Nursing Discussion Post: Your Patient Has Just Been Diagnose ✓ Solved

Nursing Discussion Postyour Patient Has Just Been Diagnosed With Diabe

Your patient has just been diagnosed with Diabetes Type 2 and the doctor prescribed metformin. 1. Describe the mechanism of action of metformin and potential contraindications. 2. What education that the registered nurse would have provided would you reinforce? 3. Explain lifestyle changes a person should if diagnosed with diabetes type 2? Include in-text citations and two references from the last 5 yrs.

Sample Paper For Above instruction

Diabetes mellitus type 2 is a chronic metabolic disorder characterized by insulin resistance and relative insulin deficiency. The management of this condition involves various strategies, including pharmacologic intervention with medications such as metformin, as well as lifestyle modifications. Understanding the mechanism of action of metformin, its contraindications, and the necessary patient education and lifestyle changes is essential in providing comprehensive care for individuals diagnosed with this condition.

Mechanism of Action of Metformin and Potential Contraindications

Metformin is an oral antihyperglycemic agent primarily used in the management of type 2 diabetes mellitus. Its mechanism of action involves decreasing hepatic glucose production through inhibition of mitochondrial respiratory-chain complex I, which results in reduced gluconeogenesis (Rena, Hardie, & Pearson, 2017). Additionally, metformin enhances insulin sensitivity in peripheral tissues such as muscle and adipose tissue, thereby increasing glucose uptake and utilization (Rena et al., 2017). Unlike other antidiabetic agents, metformin does not stimulate insulin secretion, which reduces the risk of hypoglycemia when used alone.

Potential contraindications of metformin include renal impairment, as it is excreted unchanged by the kidneys; therefore, decreased renal function can lead to the accumulation of the drug and increase the risk of lactic acidosis—a rare but serious side effect (American Diabetes Association, 2022). Other contraindications include conditions associated with hypoxia such as congestive heart failure, liver disease, alcoholism, and acute or chronic metabolic acidosis. Before initiation, renal function should be carefully assessed, and metformin is typically avoided if estimated glomerular filtration rate (eGFR) falls below specific thresholds.

Patient Education Reinforced by the Nurse

Registered nurses play a crucial role in educating patients about their medications and disease management. Patients prescribed metformin should be advised to take the medication with meals to minimize gastrointestinal discomfort. They should be informed about the importance of adherence to the prescribed dosage and briefed on potential side effects, which may include gastrointestinal symptoms such as diarrhea, nausea, and abdominal discomfort (American Diabetes Association, 2022). Patients must understand signs of lactic acidosis—a rare but fatal complication, which include muscle pain, weakness, unusual somnolence, and respiratory distress—and to seek immediate medical attention if these occur. Regular monitoring of renal function is essential to ensure safety, especially in the initial stages of therapy. Additionally, patients should be educated on the importance of blood glucose monitoring, recognizing symptoms of hyperglycemia, and adhering to follow-up appointments.

Lifestyle Changes for Managing Type 2 Diabetes

In addition to medication, lifestyle modifications are fundamental in managing type 2 diabetes. Patients should be encouraged to adopt a balanced diet rich in fiber, low in saturated fats, trans fats, and refined sugars. Emphasizing portion control and consistent carbohydrate intake helps maintain blood glucose levels within target ranges (Evert et al., 2019). Regular physical activity, such as at least 150 minutes of moderate-intensity exercise per week, improves insulin sensitivity and aids in weight management (Colberg et al., 2016). Weight loss, even modest reductions of 5-10%, can significantly improve glycemic control and potentially lead to remission in some cases (Evert et al., 2019).

Furthermore, smoking cessation and moderation of alcohol intake are advised to reduce cardiovascular risk associated with diabetes. Stress management and adequate sleep also contribute to better glycemic control. Patients should be educated on the importance of routine blood glucose monitoring and maintaining regular follow-up with healthcare providers to adjust treatment plans accordingly.

Effective management of type 2 diabetes involves a holistic approach that integrates pharmacotherapy, lifestyle modification, and continuous patient education. Empowering patients with knowledge about their condition and treatment fosters adherence and improves outcomes.

References

• Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., ... & Braun, B. (2016). American College of Sports Medicine and the American Diabetes Association: Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079.
• American Diabetes Association. (2022). Standards of Medical Care in Diabetes—2022. Diabetes Care, 45(Supplement 1), S1–S264.
• Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H., MacLeod, J., ... & Urbanski, P. (2019). Nutrition therapy for adults with diabetes or prediabetes: A consensus report. Diabetes Care, 42(5), 731-747.
• Rena, G., Hardie, D. G., & Pearson, E. R. (2017). The mechanisms of action of metformin. Diabetologia, 60(9), 1577-1585.