Introduction
This essay is built on showing the assessment progress of a patient who has been under my care for a while now. The patient is a male diagnosed with type two diabetes mellitus. This patient also suffers from schizophrenia, a condition since childhood. This progress will aid in showing the appropriate way to care for him to regulate both conditions simultaneously without triggering the other, as he had been off the clozapine medications due to a trip that he was having in Bangladesh. It is important to note that he frequently suffers from paranoia, in that his food is poisoned, escalating his hypoglycemia levels, and resulting in low blood sugar levels. He also suffers from drug-induced psychosis. He also suffers from COPD, which he regulates using inhalers.
In every healthcare position, it is necessary to ensure that patient confidentiality is upheld to ensure discretion between the healthcare providers and the patients (Farouk et al., 2020). In this case, all the health situations this man and the doctors discussed remain between them. Since his condition requires frequent follow-up, his details have been fed into the hospital’s patient database, which is protected by a massive firewall to prevent hacking hence leakage of the patient details (Lv and Qiao, 2020.). In case he falls ill in a different place and is treated at another hospital other than our own, his medical details are strictly sent only to the concerned healthcare unit he has visited.
Since he has fallen ill while away from our hospital, it is necessary that his record, as explained above, are sent to the healthcare unit providing the care services to him. It is recommended that he is immediately put under clozapine titrations. Further, a medication list should be sent showing the dosage for each prescription at the healthcare unit.
Identified healthcare priorities
This middle-aged man has a pair of healthcare priorities; physical and mental. Under physical health care, the priority is type two diabetes mellitus which primarily manifests in this case due to the high paranoia that he is offered poisoned food hence declining food. This resultantly leads to a reduction of blood sugar levels. The patient is also suffering from COPD.
His mental health care priority is drug-induced psychosis with very high distrust and paranoia symptoms. As seen above, this highly affects his social and personal life as it leads him to distrust those whore who is offering him home care support. Due to this distrust, he declines food that should help stabilize his blood sugar levels, dropping them below normal sugar levels.
Findings and nursing interventions.
Hypoglycemia or type 2 diabetes is characterized by having more deficient blood sugar levels than usual, 70mg/Dl (Silbert et al. 2018). While blood sugar levels sometimes fluctuate to these low levels in ordinary people, it is necessary to know that it is consistent; then, there is a high likelihood they are suffering from type two diabetes mellitus. Therefore, it is essential to identify this condition early enough before it’s too late.
There are varying reasons that would lead to this condition. In our case, the prevalence of type 2 diabetes is due to failing to eat. For regular body functioning, energy is needed. This energy is sourced from the food eaten, broken down into glucose necessary for energy production in the body, and raises blood sugar levels.
Type 2 diabetes also manifests in patients suffering from the latter, type 1 diabetes, when they inject themselves with too much insulin in trial to regulate their blood sugar levels by bringing them down hence going way below the average glucose levels. Not taking enough carbohydrates for the insulin-induced to work.
Bad timing intervals while administering the insulin where the time intervals are too close should increase the insulin levels in the blood, lowering blood sugar levels. Poor timing while undertaking exercises, where one activity too much reduces the sugar levels below the expected levels (Rossi et al. 2019). Further, too much intake of alcohol reduces blood sugar levels as most sugars are converted into energy to eliminate the alcohol from the blood.
Hypoglycemia mostly has symptoms like racing heartbeats, abnormal sweating and shaking, anxiety and confusion, dizziness, and poor clarity in seeing. To treat these low blood sugar levels, these patients must always be aware of their blood sugar levels. The blood sugar kit can do this by constantly checking the levels. Further, the patients should always take enough carbohydrates and glucose-generating foods to prevent their blood sugar levels from falling below normal blood sugar levels.
Low blood sugar patients should also ensure that they eat enough when taking alcohol. In adverse cases of low blood sugar, the patients should inject themselves with glucagon or ask for help infiltrating it (Freeman, 2019). Soon after, they should ensure they eat foods that help in glucose generation, such as carbohydrates. They should also visit the doctor to ensure that their blood sugar levels are well stabilized. Further, the patient should have their COPD checked to ensure that they are stable, as well as have their inhalers with them every time in case there is a need for emergency respiratory treatment.
Drug-induced psychosis is a mental health situation that leads one to perceive things differently from those around them (Rossi et al., 2020). It is most evident when one is experiencing psychotic episodes such as delusion, paranoia, and hallucination. Just as the name suggests, this results from abusing drugs or too much exposure to a specific drug, increasing its toxic levels in the blood hence provoking psychotic episodes. It may also result from consuming a combination of drugs and withdrawing from prescribed or abused drugs.
Drug-induced psychosis is most prevalent when an underlying mental condition has not been provoked, but the rise of the drug’s toxicity in the system worsens the mental illness (Patel et al. 2019). The symptoms are gradual depending on the level of risk of drug toxicity. For recovery, the mental condition and the drug addiction must be treated separately. In our case, the prevalence of schizophrenia will necessitate the administration of drugs such as clozapine is recommended to help stabilize the mental condition.
To control drug-induced psychosis, the drug triggering it must be identified and withdrawn immediately or systematically depending on the effects of withdrawal by medical detoxification. After successful medical detoxification, the patient should undergo cognitive behavioral therapy to learn the moods before the psychotic episodes to help manage the emotions and paranoia and identify the triggers (Kendler et al. 2019). The most effective therapy includes those closest to the patient to support the patient during recovery.
Healthcare and social interventions, and multiagency working to care for patients.
Healthcare interventions are actions taken to improve an individual’s health status or a group of people (O’Cathain et al., 2019). In our case, a hypoglycemic and drug-induced psychotic patient. For such a patient, the most effective healthcare intervention would be to administer counseling and therapy sessions to help manage the paranoia and distrust, which are drug-induced psychosis symptoms. Part of the therapy will encourage them to eat the food offered without being paranoid that it has been poisoned. This will be effective even in dealing with the hypoglycemia problem. Further, the patient can be provided free glucagon to help manage their blood sugar levels in case they fall below normal.
Social interventions include helping the patients have a place in society (Pollock et al.2020). In our case, this patient social life may be very detrimental given that he suffers from a mental health issue too. Social intervention can be administered by providing the patient with financial support to aid their treatment and daily lives. This will reduce the pressure of thinking about finances, leading to better recovery, especially from a mental disorder. Further, they may be placed in an interactive institution to help build on their social lives.
Multiagency care means organization mechanisms that provide healthcare services to individuals with complex and long-term healthcare needs (Taberna et al., 2020). The agency comprises medical practitioners and specialists overseeing holistic healthcare and support. To achieve the holistic provision of health care and support, there is the coordination of multiple interventions and services depending on the specific complex needs of the patients.
In our case, multiagency care should look into the patient’s hypoglycemic condition and drug-induced psychosis disorder. In this, multiple health specialists would be involved, one who would ensure that the diabetes disorder is well managed and another who would help treat the schizophrenia disorder. Further, a therapist will be involved to deal with helping the patient get over the drug addiction and manage the psychosis episodes.
Implications in nursing practice and knowledge
From evaluating the treatment of the hypoglycemic and drug-induced psychotic patient, I have identified that one health problem could worsen the other. As seen from the disorders above, the paranoid situation affecting the patient led to the rise or manifestation of the hypoglycemic condition. For this reason, it is necessary to work on both health disorders to successfully treat them. As discussed, the medications offered to treat the diseases should not reduce the impact of the other or hinder the health improvement of the latter disorder.
It is also necessary to learn that with such a kind of treatment, there is a need to involve multiple health practitioners who specialize in each disorder to develop effective health stabilization for their patients. The patient is supposed to understand the importance of initiating the desired treatment and comply. Further, as a nurse, I should offer as much help to ensure that both conditions are well treated and maintain high levels of discretion to maintain trust with the patient.
Conclusion
Treatment of a patient with acute and long-term needs is very complex and crucial. As seen in this case, the acute disorder in our patient is diabetes and COPD, and drug-induced psychosis disorder. From the explanation above, the occurrence of the diseases should be looked into closely to beware if their event is interdependent. In this case, type 2 diabetes occurred due to failure to eat. Type 2 diabetes symptoms, which include increased heartbeat, might lead to COPD.
For this reason, glucagon should be injected into the patient’s body to help improve their blood sugar levels. Further therapy sessions should be offered to help with the paranoia management. To enhance the effectiveness of the therapy sessions, clozapine should be administered correctly to help deal with psychotic episodes.
As explained, the occurrence of the psychotic disorder could be triggered by the prolonged use of certain medications or their abuse. Therefore, it is clear that as much as these medications could be used for medicinal purposes, they could also be the sole reason for addiction and trigger underlying mental problems, making their occurrence severe as they are toxic. Therefore they must be administered correctly and with care so that patients do not get addicted. For example, some antibiotics are used in medication; they should be used only for prescription, and medical practitioners should be keen to see that the patients are not exposed for long, prompting addiction.
To manage a patient’s acute and long-term needs, it is necessary to involve multiple unique health practitioners to oversee the treatment and follow-up of the patient. Enough support should be offered to the patient to aid recovery, including support from those around the patient. The social lives of these patients should be encouraged. Further home based care should be sort to help in achieving successful patient treatment.
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