Paguio. Emilito F.

NCM 112
BSN III-B Module 9

TASK 1. ACTIVE LEARNING TEMPLATE

Instructions: Using the active learning template, choose one alteration/dysfunction/disorder of the
immune system. Fill in the necessary details needed to accomplish the template. (see rubrics for
scoring)

Pathophysiology Related Safety Consideration

Client Problem
Alteration in Related to to Client Problem
Health 1. Make a
Alteration in
(Diagnosis) Type 1 DM is the commitment to
Health
culmination of lymphocytic managing your
Type 1 Diabetes Family History of infiltration and destruction diabetes
Diabetes of insulin-secreting beta 2. Don't smoke
cells of the islets of 3. Keep your blood
pressure and
Langerhans in the pancreas.
cholesterol under
Assessment As beta-cell mass declines,
control
insulin secretion decreases 4. Schedule regular
Medications until the available insulin physicals and eye
no longer is adequate to exams
Insulin maintain normal blood 5. Keep your vaccines
-Short-acting glucose levels. After 80- up to date
(regular) insulin 90% of the beta cells are 6. Take care of your
Past Medical -Rapid-acting teeth
destroyed, hyperglycemia
History insulin 7. Pay attention to
develops and diabetes may
-Intermediate- your feet
-Have you had acting (NPH) be diagnosed.
increased thirst, 8. Consider a daily
insulin aspirin
increased urination, -Long-acting
and fatigue? 9. If you drink
insulin alcohol, do so
-How long have the
Teamwork and responsibly
symptoms been
present? Collaboration 10. Take stress
-Have you had an Laboratory seriously
increase in appetite? Data Discharge Planning 11. Exercise involving
-Have you lost heavy weights may be
A1C, plasma Medications bad for people with
weight lately? -Instruct patient to
-Is there a family glucose test, blood pressure, blood
FPG continue medications at vessel, or eye
history of diabetes?
home prescribed by the problems.
-What other medical
conditions do you physician with right drug, 12. Check your blood
have? right dose at right time and glucose before you
Diagnostic right frequency and route. exercise. wear cotton
Procedure/Sur - Review the role and socks and athletic
regimen for oral diabetes shoes that fit well and
gical
medications, insulin are comfortable. After
Intervention you exercise, check
regimens, and any other
Blood Test medication changes with your feet for sores,
patient. blisters, irritation,
cuts, or other injuries.
 13. Drink plenty of
Environment
Risk Factors fluids during physical
-Advise patient or the
activity, since your
Family history, Genetics, Geography and significant other to avoid
places that can be a risk blood glucose can be
Age.
factor to the patient’s affected by
condition such as places dehydration.
where enterovirus can be
Objective and Subjective Data
acquired and early
Subjective Data: “I always feel so weak
exposure to cow's milk.
and thirsty.”
Treatment
Objective Data: Dry skin and mucous
-Discussed the importance
membrane, poor skin turgor and sudden
of complying on the
weight loss.
treatment.
-Advise patient to comply
with his/her medications
all the time.
Health Teaching
Nursing Intervention (Evidence- -Monitor your blood
Based) glucose levels carefully
-Ensure adequate and appropriate -Eat a balanced
nutrition. diet. Exercise regularly
-Prevent skin breakdown. and reduce your weight if
-Prevent skin infection. you are
-Regulate glucose levels. overweight. Losing small
amounts of weight is
helpful for diabetes
management.
-Monitor blood pressure.
Client Education Keep cholesterol within
normal limits.
-Instruct patient to continue medications -Attend all of your
at home prescribed by the physician with scheduled medical
right drug, right dose at right time and appointments.
right frequency and route. Out Patient Referral
-Monitor blood glucose levels carefully. -The patient should return
-Eat a balanced diet. Exercise regularly to her physician after 1
and reduce weight overweight. Losing week for follow up check-
small amounts of weight is helpful for up and reassessment.
-Attend all of your scheduled medical Diet
appointments. -Advise patient not to skip
meals
-Include making
healthier food choices that
are lower in saturated fat,
sugar and salt. Doing this
will help control blood
fats.
-Drink 8-10 glasses of
water a day.
 Coordination of Client
Care
Inform other health care
provider in the health care
team about the status of
the patient so that
appropriate health care
will be provided to the
patient by each of the part
of the health care team.

Outcome and Evaluation

GOAL MET
-Client’s blood glucose
levels will maintain between
60 mg/dL and 120 mg/dL.
-No presence of weakness
and less presence of being
thirsty.

TASK 2. WELL-BUILT, PATIENT-ORIENTED CLINICAL QUESTION

Instructions: Using the PICO format, write a focused clinical question based on the clinical
domain(s) it falls under (intervention, diagnosis, etiology, prevention, prognosis/prediction,
quality of life/meaning, and therapy). Search and read journals/research articles pertaining to
patients with disorder in the immune system. Use the PICO format to break down your question
into smaller parts and develop a well-built, patient-oriented clinical question. For your reference,
see this link: https://libraryguides.nau.edu/c.php?g=665927&p=4682772

Intervention
In a patient with Type 1 Diabetes, how does natural remedy compared to insulin affect the level of
blood glucose in just a day?
Diagnosis
Is a Blood Glucose Test done in 5 years old more accurate in diagnosis of Type 1 Diabetes
compared with Blood Glucose Test done after a patient rich at age of teen or adult?
Etiology
Are the individual with a family history of diabetes compared with those without a family history
of diabetes are at risk for developing diabetes during younger age?
Prevention
In a caring for a diabetic patient, what are the differences between the health care of a health care
team and the significant other during hospital visits and home stay?
Prognosis/Prediction
In a patient that has a Type 1 Diabetes, how does use of insulin and natural remedies at the same
time influence the normal regulation of blood glucose every day?
Quality of life/Meaning
How does a child that is newly diagnosed with Type 1 diabetes perceive reporting of alteration in
his/her health related to his/her condition to his/her significant other when he/she feels different?
Therapy
For a patient with newly diagnosed Type 1 diabetes, as an insulin is firstly administered to the
patient compare to patients that was diagnosed long time ago who are regularly administering
insulin, is there a difference in the result of lowering/regulating their blood glucose within a day?

References:
Martin, P. (2019, April 10). 4 Diabetes Mellitus Type 1 (Juvenile Diabetes) Nursing Care Plans.
Retrieved from https://nurseslabs.com/diabetes-mellitus-type-1-juvenile-diabetes-nursing-
care-plans/3/
Kodner, C. et. Al. (2017, November 10). Glucose Management in Hospitalized Patients. Retrieved
from https://www.aafp.org/afp/2017/1115/p648.html
Knip, M. (2005, December). Environmental Triggers and Determinants of Type 1 Diabetes.
Retrieved from https://diabetes.diabetesjournals.org/content/54/suppl_2/S125
Belleza, M. (2020, November 22). Diabetes Mellitus Type 1. Retrieved from
https://nurseslabs.com/diabetes-mellitus-type-1-juvenile-diabetes/#nursing_interventions
Mayo Clinic (2011). Diabetes care: 10 ways to avoid complications. Retrieved from
https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-
management/art-20045803