Dehydration

Mr George Brown has problems such as peripheral arterial disease (PAD), hypertension and type 2 diabetes mellitus. He was brought in two month ago for Hyperosmolar Hyperglycaemic Nonketotic Syndrome and one year ago for myocardial infraction. Mr Brown had a surgery after he felt rigorous pain in his frontal right lower limb. The highest priority problem to manage for Mr Brown is dehydration. Furthermore, beside the important problem that he experiencing, he is also hyperthermic and further experiencing lectrolyte imbalance Therefore, using IV fluids on Mr Brown is a primary intervention. McDermott, ‘et al.’, (2013) found patients that have (HHNS) usually end up losing up to 12 litres of body fluids instigating hypovolemic shock that could be harmful. Correspondingly, Stunkard & Foley (2011) identified that; patients with HHNS should be treated with vigorous IV fluids, replacing their electrolyte and finally administrating insulin. Thereafter, the coexisting conditions should also be treated. There is no proof to show assistance in giving an primary bolus to patients that are hyperglycaemic and dehydrated (De beer 2008). Hence, in Mr Brown’s case his hyperglycaemia can be enhanced by initiating IV fluid before starting insulin treatment.

There are multiple advantages in administrating IV fluids. Researchers found lower blood sugar levels when a patient with HHNS is administered IV fluid. Furthermore, Stunkard & Foley (2011) found a reduction in serum glucose 75-100mg/d1/hr if patient fluid are adequately replaced irrespective to insulin administration. Moreover, to improving hyperglycaemic disorders adequately replacing fluid is linked to re-establishing heart conditions. If Saline IV fluids were used in a patient who is hyperka...

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... Medical Research Council, (2013) stated that life style modification reduces risks of type 2 diabetes and decreases risks of heart disease. Mr Brown was diagnosed with type 2 diabetes 2 years ago, peripheral arterial disease (PAD) 1 year ago, he has 2 years of hypertension and 10 years history of smoking. Likewise, Mr Brown needs to be educated and told about the benefits of lifestyle modification. Consequently, all of the above can cause significant stressors, therefore, he needs to be advised about the negative effect of stress on his diabetic condition. In conjunction with his family support Mr Brown will be associated with a diabetes support groups, to learn how to manage his diabetes successfully. Mr Brown will be connected or provided with contact details of a social carer and support groups that help him and support him with his situation.