Pathophysiology to Prevention and Management

Question: Discuss about the Pathophysiology to Prevention and Management. Answer: Introduction: The first problem identified for Mrs. Mallacoota is ineffective management of her type 2 diabetes. Poor management of type 2 diabetes has led to the onset of chronic kidney disease. In case of diabetes, blood vessels are injured and kidney becomes unable to clean blood properly. As a result, body retain more water and salt, which causes ankle swelling, as observed in Mrs. Mallacootas case. On the other hand, diabetes damages nerves, emptying the bladder, this pressure in blood causes kidney injury, for long term negligence, frequent infection can develop. To prevent the progression of CKD, her BGL level needs to be controlled (Nolan et al. 2011). For this a dietician needed to be referred, who can help her to make a healthy diet routine. As she has already established kidney damage, she needs to reduce protein consumption in diet, thereby limiting sodium, potassium and phosphorus intake. Adequate protein intake is 0.8 g/kg body weight/day. In addition to that, she also needs regular physical activity for maintaining a healthy weight. In this context, another key concern nursing problem for Mrs. Mallacoota is controlling her blood pressure level. There is a significant level in diabetes type 2 and high blood pressure or hypertension. On the other hand, high blood pressure causes damage to nerves; on the other hand, renal hypertension causes kidney damage. In this context, 6o reduce the risk of further progression in kidney damage, Mrs. Mallacoota needs to more carefully keep her blood pressure under control (Afkarian et al. 2013). Her blood pressure should not be enhanced through the care intervention plan, because, improved blood pressure has been demonstrated as the key effective intervention for slowing the progressive kidney disease. Other factors like smoking and alcohol consumption needed to be ceased, as smoking enhance the risk of high blood pressure and alcohol consumption directly damages the kidney. A health promotion program can be arranged for her to make her aware about the importance of controlling her BP along with the coping strategies (Inzucchi et al. 2012). Beta blockers should be administered for reducing BP. She can be referred to a physical therapist for making a physical activity program. In addition, she should be motivated for reducing the chances of stress, which also contribute in elevating BP. Reference List Afkarian, M., Sachs, M.C., Kestenbaum, B., Hirsch, I.B., Tuttle, K.R., Himmelfarb, J. and De Boer, I.H., 2013. Kidney disease and increased mortality risk in type 2 diabetes.Journal of the American Society of Nephrology, pp.ASN-2012070718. Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A.L., Tsapas, A., Wender, R. and Matthews, D.R., 2012. Management of hyperglycemia in type 2 diabetes: a patient-centered approach.Diabetes care,35(6), pp.1364-1379. Nolan, C.J., Damm, P. and Prentki, M., 2011. Type 2 diabetes across generations: from pathophysiology to prevention and management.The Lancet,378(9786), pp.169-181.