Nursing care

Present a comprehensive discussion linking the health issues identified through a client assessment to the impact they have on the client and their level of function in the community setting. It requires the student to prioritise the health issues and to show analysis of the complexity of care provision demonstrating critical reflection on practice?

As a community nurse by taking into consideration all the details provided by the client it can be assumed that this 28 year old woman, Jessica has specific history of epilepsy, as the specification given by the client in respect of her health conditions are very much similar to that of the symptoms of major epileptic seizures. The nurse are present to Jessica’s house as restriction of Jessica’s movement. Depending upon details provided by the client in this regard about her ongoing medications, troubles suggest she associated with type II diabetes also. According to a scientific survey almost 50 million people are suffering from epilepsy in the whole world (Ballantyne, 2005). In her physic and the condition of his health at this present situation made me to come into a decision that the person is suffering from heavy diabetes Another type of symptom throughout the world the menace of diabetes is threatening the aspects of the health of an individual and it is also threatening the diameters of the medical science. In recent past diabetes is the most increasing health issue of human beings throughout the world. From the very beginning this health issue started to spread among the eastern part of the Europe and thereafter it strengthen its roots in the Middle East part of Asian sub continent. There are several factors which are relevant for causing this health issue namely Epilepsy. According to a scientific study almost 9%-10% of whole woman population is affected by Epilepsy in the age group between 20 to 35.Specially the chances of epilepsy is generally increased in pregnancy time as it affects the central nervous system (Cramer, Brandenburg, Xu,2005).

It is the foremost responsibility of a community nurse to recognition of patient’s actual disorder as well as given a clear overall picture of this abnormality to Jessica.  From the very beginning this health issue regarding epilepsy started to spread among the eastern part of the Europe and thereafter it strengthen its roots in the Middle East part of Asian sub continent. Epilepsy is chronic neurological disorder which is characterized by sudden episodes associated with unconsciousness. Here a clear outline related to pathophysiology of epilepsy is systematically explained (Elliott, 2014).

In other side nurse should be careful to Jessica’s diabetes also. Type 2 diabetes is associated with physico-metabolic disorder which is characterized by high glucose level in blood which caused by insulin resistant by internal metabolic system or lack of insulin. Secretion of abnormal amount of insulin as well as resistance of insulin hormone for internal metabolic disorder of body systems are the two main characteristics of pathophysiology of type II diabetes. The abnormality of beta cell in pancreatic function is mainly responsible for impairment of insulin release (Kelner, 2013).

Identification of the patient

Antiepileptic drugs which are also known as anticonvulsants are mainly administered to manage as well as reduce the frequency of epileptic seizures. Here in the case of Jessica epililm is administered as anticonvulsant. Anticonvulsants act as suppressor by repress the prompt firing which is caused by various neurons during the time of seizures. The main function of anti-epileptic drug is relating to the blockage of sodium channel. It may also enhance the function of acid relating to Y-aminobutyric acid which also known as GABA (James, Ashwill, 2013).

Here as per source epilim is prescribed to Jessica as anticonvulsant to the patient in the dose of 1mg daily. It mainly controls the secretion of some brain chemical which are responsible for nerve signaling, as a result of which frequencies of seizures decreases.

Pharmacodynamics as well as pharmacokinetics of a anticonvulsants is explained systematically as follows.

For the proper care of epilepsy, nurses have to go thorough intensely some significant factor and some clinical intervention of the patient. Such as in what frequency the seizure occur, the specific date and timing of epileptic episode as well as the duration of episode. Monitoring the specific symptoms of patient just prior to seizures as well as the behavioral alteration that may occur after the episode is very essential for nurses (Kobau,2008). There are some risk factors also significantly influence the epilepsy, nurses should be well aware of this factor. These are some genetic disorder in the medical history of the patient which may also applicable for diabetes also. Disorder relating to development which may caused by brain damage followed by accident, infection along with inflammation of meningitis, brain tumor and also abuse of alcohol and drug which markedly increases the chances of epileptic disorder.

For developing a care plan for Jessica in order to manage the epileptic episode of the patient, physical as well as mental support is very essential from nurses’ point of view. As during and after seizures patient experiences the whole environment which surrounded her is stressful so along with proper medicine nurses should also do a counseling of patient in order to put a positive vibration into her (Peate, Fearns, 2012).  Antiepileptic drugs which are also known as anticonvulsants are mainly administered to manage as well as reduce the frequency of epileptic seizures. Anticonvulsants act as suppressor by repress the prompt firing which is caused by various neurons during the time of seizures. The main function of anti-epileptic drug is relating to the blockage of sodium channel. It may also enhance the function of acid relating to Y-aminobutyric acid wich also known as GABA (Poochikian-Sarkissian,2005).

Here as per source epilim is prescribed as anticonvulsant to the patient in the dose of 1mg daily. It mainly controls the secretion of some brain chemical which are responsible for nerve signaling, as a result of which frequencies of seizures decreases.

For controlling high blood sugar level of Jessica  have to follow a strict diet and there shall be no foodstuff in his diet chart which contains extra carbohydrate. Apart from that physical activity is very much required and proper medication is also mandatory. There is no scope for any kind of mental stress for the patient. The patient has to intake a good quantity of water every day out of which the most part must be taken at day time (Rosemond,2005).

Identification of issue

In most of the well recognized hospitals and medical researches centers are well equipped for the treatment of diabetes but some factors are to be kept in mind before selecting any domain for treatment of this disease; those are there must an endocrinologist, there should be pathological laboratory for examinations and the doctors are well experienced in treating diabetic patients. The patient have to go through from some medical tests; those are blood sugar level test (Fasting and P.P), blood pressure level check and lipid profile test.

Jessica needs good care especially as to his diet chart and physical exercise. Apart from that proper medication in prescribed time is also mandatory for the purpose of taking care of the patient.

For proper care of Jessica in this case at the morning the patient should do walking in naked feet on grass, thereafter the patient is to conduct for his breakfast, lunch and dinner at a particular and fixed time every day. Complete prohibition of alcohol intake also a primary advise in order to minimizes the chances of frequent seizures. Apart from that medicines are to be given to the patient in prescribed time and it should be kept in mind that which medicines are to be given before having food and those which are to be given after having food as for a diabetic patient it is very significant (Rubin, Crocker, 2006).

Among all the medal domain conducting treatment procedure of epilepsy as well as  diabetes should not only care for proper medication but also to provide a mental and psychological support to the patient. There are some other relevant issues which may take part in treatment of diabetic patient; those are spiritual factors, social phenomena, physiological issues and many others.

Evaluation of the care can be measured by way of considering the health of the patient. If proper medication and care to the patient is done then his blood sugar level will come to normal level and this shall be checked by doing blood sugar test in regular intervals (Swearingen, 2012).

From ethical point of view nurses are responsible for the health care of their patients. They take care of them and follow the rules prescribed by the doctor. Apart from that in some situation a nurse may have to take some decision for the patient by her own discretion that is also for the welfare of the patient. Sometime the patient is reluctant to do something prescribed by the doctor but it is the duty of the nurse to compel the patient to abide the prescription of the doctor and for that nurses are required to take prior permission from the legal guardian of the concern patient (Yeomans, 2005).

Conclusion:

 In present society health is the major concern for every person as today there are so many issues relating to the health of the human beings among all of them diabetes is alarming the medical science. With the passing of time the quality of health of every human being is getting degraded due to several relevant factors out of which epilepsy as well as diabetes is one of the most dangerous. Here for this patient main symptom are repeated seizures which is directly indicating the epilepsy. In the other hand today’s society the most alarming health issue is diabetes, which is clearly suggested by her excessive over weight. So in order to manage epilepsy as well as diabetes patient have to maintained a standard prescheduled daily-life activity which is prescribed by physician or skilled nurses and take her appropriate medicine in proper dose regularly.

References:

Ballantyne, G. (2005). Setting up a register to improve epilepsy care. Practice Nursing, 16(1), 30-34. doi:10.12968/pnur.2005.16.1.17343

Cramer, J., Brandenburg, N., & Xu, X. (2005). Differentiating anxiety and depression symptoms in patients with partial epilepsy. Epilepsy & Behavior, 6(4), 563-569. doi:10.1016/j.yebeh.2005.02.017

Elliott, J. (2014). Commentary on Szaflarski’s “Social determinants of health in epilepsyâ€Â in Epilepsy & Behavior. Epilepsy & Behavior, 41, 272-273. doi:10.1016/j.yebeh.2014.08.139

James, S., Nelson, K., & Ashwill, J. (2013). Nursing care of children. St. Louis, Mo.: Elsevier/Saunders.

Kelner, L. (2013). Facing the epileptic mind — Notes of B. KubiÅ¡ta’s epileptic woman of 1911. Epilepsy & Behavior, 28(2), 303. doi:10.1016/j.yebeh.2012.04.004

Kobau, R. (2008). Epilepsy surveillance among adults — 19 states, Behavioral Risk Factor Surveillance System, 2005. Atlanta, GA: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention.

Peate, I., & Fearns, D. (2012) Caring for people with learning disabilities.

Poochikian-Sarkissian, S. (2005). Illness intrusiveness, quality of life and self-concept in epilepsy.

Rosemond, E. (2005). Molecular pharmacology of the metabotropic glutamate receptors.

Rubin, I., & Crocker, A. (2006). Medical care for children & adults with developmental disabilities. Baltimore: Paul H. Brookes Pub.

Swearingen, P. (2012). All-in-one care planning resource. Philadelphia, PA: Elsevier/Mosby.

Yeomans, J. (2005). Caring for the older person with epilepsy. Nurs Residential Care, 7(6), 258-260. doi:10.12968/nrec.2005.7.6.18220