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On time, ill use their service again, much appreciated, before deadline they finished my assignment. Nursing Case Study Help Healthcare Industry is one of the important industries since the ancient times and nursing is a vital part of this industry.

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How safe and secure am I using your service? Clement 2 commented in a review of diabetes self-management education issues that unless ongoing management is part of an education program, knowledge may increase but most clinical outcomes only minimally improve. Advanced practice nurses by the very nature of their scope of practice effectively combine both education and management into their delivery of care.

At the completion of assessments, advanced practice nurses, in conjunction with patients, identify management goals and determine appropriate plans of care. Many advanced practice nurses NPs, CNSs, nurse midwives, and nurse anesthetists may prescribe and adjust medication through prescriptive authority granted to them by their state nursing regulatory body. Currently, all 50 states have some form of prescriptive authority for advanced practice nurses.

It is a crucial component in the care of people with type 1 diabetes, and it becomes increasingly important in the care of patients with type 2 diabetes who have a constellation of comorbidities, all of which must be managed for successful disease outcomes. Many studies have documented the effectiveness of advanced practice nurses in managing common primary care issues. In diabetes, the role of advanced practice nurses has significantly contributed to improved outcomes in the management of type 2 diabetes, 5 in specialized diabetes foot care programs, 6 in the management of diabetes in pregnancy, 7 and in the care of pediatric type 1 diabetic patients and their parents.

The following case study illustrates the clinical role of advanced practice nurses in the management of a patient with type 2 diabetes. Although he was diagnosed in , he had symptoms indicating hyperglycemia for 2 years before diagnosis. Referred by his family physician to the diabetes specialty clinic, A. He has been trying to lose weight and increase his exercise for the past 6 months without success.

He had been started on glyburide Diabeta , 2. He has tolerated this medication and adheres to the daily schedule. He stopped these supplements when he did not see any positive results. He does not test his blood glucose levels at home and expresses doubt that this procedure would help him improve his diabetes control.

He lives with his wife of 48 years and has two married children. Although both his mother and father had type 2 diabetes, A. In the past, his wife has encouraged him to treat his diabetes with herbal remedies and weight-loss supplements, and she frequently scans the Internet for the latest diabetes remedies.

During the past year, A. Since retiring, he has been more physically active, playing golf once a week and gardening, but he has been unable to lose more than 2—3 lb.

He has never seen a dietitian and has not been instructed in self-monitoring of blood glucose SMBG. His normal dinners consist of 2 cups of cooked pasta with homemade sauce and three to four slices of Italian bread.

He also eats eight to ten pieces of fresh fruit per day at meals and as snacks. He prefers chicken and fish, but it is usually served with a tomato or cream sauce accompanied by pasta. The medical documents that A. However, his medical records also indicate that he has had no surgeries or hospitalizations, his immunizations are up to date, and, in general, he has been remarkably healthy for many years.

The first task of the NP who provided his care was to select the most pressing health care issues and prioritize his medical care to address them. The patient and his wife agreed that a referral to a dietitian was their first priority. Weight loss would also be an important first step in reducing his blood pressure. The NP contacted the registered dietitian RD by telephone and referred the patient for a medical nutrition therapy assessment with a focus on weight loss and improved diabetes control.

The RD requested that during the intervening week, the patient keep a food journal recording his food intake at meals and snacks. She asked that the patient also try to estimate portion sizes. Although his physical activity had increased since his retirement, it was fairly sporadic and weather-dependent. After further discussion, he realized that a week or more would often pass without any significant form of exercise and that most of his exercise was seasonal.

Whatever weight he had lost during the summer was regained in the winter, when he was again quite sedentary.

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