Discharge Plan

Medication a. Continue home medications such as hypoglycemic medicines b. Educate the patient with the purpose of each drug and its side effects c. Instruct patient to take medicine at the exact time and at the prescribed dosage. d. Instruct to take prescribed antibiotics with the prescribed duration. e. Take medicines as prescribed by the doctor and do not self-medicate.

Exercise a. The patient should be aware of any restrictions on exercise or activity that she needs to follow such as: Do not exercise if your blood sugar level is less than 100 mg/dL. b. Encourage patient to have regular exercise, if not contraindicated, to ensure wellness. c. Explain the importance and the benefits of having a regular exercise

Treatment a. Comply with treatment regimen. b. Emphasize rehabilitation through exercise and proper diet. c. Apply betadine at the wound as indicated by the doctor. d. Avoid overexposing the wound site as much as possible. e. Monitor blood glucose level.

Hygiene a. Encourage to take a bath daily. b. Instruct on how to clean and to change dressing on a regular basis. c. Use only clean cloth, cotton and gauze bandages.

Outpatient Orders a. Instruct to see doctor for continuing care, treatments, home services, and ask for more information. b. Encouraged the help of a physician once the wound displays signs or progressive infection such as increased bleeding, increased pus formation, unusual pain sensation, increased swelling at the wound site and if fever develops.

Diet

a. Encourage to eat foods rich in fiber to avoid constipation. b. Encourage to eat foods rich in protein such as meat. c. Encourage to eat foods rich in iron such as green leafy vegetables. d. Never skip a meal to control your blood sugar level. e. Instructed to increase oral fluid intake. f. Diabetic Diet

Carbohydrates should provide 45 - 65% of total daily calories. Best choices are

vegetables, fruits, beans, and whole grains. These foods are also high in fiber. Carbohydrate counting or meal planning exchange lists. Fats should provide 25 - 35% of daily calories. Limit saturated fat.
Protein should provide 12 - 20% of daily calories, although this may vary

depending on a patient individual health requirements Avoid eating too much sweet foods. Eat foods rich in fiber such as banana.

There is a cause and an effect in this world. There is constant change and there are things that we cannot control. The BSN-3F Group 1- Subgroup 2 of San Pedro College were exposed at St. Dominic Ward of San Pedro Hospital, Davao City. The concept focuses on the conditions and diseases regarding fluid and electrolyte. Fluid and electrolyte clinical rotation will prepare a nursing student for providing medical care and education about diseases and treatment plans to patients with conditions related the concept. This case study focuses on the status and the medical management of our chosen client, patient MGQ who was admitted in St.Dominics ward due to swelling of the right leg last June 12, 2012. The client has agreed to be the subject of our case study under the supervision of our clinical instructor, Mrs. Portia T. Ituhat, RN, MN.

Our client has spontaneously and willingly answered all of our questions and has provided us a good data for our study. We chose her because her condition is something that needs effective nursing care and management of possible complications that may arise. It may also help that we are equipped with knowledge regarding such issues thus we would be able to provide some nursing care and love to our patient. Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. It is often associated with different complications and illnesses due to its systemic influence to the body. In the case of our patient, her ordinary wound cut had progressed into cellulitis due to delayed wound healing as influenced by her type II diabetes mellitus. Type 2 diabetes occurs when your pancreas (an organ that lies behind the stomach) has trouble using insulin or is not making enough insulin. According to World Health Organization (WHO) 2.2% died of having diabetes mellitusin the year 2009. For the national statistics according to US department of health and human services, diabetes affect 25.8 million people of all ages which is 8.3 percent of the U.S population in 2009. In Manila, survey of 12,293 Filipinos 8.4% has diabetes mellitus (Diabetesjournals.org 2008). Diabetes also ranks 8thin the top 10 leading causes of death in the Philippines according to DOH-Health Statistics 2008. This case study can contribute a lot on the quality of nursing care of students and as well as registered nurses. This could provide a clear view on how to take care of a client with Diabetis Mellitus .First, to nursing research, we would be able to gather all the data from different sources necessary for our case study. The data that we have gathered will help us identify current and future problems. And it would also provide us the essential information we need in the making of this case study. From these, it will guide us in searching for the appropriate interventions geared towards our patient. We, student nurses, would greatly benefit from this research because it would help us formulate our care plans for the holistic care of our patient.

Secondly, to nursing education, this case study would help us increase our knowledge on how to deal with our patient and her current condition. This would also serve as a start in improving our education because it would serve as an evaluation of what we have learned. Education is not only limited to the four walls of the classroom but it is best learned through experience. And lastly to nursing practice, we would be able to apply all the things that we have learned. And also it would give us the chance to enhance our skills.