina pectoris and myocardial infarction are discussed. Coronary artery disease occurs when plaque builds up in the coronary arteries, limiting blood flow to the heart. Angina pectoris, commonly known as chest pain, occurs when oxygen demand of the heart exceeds supply and has types including stable, unstable, and variant angina. Myocardial infarction, or heart attack, happens when an area of heart muscle dies due to lack of oxygen from a blockage of one of the coronary arteries. Nursing care focuses on pain management, preventing complications, health education, and cardiac rehabilitation.
This document summarizes a group presentation on angina pectoris. The 7 member group will define, describe the classification, etiology, pathophysiology, clinical manifestations, diagnostic evaluation, nursing assessment and management, medical/surgical management, and complications of angina pectoris. The broad objective is for learners to be able to manage patients with angina pectoris. The outline includes defining angina pectoris, describing its types, explaining what causes it and how it works, symptoms patients experience, tests to diagnose it, how nurses assess and care for patients, medical and surgical treatments, and potential issues that can arise.
Angina is chest pain caused by reduced blood flow to the heart. There are four types including stable angina triggered by exertion, unstable angina lasting over 15 minutes, microvascular angina of unknown cause, and Prinzmetal's angina caused by coronary artery spasm. Diagnosis involves ECG, stress test, imaging, and angiography. Treatment includes medications like beta blockers, nitrates, calcium channel blockers, and lifestyle changes.
This document summarizes the case of a 73-year-old male patient admitted to the hospital for coronary artery disease. It provides details on his medical history including diabetes, hypertension, and a history of smoking. It then discusses coronary artery disease including symptoms, risk factors, diagnostic tests, treatment options through lifestyle changes, medications, and surgery. It concludes with a nursing care plan to address ineffective airway clearance related to secretions in the bronchi.
This document discusses angina pectoris, or chest pain due to insufficient blood flow to the heart. It defines angina and lists its main types. It then covers the epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, and management of angina. Management involves both non-pharmacological approaches like lifestyle changes as well as pharmacological treatments including nitrates, beta blockers, and calcium channel blockers. Revascularization procedures like percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) may also be used in some cases.
case presentation on unstable angina in SOAP format. About the disease, etiology, pathophysiology, symptoms, treatments, drugs to be given in angina and lifestyle modifications are included.
This document discusses ischaemic heart disease and angina pectoris. It defines IHD as a condition where there is inadequate blood supply and oxygen to the myocardium. Angina pectoris is defined as a clinical syndrome characterized by precordial discomfort due to myocardial ischemia, typically brought on by exertion and relieved by rest. The document covers the epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis and treatment of these conditions. It emphasizes that risk factor identification and modification are important for managing patients with known or suspected IHD.
Angina is chest pain caused by transient myocardial ischemia due to an imbalance between myocardial oxygen supply and demand. There are three main types of angina: stable angina which is the most common type, unstable angina which can occur at any time and is considered an urgent condition, and Prinzmetal angina which involves coronary artery spasm. Angina is typically diagnosed through ECG or coronary angiography and can be managed through risk factor modification, pharmacological treatments like beta blockers, calcium channel blockers, and nitrates, and potentially surgery. The most important treatment is modifying risk factors such as smoking, diet, exercise, and controlling conditions like high blood pressure and cholesterol.
This document provides information on CAD, gastroenteritis, and hypertension. It includes sections on causes, transmission, symptoms, and standard treatment protocols for each condition. It then presents a case study of a 58-year-old male patient with complaints of vomiting, abdominal pain, and weakness. His medical history and examination results are detailed. He is assessed as having gastroenteritis, hypertension, and CAD. A 5-day treatment plan is outlined, along with discharge instructions and counseling on lifestyle modifications and medication management.
This document provides a summary of angina pectoris (chest pain). It begins with an example case history and treatment. It then defines angina and describes the main types (stable and unstable). It discusses the pathophysiology and clinical presentation. It outlines the diagnostic tests and procedures used to diagnose angina. The goals and approaches to treatment are summarized, including drug therapies like nitrates, beta blockers, and calcium channel blockers. Other measures for managing coronary artery disease are mentioned like treating risk factors and lifestyle changes.
What is hypertension, Definition of hypertension, Classification of hypertension, pathophysiology of hypertension, Signs and symptoms of hypertension, Risk factors of hypertension, Causes of hypertension, Differential diagnosis of hypertension, Medications of hypertension, Different class of medications for hypertension, Patient education for hypertension
Angina is a type of chest pain caused by reduced blood flow to the heart. It is a symptom of coronary artery disease. Angina, which may also be called angina pectoris, is often described as squeezing, pressure, heaviness, tightness or pain in your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. Angina may be a new pain that needs evaluation by a doctor, or recurring pain that goes away with treatment
Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.
This document discusses the nursing management of a 52-year-old woman presenting with fatigue, nausea, and chest discomfort diagnosed with an acute myocardial infarction (AMI). It outlines her assessment, including vital signs and ECG findings consistent with AMI. It then reviews AMI pathophysiology, diagnostic testing, signs and symptoms, and appropriate medications and treatments including aspirin, nitroglycerine, oxygen, morphine, heparin, clopidogrel, beta blockers, and ACE inhibitors. It discusses nursing diagnoses and guidelines for monitoring, preventing complications, managing pain and anxiety, and providing patient education on diet, activity, medications and risk factor modification.
Related with cardio vascular system. Angina is Retrosternal chest pain which if left untreated can cause the higher complications with respect to cardiac health of human body. May be this is simple chest pain but if exceeds can cause major damage # prevention is better than cure :-)
Angina and myocardial infarction (MI) are both forms of ischemic heart disease that occur due to insufficient blood flow to the heart muscle. Angina is chest pain or discomfort caused by reduced oxygen to the heart muscle, while an MI occurs when an area of heart muscle dies due to complete blockage of blood flow. The document defines the conditions, compares their symptoms, and outlines their diagnosis and treatment, including lifestyle changes and various medications. It also discusses management considerations for patients with angina or a history of MI in the dental clinic setting.
A União Europeia está considerando novas regras para regular as grandes empresas de tecnologia. As novas regras visam limitar o poder de mercado dessas empresas e garantir uma concorrência justa. As empresas afetadas incluiriam gigantes como Google, Amazon, Facebook e Apple.
Dropbox is a free service that automatically syncs and saves files across a user's devices. Any file saved to the Dropbox folder on one device is instantly available on all other linked devices. This allows users to access their files from any computer or phone and work seamlessly across multiple devices. The Dropbox folder works just like any other folder but syncs file changes in real-time. Dropbox uses encryption to ensure files are kept secure during the syncing process.
Hypertension, or high blood pressure, refers to persistently high arterial blood pressure that can damage organs if untreated. It is a major risk factor for heart disease and stroke. While hypertension often has no symptoms initially, over time it increases the risk of serious disorders like heart disease, stroke, and kidney failure. The causes are usually lifestyle factors like diet, obesity, smoking, excessive alcohol, as well as genetic predisposition. Treatment involves lifestyle modifications like diet changes, exercise, and reducing stress. Medication may also be needed to lower high blood pressure. Uncontrolled hypertension can lead to complications affecting the heart, brain, kidneys and eyes.
Angina pectoris, commonly known as angina, is a type of chest pain or discomfort that occurs when an area of the heart muscle is not receiving enough oxygen. There are two main types of angina: stable angina and unstable angina. Stable angina follows a predictable pattern and is brought on by physical exertion, while unstable angina does not follow a regular pattern and can occur at rest. Risk factors for angina include unhealthy cholesterol levels, hypertension, smoking, diabetes, obesity, and physical inactivity. Angina is usually caused by underlying coronary artery disease and physical exertion can trigger stable angina episodes, while unstable angina may be caused by blood clots partially or totally blocking an artery
Coronary artery disease and its resulting conditions of angina pectoris and myocardial infarction are discussed. Coronary artery disease occurs when plaque builds up in the coronary arteries, limiting blood flow to the heart. Angina pectoris, commonly known as chest pain, occurs when oxygen demand of the heart exceeds supply and has types including stable, unstable, and variant angina. Myocardial infarction, or heart attack, happens when an area of heart muscle dies due to lack of oxygen from a blockage of one of the coronary arteries. Nursing care focuses on pain management, preventing complications, health education, and cardiac rehabilitation.
This document summarizes a group presentation on angina pectoris. The 7 member group will define, describe the classification, etiology, pathophysiology, clinical manifestations, diagnostic evaluation, nursing assessment and management, medical/surgical management, and complications of angina pectoris. The broad objective is for learners to be able to manage patients with angina pectoris. The outline includes defining angina pectoris, describing its types, explaining what causes it and how it works, symptoms patients experience, tests to diagnose it, how nurses assess and care for patients, medical and surgical treatments, and potential issues that can arise.
Angina is chest pain caused by reduced blood flow to the heart. There are four types including stable angina triggered by exertion, unstable angina lasting over 15 minutes, microvascular angina of unknown cause, and Prinzmetal's angina caused by coronary artery spasm. Diagnosis involves ECG, stress test, imaging, and angiography. Treatment includes medications like beta blockers, nitrates, calcium channel blockers, and lifestyle changes.
This document summarizes the case of a 73-year-old male patient admitted to the hospital for coronary artery disease. It provides details on his medical history including diabetes, hypertension, and a history of smoking. It then discusses coronary artery disease including symptoms, risk factors, diagnostic tests, treatment options through lifestyle changes, medications, and surgery. It concludes with a nursing care plan to address ineffective airway clearance related to secretions in the bronchi.
This document discusses angina pectoris, or chest pain due to insufficient blood flow to the heart. It defines angina and lists its main types. It then covers the epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, and management of angina. Management involves both non-pharmacological approaches like lifestyle changes as well as pharmacological treatments including nitrates, beta blockers, and calcium channel blockers. Revascularization procedures like percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) may also be used in some cases.
case presentation on unstable angina in SOAP format. About the disease, etiology, pathophysiology, symptoms, treatments, drugs to be given in angina and lifestyle modifications are included.
This document discusses ischaemic heart disease and angina pectoris. It defines IHD as a condition where there is inadequate blood supply and oxygen to the myocardium. Angina pectoris is defined as a clinical syndrome characterized by precordial discomfort due to myocardial ischemia, typically brought on by exertion and relieved by rest. The document covers the epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis and treatment of these conditions. It emphasizes that risk factor identification and modification are important for managing patients with known or suspected IHD.
Angina is chest pain caused by transient myocardial ischemia due to an imbalance between myocardial oxygen supply and demand. There are three main types of angina: stable angina which is the most common type, unstable angina which can occur at any time and is considered an urgent condition, and Prinzmetal angina which involves coronary artery spasm. Angina is typically diagnosed through ECG or coronary angiography and can be managed through risk factor modification, pharmacological treatments like beta blockers, calcium channel blockers, and nitrates, and potentially surgery. The most important treatment is modifying risk factors such as smoking, diet, exercise, and controlling conditions like high blood pressure and cholesterol.
This document provides information on CAD, gastroenteritis, and hypertension. It includes sections on causes, transmission, symptoms, and standard treatment protocols for each condition. It then presents a case study of a 58-year-old male patient with complaints of vomiting, abdominal pain, and weakness. His medical history and examination results are detailed. He is assessed as having gastroenteritis, hypertension, and CAD. A 5-day treatment plan is outlined, along with discharge instructions and counseling on lifestyle modifications and medication management.
This document provides a summary of angina pectoris (chest pain). It begins with an example case history and treatment. It then defines angina and describes the main types (stable and unstable). It discusses the pathophysiology and clinical presentation. It outlines the diagnostic tests and procedures used to diagnose angina. The goals and approaches to treatment are summarized, including drug therapies like nitrates, beta blockers, and calcium channel blockers. Other measures for managing coronary artery disease are mentioned like treating risk factors and lifestyle changes.
What is hypertension, Definition of hypertension, Classification of hypertension, pathophysiology of hypertension, Signs and symptoms of hypertension, Risk factors of hypertension, Causes of hypertension, Differential diagnosis of hypertension, Medications of hypertension, Different class of medications for hypertension, Patient education for hypertension
Angina is a type of chest pain caused by reduced blood flow to the heart. It is a symptom of coronary artery disease. Angina, which may also be called angina pectoris, is often described as squeezing, pressure, heaviness, tightness or pain in your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. Angina may be a new pain that needs evaluation by a doctor, or recurring pain that goes away with treatment
Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.
This document discusses the nursing management of a 52-year-old woman presenting with fatigue, nausea, and chest discomfort diagnosed with an acute myocardial infarction (AMI). It outlines her assessment, including vital signs and ECG findings consistent with AMI. It then reviews AMI pathophysiology, diagnostic testing, signs and symptoms, and appropriate medications and treatments including aspirin, nitroglycerine, oxygen, morphine, heparin, clopidogrel, beta blockers, and ACE inhibitors. It discusses nursing diagnoses and guidelines for monitoring, preventing complications, managing pain and anxiety, and providing patient education on diet, activity, medications and risk factor modification.
Related with cardio vascular system. Angina is Retrosternal chest pain which if left untreated can cause the higher complications with respect to cardiac health of human body. May be this is simple chest pain but if exceeds can cause major damage # prevention is better than cure :-)
Angina and myocardial infarction (MI) are both forms of ischemic heart disease that occur due to insufficient blood flow to the heart muscle. Angina is chest pain or discomfort caused by reduced oxygen to the heart muscle, while an MI occurs when an area of heart muscle dies due to complete blockage of blood flow. The document defines the conditions, compares their symptoms, and outlines their diagnosis and treatment, including lifestyle changes and various medications. It also discusses management considerations for patients with angina or a history of MI in the dental clinic setting.
A União Europeia está considerando novas regras para regular as grandes empresas de tecnologia. As novas regras visam limitar o poder de mercado dessas empresas e garantir uma concorrência justa. As empresas afetadas incluiriam gigantes como Google, Amazon, Facebook e Apple.
Dropbox is a free service that automatically syncs and saves files across a user's devices. Any file saved to the Dropbox folder on one device is instantly available on all other linked devices. This allows users to access their files from any computer or phone and work seamlessly across multiple devices. The Dropbox folder works just like any other folder but syncs file changes in real-time. Dropbox uses encryption to ensure files are kept secure during the syncing process.
Imaginea enhanced and managed a Hadoop platform for a video marketing company to perform statistical analysis on video playtime data. This included migrating the platform to a new Hadoop version, improving cluster monitoring and management using tools like Zookeeper and Puppet, resolving performance issues like job starvation, and contributing over 14 patches to the Hadoop open source community that were all accepted.
The document discusses the benefits of exercise for mental health. It states that regular exercise can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help prevent mental illness and improve symptoms.
This document provides specifications for a Swingfire heater. It is 46 inches long, 11.5 inches wide, 11 inches tall and weighs 76.2 pounds. The document includes an image labeled "Image1" but no other details.
The family had their best holiday yet in Busselton, Western Australia where they were constantly busy doing activities and were exhausted by nightfall. It was extra special because for the first time all of the family including parents and three sisters could attend the trip together.
This document provides information about pestil, a dried fruit pulp product commonly seen in Anatolian culture. It discusses how pestil is traditionally made using mulberries, grapes, apricots and other fruits. The production process involves cooking and drying the fruit pulp into thin sheets. Pestil is a nutritious food that provides energy, vitamins, minerals and fiber to the diet. Modern pestil production may use molasses or thickened fruit juice as the raw material.
This document discusses health education intervention strategies for preventing and managing diabetes. It describes the different types of diabetes, including type 1, type 2, gestational diabetes, metabolic syndrome, and pre-diabetes. The causes of diabetes are discussed, including genetics and lifestyle factors like obesity and lack of exercise. Health education strategies are recommended to increase awareness of diabetes symptoms and management through programs run by health agencies.
This document discusses diabetes, including the different types, causes, risk factors, management, treatment, and prevention. It provides statistics on the growing prevalence of diabetes in the United States and the economic and public health burden associated with the disease. The document also outlines innovative strategies and emerging technologies for managing diabetes.
This document discusses diabetes mellitus (DM), a metabolic disorder caused by factors that result in chronic hyperglycemia. It begins with background on DM and how it is an increasing health problem. DM is classified into type 1, caused by autoimmune destruction of insulin-producing beta cells, and type 2, caused by insulin resistance. Signs and symptoms of DM include frequent urination, excessive thirst, hunger, and weight loss. DM is diagnosed through blood tests measuring glucose levels when fasting and after consuming glucose. Treatment depends on the type, with type 1 requiring insulin injection and type 2 often controlled through diet, exercise and oral medication.
Makalah bahasa inggris diabetes melitusWarnet Raha
1. The document discusses diabetes mellitus, including its definition, pathophysiology, classification, signs and symptoms, and diagnosis. It is a metabolic disorder caused by many factors that results in chronic hyperglycemia and impaired processing of carbohydrates, fats, and proteins.
2. There are two main types of diabetes - type 1 is characterized by an inability to produce insulin, while type 2 involves decreased sensitivity to insulin. Diagnosis involves measuring fasting blood glucose levels and levels after consuming glucose.
3. Common symptoms include frequent urination, excessive thirst, unexplained weight loss, and tingling or numbness in the extremities. Diagnosis is based on blood tests measuring glucose levels according to WHO criteria.
This document provides an introduction to diabetes mellitus, including:
1. A definition of diabetes mellitus and discussion of its pathophysiology and classification into types 1 and 2.
2. Details on the signs and symptoms, diagnosis, and factors that can contribute to diabetes.
3. An overview of treatment approaches including physical exercise, medications like sulfonylureas, and management of blood sugar levels.
Type 2 diabetes is caused by lifestyle factors like lack of exercise, poor diet, obesity, and family history. People with type 2 diabetes cannot properly regulate their blood sugar levels due to insufficient insulin production or cells ignoring insulin. They must carefully manage their diet, exercise regularly, and potentially take medication or insulin injections to control their blood sugar and prevent serious health complications affecting organs like the eyes, kidneys, heart, and nerves.
Understanding and Managing Diabetes A Comprehensive Guide.pdfCarlNell3
Diabetes is a chronic medical condition that affects millions of
people worldwide. It is a metabolic disorder characterized by
high blood sugar levels due to the body's inability to properly
produce or use insulin. Understanding diabetes is crucial for
individuals living with the condition and their loved ones, as it
helps in effective management and promotes a better quality
of life. In this chapter, we will delve into the fundamental
aspects of diabetes, exploring its causes, symptoms, and the
impact it has on the body.
This document provides an overview of diabetes mellitus (DM). It defines DM as a chronic condition characterized by high blood glucose levels due to defects in insulin production or action. The document discusses the causes, risk factors, types (type 1, type 2, gestational, pre-diabetes), symptoms, complications, trends, and management of DM, including through prevention, treatment, nutrition, medication, exercise, and blood glucose monitoring. It also provides details on insulin action and the differences between type 1 and type 2 DM.
This document discusses diabetes, including the different types and causes. Some key points:
- Diabetes is a group of metabolic diseases where a person has high blood glucose due to inadequate insulin production or cells not responding properly to insulin.
- There are an estimated 347 million people worldwide with diabetes, and it is predicted to become the 7th leading cause of death by 2030.
- The main types of diabetes are type 1, where the body does not produce insulin, and type 2, where the body does not produce enough insulin or cells do not respond properly to insulin.
- Risk factors for type 2 diabetes include family history, age, weight, and physical inactivity. Prevention focuses on maintaining a healthy weight and
Type 2 diabetes is characterized by high blood glucose levels due to the body becoming resistant to insulin or not producing enough insulin. It accounts for 90% of diabetes cases and risk factors include family history, obesity, poor diet, and lack of exercise. Symptoms may include increased thirst, hunger, fatigue, and blurred vision. Untreated diabetes can lead to serious complications affecting the eyes, kidneys, heart, nerves, and feet. Treatment involves lifestyle changes like diet and exercise as well as medications to lower blood glucose levels such as metformin, glipizide, and insulin injections if needed.
A Case Study On A 52-Year-Old Female Patient Diagnosed With Type II Diabetes ...Richard Hogue
This document summarizes a case study on a 52-year-old female patient diagnosed with Type 2 diabetes mellitus and uncontrolled hypokalemia. The introduction provides background on electrolyte disorders commonly associated with diabetes and discusses causes of hypokalemia in diabetic patients. The objectives of the case study are to assess the patient's condition, provide nutrition interventions, and develop a sample one-day menu. Limitations include reliance on self-reported dietary intake and focus on one individual.
Importance of addressing type 2 diabetes
Type 2 diabetes has become a global health crisis, affecting millions of people worldwide. It is a chronic condition characterized by high blood sugar levels and impaired insulin function. The prevalence of type 2 diabetes has been steadily increasing due to various factors, including sedentary lifestyles, poor dietary choices, and an aging population. This chronic condition not only poses significant health risks but also places a substantial burden on healthcare systems and individuals alike.
B. Overview of the ebook's purpose and contents
The purpose of this ebook is to explore the question: Is Type 2 Diabetes Reversible? We will delve into the latest research, scientific evidence, and personal stories to provide a comprehensive understanding of the potential for reversing type 2 diabetes. By examining the causes, traditional management approaches, emerging evidence, and lifestyle modifications, we aim to empower readers with knowledge and practical strategies to potentially reverse this condition and improve their overall health and well-being.
Throughout the pages of this ebook, we will explore the factors that contribute to the development of type 2 diabetes including
genetic predisposition, lifestyle choices, and other underlying conditions. We will discuss the traditional approaches to managing diabetes, such as medications, blood sugar monitoring, and dietary recommendations. Moreover, we will explore emerging evidence that suggests type 2 diabetes may be reversible through various lifestyle modifications.
This ebook will provide an in-depth examination of lifestyle modifications, including dietary changes, physical activity, weight management strategies, and stress management techniques, which have shown promise in potentially reversing type 2 diabetes. Additionally, we will discuss the role of medications and alternative therapies in diabetes management and reversal.
To inspire and motivate readers, we will share personal stories of individuals who have successfully reversed type 2 diabetes. Their experiences will offer valuable insights and practical tips for embarking on a journey towards diabetes reversal.
It is important to note that while the possibility of reversing type 2 diabetes exists, each individual's circumstances may differ. Therefore, it is crucial to consult with healthcare professionals and tailor the approach to personal needs and circumstances.
By the end of this ebook, you will have a deeper nderstanding of type 2 diabetes, the potential for reversal, and the lifestyle modifications that can aid in achieving and sustaining positive outcomes. It is our hope that this ebook will empower you to take control of your health and explore the possibilities of reversing type 2 diabetes.
Diabetes_ A chronic metabolic disorder characterized by high blood sugar leve...Shankar794304
This document discusses diabetes, a chronic metabolic disorder characterized by high blood sugar levels. It begins with an introduction that defines diabetes as a condition caused by the body's inability to produce or effectively use insulin. It then covers the types of diabetes, including type 1 which results from the immune system attacking insulin-producing cells, and type 2 which occurs when the body becomes resistant to insulin. The document also discusses risk factors for diabetes such as genetics, obesity, physical inactivity, and lifestyle choices. It emphasizes that diabetes is a lifelong condition but can be managed through treatment including lifestyle changes and medication.
Diabetes is a metabolic disorder where the body has too much glucose in the blood due to either not producing enough insulin or cells not responding to insulin. There are four main types of diabetes: Type 1 is characterized by insulin deficiency due to loss of beta cells in the pancreas and accounts for 10% of cases. Type 2 is characterized by insulin resistance and accounts for 90% of cases. Type 3 covers specific genetic defects affecting insulin action. Gestational diabetes occurs in 2-5% of pregnancies and may improve after delivery but increases risk of later Type 2 diabetes. Diabetes increases risks of heart disease, stroke, nerve damage, foot ulcers, blindness, and kidney failure. Treatment focuses on blood glucose control through lifestyle changes
BETH MARTINSExplain the difference between the types of dia.docxtangyechloe
BETH MARTINS
Explain the difference between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes
Type I Diabetes is hyperglycemia due to insulin deficiency. This is caused by autoimmune destruction of B cells that are within the islets of Langerhans (Chetan, Thrower,& Narendran, 2019). Some signs surrounding Type I DM is polydipsia, polyuria, and weight loss. This is more common in children, but can be diagnosed at any age throughout life. Type I diabetes used to be called juvenile diabetes,but this is now known to not be the correct way to view this disease.
Type 2 Diabetes is impaired insulin secretion and abnormal suppression of postprandial (Hurtado & Vella, 2019). Type 2 DM the pancreas resists insulin, or does not produce enough insulin on its own. Often Type I and Type 2 DM are diagnosed incorrectly or mistaken for each other as signs and symptoms are similar. Being overweight or reduced amount of exercise is though to be a contributing factor as well as genetics, but this is till not fully understood.
Gestational diabetes is characterized by spontaneous hyperglycemia during pregnancy. Some risk factors include family history of diabetes, obesity during pregnancy, and advanced maternal age (Plows, Stanley, Baker, 2019). B cell dysfunction which lacks the ability to release insulin when the body needs it is what causes gestational diabetes.
Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
Patients who have Type 2 DM have both insulin resistance and impaired insulin secretion (Rosenthal & Burchum, 2021). The liver, muscle and adipose tissue are insulin resistant and increased blood sugar causes B cell function to fail. Insulin secretion decreases and B cells must increase how hard they must work to work against insulin resistance within the tissues (Rosenthal & Burchum, 2021).
The medication I chose os Metformin from the class of Biguanide medications for treatment of Type 2 DM. Metformin uses 3 mechanisms to help lower blood sugar.
Inhibits glucose production in the liver
Reduces glucose absorption in the gut
Sensitizes insulin receptors in fat and skeletal muscle
Metformin is taken by mouth and is absorbed by the small intestines and excreted by the kidneys. Metformin is known to be a great choice for those who skip meals as it will not make blood sugar levels become dangerously low. Those with DM Type 2 should eat healthy carbs such as fruits and vegetables and not indulge in sugary drinks. Protein and polyunsaturated fats should be a staple in the everyday diet. Alcohol should be avoided, and the patient should try to eat several small “meals” per day tp keep blood sugar steady. If blood sugar becomes low having a sugary snack with a complex carbohydrate such as peanut butter and crackers should be on hand.
Short-term and long-t.
Type 2 Diabetes Mellitus (T2DM) is a metabolic disorder characterized by high blood glucose levels due to the body's ineffective use of insulin. The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 worldwide. India has a large number of people with diabetes which is projected to increase further. T2DM can be prevented or managed through diet, exercise, weight control, and treatment of complications. The pathophysiology of T2DM involves decreased insulin secretion, increased glucagon secretion, increased hepatic glucose production and decreased incretin effect.
This document provides an overview of diabetes, including:
- Diabetes is a metabolic disease where the body does not properly process glucose due to not producing or responding to the hormone insulin.
- There are three main types of diabetes: type 1, type 2, and gestational diabetes.
- Risk factors include family history, age, lifestyle, and ethnicity. Symptoms include frequent urination, thirst, and weight changes.
- Complications can include kidney damage, heart disease, eye problems, and limb amputation if not properly managed.
- Diagnosis involves blood glucose testing and management involves monitoring levels and lifestyle changes like diet and exercise.
This document discusses diabetes, including what it is, types of diabetes, treatments, and statistics. It defines diabetes as a disease where the body does not properly produce or use insulin, and lists the three main types as type 1, type 2, and gestational diabetes. Statistics provided indicate that in 2011, 25.8 million Americans had diabetes, with 18.8 million diagnosed and 7 million undiagnosed. Type 1 diabetes is usually diagnosed in children and occurs when the body does not produce insulin, while type 2 diabetes affects how the body metabolizes sugar and may be preventable through lifestyle changes like diet and exercise. Treatments aim to control blood sugar levels.
"Empowered Living with Diabetes: Navigating the Path to Wellness" is an indispensable guide for individuals seeking comprehensive knowledge and practical strategies for effectively managing diabetes. Written by Dr. Olivia Mitchell, a renowned expert in the field of diabetes management, this book offers a holistic approach to understanding and navigating the complexities of diabetes.
From the introductory chapters that provide a thorough overview of diabetes and its various types, to the detailed discussions on prevention, management, and coexisting conditions, this book covers it all. With clarity and expertise, Dr. Mitchell delves into topics such as blood glucose monitoring, medication management, healthy eating, physical activity, stress management, and the emotional well-being of individuals with diabetes.
Through insightful chapters that address common comorbidities associated with diabetes, readers will gain valuable knowledge on how to effectively manage cardiovascular health, hypertension, kidney disease, eye complications, nerve damage, and mental health concerns. Practical tips, evidence-based recommendations, and real-life examples provide readers with the tools needed to take control of their health and embrace a life of empowerment.
Furthermore, this book offers guidance for navigating special occasions, traveling with diabetes, and staying motivated while overcoming challenges. Dr. Mitchell emphasizes the importance of a supportive environment, self-advocacy, and the power of a positive mindset in achieving long-term success in diabetes management.
"Empowered Living with Diabetes" is not just a guidebook, but a source of inspiration and empowerment for individuals living with diabetes. Dr. Olivia Mitchell's expertise and compassionate approach create a valuable resource that will help readers develop the skills, knowledge, and confidence to thrive while managing their condition.
Whether you are newly diagnosed, have been living with diabetes for years, or are a caregiver or healthcare professional seeking comprehensive insights, this book is an invaluable companion on your journey towards wellness and empowerment. With its practical advice, empowering strategies, and the belief that a fulfilling life with diabetes is possible, "Empowered Living with Diabetes" will guide you towards a healthier, happier, and more empowered future.
Diabetes Mellitus is a chronic condition that affects the body's ability to regulate blood sugar levels. It is caused by a deficiency of the hormone insulin, which helps the body convert sugar from food into energy. People with diabetes often have high levels of sugar in their blood, which can lead to serious health problems if left untreated. Symptoms of diabetes include excessive thirst, frequent urination, fatigue, weight loss, and blurred vision. Treatment typically involves lifestyle changes, such as exercising regularly, eating healthy, and taking medications, as well as monitoring blood sugar levels. With proper treatment and management, people with diabetes can enjoy a normal life. Know more from the documents
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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1. Running Head: TYPE 2 DIABETES
Type 2 Diabetes: An Overview of Nursing Care
Alana B. Snyder
California State University, Chico
2. TYPE 2 DIABETES! 2
Type 2 Diabetes: An Overview of Nursing Care
According to the Center for Disease Control & Prevention (2011), diabetes is the sixth
most common cause of death in adults in the United States, 25.8 million people in the United
States have diabetes, and 90 to 95% of adults with diabetes suffer from Type 2 Diabetes.
Diabetes is a major cause of heart disease, stroke, and complications such as hypertension,
blindness, kidney disease, non-traumatic amputations, and nervous system damage (CDC, 2011).
Total estimated medical care costs for diabetes in the US are astronomical, and the number is
only expected to rise, to as much as $192 billion by 2020 (CDC, 2011). Rising healthcare costs,
an aging population, and other prevalent risk factors like obesity are predictors of the continued
rise in diabetes (Smeltzer, Bare, Hinkle, & Cheever, 2008). People with diabetes pay, on
average, twice that of non-diabetics in medical expenses. According to Smeltzer et al. (2008),
half of all people with diabetes undergo hospitalization every year. Research shows that Type 2
Diabetes can be prevented largely by lifestyle modifications such as weight loss and exercise
(Smeltzer et al., 2008). Educational intervention by nurses plays a vital role in the care for this
population.
Pathophysiology
Diabetes is a chronic metabolic disease characterized by high levels of glucose in the
blood, termed hyperglycemia. Glucose is needed by human cells for energy. Insulin is an
endocrine hormone produced by the beta cells of the pancreas. Insulin transports glucose into
muscle, liver, and fat cells to use for energy, stimulates storage of glycogen in the liver and
muscles, inhibits the breakdown of stored glucose, protein, and fat, and signals the liver to stop
the release of glucose (Smeltzer et al., 2008). Insulin is responsible for the management of blood
3. TYPE 2 DIABETES! 3
sugar. If the glucose in the blood stream cannot be taken into cells, it remains in the blood
(hyperglycemia) and causes many complications and health risks. Furthermore, if the body cells
do not have enough glucose to use for fuel, they may begin to use muscle and fat, producing
ketones bodies - acids that can cause Diabetic Ketoacidosis, a life threatening emergency. This is
less common in Type 2 Diabetics than in those with Type 1, as there is usually enough insulin
circulating to prevent fat breakdown (Urden, Stacy, & Lough, 2010).
Type 2 Diabetes, formerly called “non insulin-dependent diabetes,” involves a defect in
the way one’s body makes or uses insulin. In this form of diabetes, people may still able to make
and secrete some insulin, unlike those with Type 1 Diabetes who have absolute insulin deficiency
because of destroyed beta cells in the pancreas (Urden et al., 2010). Urden et al. (2010, p. 900)
explain the problem lies in a “progressive insulin secretory defect in addition to insulin
resistance.” Insulin resistance occurs when the body’s organ and tissue cells do not allow
glucose and insulin to enter, leaving high levels of insulin (that cannot do its purpose) and
glucose in the blood circulating. The patient may be producing adequate, or even an
overproduction of, insulin in the beta cells, yet it cannot be used. Insulin resistance has been
shown to increase with obesity. In others with Type 2 Diabetes, there is what is called
inadequate insulin response in that the beta cells may not be functioning efficiently or declining
in productivity and an inadequate amount of insulin is produced (Urden et al., 2010). The effect
is too much glucose in the bloodstream. If allowed to continue for years, the toxic effects of
glucose derivatives on body tissue are the primary cause of late complications of diabetes
(Solnica, 2006). Chronic complications of diabetes are: high blood pressure and heart problems
leading to heart attacks and heart failure; difficulty in vision and retinal damage leading to
4. TYPE 2 DIABETES! 4
blindness; compromised renal perfusion, leading to kidney failure; nerve damage primarily
leading to problems of the lower extremities but also other parts of the body (Kapur & Kelkar,
2012).
Symptoms and Risk Factors
Type 2 Diabetes is associated with insidious symptoms that may take years to become
noticeable. Increased urination and thirst are classical signs of Type 2 Diabetes. Mild fatigue,
polyuria, polydipsia, poor wound healing, blurred vision, and vaginal infections may also be
other symptoms (Smeltzer et al., 2008). A fasting plasma glucose greater or equal to 126 mg/dL,
confirmed with two tests, OR symptoms of diabetes and a random plasma glucose equal or
greater than 200 mg/dL is criteria for diagnosis (Smeltzer et al., 2008). Risk factors for
developing type 2 diabetes include family history, obesity (increases insulin resistance), older
age >45 years (age-related changes in carbohydrate metabolism), history of hypertension,
previous gestational diabetes, and low HDL cholesterol level (Smeltzer et al., 2008).
Treatment
Treatment is largely aimed at maintaining blood glucose levels in the normal range.
According to Smeltzer et al. (2008), the five components of diabetes management are: Nutrition
Therapy, Education, Monitoring, Exercise, and Pharmacologic Therapy. The first step for those
diagnosed with Type 2 Diabetes is usually diet modification and weight loss (Smeltzer et al.,
2008). Exercise is useful in maintaining blood glucose by promoting the effect of insulin
(Smeltzer et al., 2008). If hyperglycemia persists with these interventions, oral anti-diabetic
agents can be used. There are many different antidiabetic oral drugs and often a combination of
more than one is used (Urden et al., 2010). During times of illness or lack of success with oral
5. TYPE 2 DIABETES! 5
antidiabetics, subcutaneous insulin injections may be necessary due to the physiologic stress or
unstable blood glucose levels (Smeltzer et al., 2008).
Nursing Interventions
The nurse has a major role in diabetes prevention, care, and management. Teaching is an
integral nursing intervention for those with Type 2 Diabetes. The goal of diabetes treatment is
maintaining blood glucose levels at a steady, normalized rate, thereby preventing complications
such as retinopathy, neuropathy, and nephropathy (Smeltzer et al, 2008). Prevention of Type 2
Diabetes is attainable, and nurses can help patients at risk for developing diabetes by teaching
lifestyle modifications. Regular exercise and weight loss for those who are overweight are the
recommendations by the American Diabetes Association (2012). Often, newly diagnosed
patients can avoid taking medications or insulin by simply changing their diet, losing weight, and
exercising (Smeltzer et al., 2008). This may be a hurdle to many patients who do not have
adequate nutritional education or who are psychologically adverse to changing their diet or
lifestyle; nurses can help identify these issues and problem solve.
The first thing the nurse should do with a newly diagnosed patient is assess. With a
thorough assessment, the nurse can then plan interventions with the specific patient in mind. The
nurse should assess learning needs, ask the patient and family what their concerns are, address
fears, reiterate that feelings of shock and depression are normal at this time (Smeltzer et al.,
2008). Patients may fear self-injection, but this task must be accomplished if the patient is going
to need insulin in the home environment. The insulin protocol must be very clear, and patients
can eventually learn to adjust insulin to their blood glucose readings over time.
6. TYPE 2 DIABETES! 6
A major nursing intervention for the patient with Type 2 Diabetes is educating the patient
and helping he or she develop self care management and skills. All patient teaching must be
adapted to the individual, taking into consideration the progression of the disease, and any
comorbidities. Teaching the newly diagnosed patient can be divided into two phases: basic/
initial information, and advanced/ continuing education (Smeltzer et al., 2008). The initial
teaching includes the information the patient NEEDS to know to survive and is imperative for
safety. The patient must know the basics, and have a knowledge base and understanding of the
diabetic disease process. This includes the basic pathophysiology of diabetes, different treatment
modalities, recognition and prevention of hypoglycemia and hyperglycemia complications, when
to contact physician and where to buy and store supplies (Smeltzer et al., 2008). When the
patient becomes more comfortable and accepting of the diabetes diagnosis, more in-depth
teaching can occur.
Self-monitoring of blood glucose levels is an extremely important step to attaining
normalized levels and preventing complications of diabetes. The patient must also understand
what increases and decreases the need for insulin, signs and symptoms of hypoglycemia and
hyperglycemia, and proper foot, skin, and blood pressure care. The patient is taught about
supplies, medications, self blood glucose monitoring, any special assistive devices needed,
community resources and education tools. Also important are instructions regarding eye care,
skin care, infection control, and general hygiene with an acknowledgment of understanding by
the patient. The more the patient understands, the better he or she will be able to independently
manage his or her health.
7. TYPE 2 DIABETES! 7
For the hospitalized patient with newly diagnosed Type 2 Diabetes, the nurse maintains
fluid and electrolyte balance, administering any IV fluids and electrolytes, measuring intake and
output, assessing for signs and symptoms of dehydration. She monitors vital signs, lab values,
edema, and cardiac status (Smeltzer et al., 2008). Control of blood glucose in the inpatient
situation is extremely important to facilitate healing and prevent complications. One life-
threatening complication of Type 2 Diabetes is Hyperglycemic Hyperosmolar State (HHS).
Patients will have an extremely high blood glucose level (>600), leading to hyperosmolality, and
resulting in osmotic diuresis. This produces profound dehydration, changes in level of
consciousness, possible hypovolemic shock, and eventually coma if interventions do not occur.
HHS can be hard to detect in diabetic patients because of its subtle onset, but nurses should
watch for vision changes, weakness, weight loss, and polyuria in patients at risk. Nursing
interventions include: administering the prescribed intravenous rehydration (large volume),
insulin drip, supplemental potassium, monitoring BP, CVP, and HR in response to therapy, and
watching for complications (Urden et al., 2010).
For the nurse working in the hospital, many patients will have Type 2 Diabetes as a
comorbidity of the primary diagnosis for their hospitalization. Many patients in the hospital may
have unrecognized diabetes. A fasting blood glucose of 126 mg/dL or a random level of 200 mg/
dL can be classified as diabetes and later confirmed following discharge. Nurses can identify
patients with previously unrecognized diabetes and intervene to achieve normalized levels.
Research has shown that nurse-driven protocols of titrating insulin in the hospital and close
monitoring of blood glucose levels dramatically improves patient glycemic control and outcomes
(Lange, 2010). Due to the adverse effects of hyperglycemia on healing and wellness, it is vital
8. TYPE 2 DIABETES! 8
for every nurse to have diabetes knowledge and use the nursing process in the care of patients.
The nurse should focus on nutritional intake and diet teaching, with the overall goal of
maintaining glucose at an acceptable level. After assessment of the patient’s diet, food
preferences, weight and BMI, activity level, the nurse works with a dietician and diabetes
educator to develop a plan of care for the diet. The nurse also manages insulin administration
and coordination with food intake and blood glucose levels. The nurse explains the need for the
prescribed diet and works in conjunction with the registered dietician. The recommended diet
for Type 2 Diabetics is consistent, decreased quantities of carbohydrates and increased
vegetables, fruits, and whole grains (Urden et al., 2010).
The nurse needs to attend to the psychological needs of the newly diagnosed Type 2
Diabetics as well. Providing emotional support and listening to the patient, answering questions
and working to reduce anxiety, can all help the patient work through the grief process due to loss
of health. The nurse should encourage the patient and family to take an active part in care and
perform the tasks they will need to accomplish at home. This empowers the patient to manage
his or her care confidently.
Case Study
J.B., a 50 year old male, comes into the clinic for a checkup after taking a family trip
across the country. His wife noticed they would have to stop almost every hour for J.B to use the
restroom and purchase a sugary soda. He was consuming up to three 2-liters of soda throughout
a day, and remarked about how hungry he had been lately. J.B is found to have a random blood
glucose level of 270 mg/dL and 135 mg/dL on a later fasting blood glucose test. These results
along with the classic symptoms of polydipsia, polyphagia, and polyuria J.B. has been
9. TYPE 2 DIABETES! 9
experiencing are enough to diagnose him with Type 2 Diabetes. His history includes lifelong
obesity, with a BMI of 34. J.B. works 50 hours or more a week in a sedentary occupation. J.B
has no medical background, and hasn’t been to the doctor for a checkup in six years. His main
concern is, “Do I have to give myself shots forever now?”
The nurse completes the doctor’s orders of obtaining vital signs, weight, ordering labs for
lipids and electrolytes, and other markers for complications of diabetes. The nurse begins the
assessment by asking the client what his specific fears are concerning his diagnosis, and takes
time to listen and answer any questions to decrease J.B.’s anxiety. The nurse explains that Type
2 Diabetes can often be managed by lifestyle modifications in diet and exercise, and does not
necessarily mean that he will need to self inject insulin forever or even at all. She explains there
are many oral antidiabetic agents that are now used if weight loss and activity alone do not help
lower blood glucose levels. The nurse provides literature about diabetes, so that J.B. can take
them home and read them when he has more time and is less emotionally overwhelmed. The
nurse explains the basic pathophysiology of Type 2 Diabetes, what it means, how insulin and
blood sugar are related, and the symptoms of the disease. The nurse marks the spots in the
literature handouts referring to her verbal instructions for J.B. to study later. J.B. expresses
understanding of the basic diabetes regime instructions.
The nurse does a full assessment of the patient, paying special attention to the
neurovascular, cardiac, and renal systems, as those are often affected by diabetes. The nurse
checks the skin of the lower extremities, palpating pulses and checking capillary refill for blood
flow, as poor blood flow in the extremities can occur in diabetes and will increase the risk for
slow wound healing and ultimately put the patient at risk for amputation. J.B is found to have
10. TYPE 2 DIABETES! 10
diminished sensation in his feet, a sign of a common complication, peripheral neuropathy. The
nurse instructs J.B. to check his feet daily and avoid any breaks in the skin which can become a
gateway for pathogens, leading to infection. The nurse stresses to J.B that he needs to employ
proper hygiene measures like hand-washing. He should take care to avoid an infection which
J.B. would have more difficulty overcoming because of decreased circulation, oxygen, and high
blood glucose. J.B. is given an appointment for an eye exam, as retinopathy is a complication of
diabetes and he mentions that he sometimes has blurred vision. The nurse ensures J.B.
understands he needs to have all lab tests for renal function done per his physician
recommendation.
After the physical and learning needs assessment, the nurse prepares to provide initial,
“survival” skills for J.B. to take home. The nurse instructs him in use of the blood glucose meter,
and has him give a return demonstration. She tells him when he should test his blood glucose, as
prescribed by his doctor; either daily, every morning/ night, with meals, etc. The nurse explains
the parameters for the insulin dosages, and fully explains all equipment - syringes, insulin bottles
and storage of those when open, sites of injection, and demonstrates drawing up the insulin and
has J.B. return demonstration. The nurse allows J.B to practice on an object, and instructs on the
importance of rotating sites. She also gives him written instruction for further clarification. The
nurse tells J.B. to record his blood glucose levels in a log, and to notify the doctor if he gets a
reading above 300 mg/dL or below 60 mg/dL, or per MD orders. She instructs in the signs and
symptoms of hypoglycemia and treatment, actions to take if unable to eat due to sickness, how to
take oral antidiabetics, and signs of complications.
11. TYPE 2 DIABETES! 11
Discharge/Planning Patient/ Family
Luckily, J.B. came into the clinic before he needed to be hospitalized for his Type 2
diabetes or complications. The nurse at the clinic continues with the nursing process in planning
care for J.B. before he is sent home to be cared for on an outpatient basis, involving his wife as a
back up caregiver as well. The nurse identifies these goals:
(1) Blood glucose level will be within a desired range within two weeks.
(2) J.B. and caregiver will verbalize knowledge of basics of dietary regime by end of clinic visit.
(3) J.B. and caregiver will verbalize understanding of complications & preventative measures by
followup visit in one week.
(4) J.B will be competent, evidenced by return demonstration and verbalization, in med
administration and glucose monitor within one week/ time of next appointment.
(5) J.B. will verbalize understanding of lower extremity care within one week.
J.B. is in need of special resources such as a diabetes educator, a dietician, a physical therapist,
and chooses to join a Diabetes and weight loss support group. He is also given a list of online
and community resources, where he can obtain more information and support.
A week later, at his follow up visit, the nurse assesses his vitals, blood glucose, and asks
him how he is doing. J.B. replies, “I am learning as much as I can about the management of
Diabetes. It is hard for me to change my diet but I am determined to lose weight and not have to
use insulin injections or antidiabetic pills.” He reports that he has increased his intake of
vegetables and decreased simple carbohydrates and completely stopped drinking soda. His wife
is supporting him and following the diet herself. J.B has a random blood glucose reading of 120
mg/dL, 1.5 hours after breakfast, and his log shows random readings from 140-195mg/dL. J.B
12. TYPE 2 DIABETES! 12
has lost five pounds in one week, and states he is meeting with a physical therapist and walking
for fifteen minutes a day. The nurse praises him on the lifestyle changes he has made, noting he
seems very motivated. She answers any questions he has, and instructs him about the
importance of adherence and consequences of noncompliance in diabetic management. J.B. has
met the goals (2), (3), (4), (5), and needs more time to fulfill (1). J.B. states he now wears
slippers in the home, and washes his feet everyday, examining his lower extremity skin for
breaks.
A few months later, J.B. gets an unnoticed scratch on his foot from a new kitten. A large,
painful lump soon forms on his foot, oozing purulent drainage and interfering with walking. J.B.
ends up in the hospital with an abscess in his foot that requires surgical incision and
debridement, and IV antibiotics. After 6 days, J.B. is going to be discharged home and the nurse
is planning his care. In talking with him while recovering, the nurse learns that J.B. has had to
travel often for work lately, is under stress, and has “slipped a little” with his meal plan. He
states his blood glucose readings have been always under 300 mg/dL, so he never notified his
physician. He can count five times in the weeks prior when his reading was above 260 mg/dL.
J.B. explains that although he has lost a total of twenty-five pounds, he is still having trouble
with meal planning. The nurse decides to suggest he and his wife attend another session with a
dietician. The nurse asks if there is anything else he is having concerns about and he relates that
he feels overwhelmed with his diabetes management and that he “still doesn’t know enough.”
The nurse decides that J.B. should be referred to home care when he returns home, so that he can
be monitored and assessed in the home environment, and given more instruction on the disease
process of Type 2 Diabetes. The nurse also instructs J.B. about foot care and hygiene, stressing
13. TYPE 2 DIABETES! 13
again the importance of monitoring for lower extremity lesions. The nurse instructs about the
effects of stress on glucose and teaches him some simple stress management skills such as
mindful deep breathing, journal writing, daily walking, and supportive relationships. The nurse
also determines that the wife needs support and offers her information about a Diabetes caregiver
support group. Lastly, the nurse stresses that he must follow up with his physician for all
appointments and follow medication regime to decrease exacerbations.
Cultural & Spiritual Considerations
It is always important to take into account the specific ethnic background of the patient
when a nurse is planning care. The nurse needs to assess cultural and spiritual beliefs and
develop goals and interventions that respect those preferences or customs. For Type 2 Diabetes,
the preference or cultural food choices is very important. Diet and glucose control are very
closely related and the nurse needs to know what the patient typically eats. Also for diabetes,
some patients of different cultures view disease differently. Some may not want to take
medications or injections for cultural or spiritual reasons. Others may have specific rituals,
beliefs, or family roles that can change the way healthcare is delivered.
For example, for the Hispanic culture, which incidentally have a higher rate of Type 2
Diabetes than caucasians: According to Parada, Horton, Cherrington, Ibarra, & Ayala (2012):
In the United States, the incidence of diabetes in adults aged 18 to 79 has almost doubled in
the past decade. While rates have increased in the general population, the prevalence
remains unevenly distributed, with 11.8% of Hispanics, 12.6% of non-Hispanic blacks, and
8.4% of Asian Americans diagnosed with diabetes compared to 7.1% of non-Hispanic
whites. (p. 553)
14. TYPE 2 DIABETES! 14
Furthermore, the authors assert that Latinos have less blood glucose control than other ethnic
groups, for these reasons: language and cultural barriers to health information, lack of access to
health care, and sociocultural barriers to adherence with treatment and diabetes management.
The study found that noncompliance in the Latino population is associated with being male,
having depression, and engaging in less “personal actions.” The most common reason given for
non-adherence was forgetting to take the prescribed oral medication. The nurse can address this
issue by instructing the client to link taking the diabetes medication to daily events, with the use
of email or note reminders, or dosing cups (Parada et al., 2012).
According to Silvestri (2011), patients of Hispanic origins tend to be verbally expressive,
may avoid eye contact out of respect, and tend to use gestures or facial expressions to show pain
and emotions. The importance of extended family and the Catholic religion are also common
considerations. A barrier to effective communication might be language, as Spanish is usually
their primary language, and if there is a possibility of any misunderstanding on either side, an
interpreter should be used. Written educational literature in the primary language of the patient
should be provided. Some folk beliefs related to health may be present depending on the age and
cultural orientation of the patient. It is important that the nurse understands different beliefs and
that some patients may believe health to be connected to a reward or punishment from God
(Silvestri, 2011). Some older Mexican patients may believe that diabetes is related to “nerves”
or emotional stress, and some may wish to practice folk remedies for their illness (Palmquist, A.,
Wilkinson, A., Sandoval, J. M., & Koehly, L., 2012). It is important to evaluate these remedies
with the current medical treatment plan and instruct as appropriate.
15. TYPE 2 DIABETES! 15
Mexican Americans are almost twice as likely as non-Hispanic whites to be diagnosed with
Type 2 Diabetes (Health Education Research Advance, 2012). It is imperative to stress diet and
exercise as effective means of controlling blood glucose. Another barrier often seen in this
cultural group is medication costs and lack of health insurance in this country. Ngo-Metzger,
Sorkin, Billimek, Greenfield, & Kaplan (2012) assert, “Mexican-American patients reported
having more financial barriers to receiving medical care, more perceived financial burden related
to their diabetes, and more cost-related medication non-adherence, compared to Vietnamese and
non-Hispanic white patients (p. 436).” Nurses as care providers should initiate a conversation
with patients about medical costs and financial pressures. Strategies to reduce medication costs
should be looked into and options for affordable medications, possibly by involving an MSW in
patient care.
Conclusions
In conclusion, Type 2 Diabetes is a national and global health issue and affects all cultures.
With high rates of obesity in the United States, an aging population, and high healthcare costs,
Type 2 Diabetes is a disease we need to fight. Nurses can play a tremendous role in determining
a positive outcome of patients through interventions and education. Nurses can make a huge
difference in the life of every diabetic patient through using evidenced-based practice and
individualized teaching centered on the common goal of health.
16. TYPE 2 DIABETES! 16
Possible Nursing Collaborative Independent
Diagnoses Interventions Interventions
Knowledge Deficit Diabetes educators, MD Instructive literature, verbal
teaching, demonstrations
Imbalanced Nutrition: more RD/ nutrition work with Patient teaching about
than body requirements patient to form a meal plan appropriate diet balance
Risk for Ineffective Tissue Wound care nurses if Monitor peripheral pulses,
Perfusion wounds present color, temp, oxygen sat
Risk for Impaired Skin DME vendors, work with Monitor skin, turn pt,
Integrity ancillary staff to turn ensure nutrition, assess
patient and bathe skin
Risk for Infection Administer prescribed Ensure nutrition, hygiene
antimicrobials measures, hand washing,
monitor vital signs for s/s
of infection
Ineffective Health Enlist interventions of PCP, Assess reasons for
Maintenance educators, mental health inability to maintain health
Anxiety MSW, PT, mental health Empathetic listening,
providers, MD instruction in nonpharm.
stress relief
Fluid Volume Deficit Administer prescribed Monitor intake & output,
fluids, monitor BG and watch for signs of
keep within normal range dehydration, monitor labs
with insulin as prescribed and electrolytes
Activity Intolerance PT to develop exercise Teach activities that can
routine perform at their level,
MD to ok patient for regular walking is an
exercise appropriate beginning
Risk for Unstable BG Diabetic educators Instruct in regular log-
keeping and evaluation by
RN
17. TYPE 2 DIABETES! 17
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Ngo-Metzger, Q., Sorkin, D.H., Billimek, J., Greenfield, S., & Kaplan, S.H. (2012). The effects
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