Use the Clinical Reasoning Cycle to review the nursing priorities in relation to the care of Michael.

1. a. The international classification of obesity and overweight is the body mass index (BMI), identify what Michael’s BMI is and his classification for his body weight and obesity. Use a reputable web site to find this information. (0.5 marks)

b. Waist circumference and body shape or fat distribution is another assessment consideration for Michael. Identify three (3) associated disease risks for Michael. (1.5 marks)

c. Having high levels of visceral fat is a health risk. Explain, justifying with relevant pathophysiology why this is so.

(2 marks)

d. Provide an explanation for Michael about the danger of having visceral fat. You will need to use language that he would understand. (2 marks)

e. State 3 actions that could assist Michael to reduce his visceral fat levels. (1.5 marks)

2. Prediabetes is where an individual is at an increased risk for developing type 2 diabetes. Discuss the testing in Australia and values that determines the presence of a pre-diabetic state. (2 marks)

a. Name 4 risk factors that are either non-modifiable or modifiable, that increase a patient’s chances of developing diabetes mellitus type 2. (2 marks)

3. Review and recall your knowledge of diabetes and the possible adverse complications that may occur. Identify six (6) signs of hypoglycaemia. Discuss one (1) of these signs of hypoglycaemia and justify using anatomy and pathophysiology. (5 marks)

4. Sertraline is a commonly used medication to treat anxiety and depression in adults Michael is being commenced on this medication by the GP. Discuss the nursing education you will provide to him. Provide four (4) clear points that he needs to understand to take this medication safely. (2 marks)

5. On review of Michael’s case, you refer Michael to a dietician with expertise in diabetes management. Provide a rationale for this discipline’s involvement in relation to the case study. (2 marks)

6. Clients like Michael often experience difficulty adhering to a treatment plan for his diabetes, name and describe three (3) evidence -based interventions that are known to increase adherence and provide brief rationale for each.

(3 marks)

7. Both research and clinical practice strongly suggest that it is important to screen for and treat symptoms of depression in order to optimise diabetes self-care and facilitate both physical and psychological well-being in people with diabetes.

a. Identify one (1) screening tool you could use for measuring depression in Michael and justify why you chose this tool (2.5 marks)

b. Discuss the importance of screening patients like Michael for depression. (2 marks)

8. On Michael’s physical assessment his blood pressure was 160/70 and he has a history of hypertension. Name and explain two (2) nursing interventions to assist Michael with hypertension control. (4 marks)

9. Mr Brennan presents with many nursing problems. Reading his case and completing the previous questions for this workbook has required you to read widely on diabetes mellitus type 2. State 2 nursing problems you have identified other than hypertension. (2 marks)

10. Write a goal of care in SMART format for Michael that address your each of your identified nursing problems (Two (2) SMART goals needed) No reference required for this response. (2 marks)

11. Many patients with diabetes mellitus suffer complications. Choose two (2) of the following and discuss the pathophysiology in relation to a diabetes diagnosis

a. Retinopathy

b. Peripheral neuropathy

c. Cerebral vascular accident

d. Vascular disease

e. Increased risk of infection (4 marks)

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