Care Plan For Diabetes in Young Children-myassignmenthelp.com

Question: Write about theCare Plan For Diabetes in Young Children. Answer: Type 1 diabetes is the disorder in which the pancreas of the body fails to produce enough amount of insulin as required by the body of individuals. Insulin can be described as the hormone that helps the body for controlling the level of glucose in the blood. Without proper amount of insulin in the blood, glucose is seen to increase in the blood (Miller et al. 2015). As result for this body can produce enough energy required for different activities and hence it results in different knife threatening situations by the failure of organs. Over the years, researchers have tried their best to find out the main causes that result in the development of the disorders (Dabela et al. 2014). They have stated that eating of sugar is neither the cause of the disorder and neither the disorder is preventable in any ways in type 1 diabetes. Proper health literacy and management of the diet and other activities can only maintain it. The assignment will mainly help to shed light on case study through which, diagnostic methods proper pathophysiology of the symptoms and care management of the disorder would be proposed. There are different procedures by which blood glucose levels can be tested in pediatric patients. A random blood glucose test can be of immense help in diagnosing the test at any time of the day. The health professional can conduct this test at any unspecified time. After the test, the level of the glucose can be assessed with any or one more symptom of the diabetes in order to find out whether the individual child is facing any issue or not. This test is considered more accurate in comparison to that of the oral as well as the fasting blood glucose level test. The other test which can be also used for measuring the condition of the blood glucose level, then, glycated hemoglobin test or the A1c test (Butwicka et al. 2015). It helps in providing an overview of the levels of glucose that were present in the past few months in comparison to that of the random blood glucose test which gives a snapshot of the glucose level in the present condition. The A1C test should be unaffected by any recent meals and it helps to measure the percentage of the hemoglobin. Hemoglobin is an oxygen transporting protein in the red blood. Glucose mainly remains bound with these red blood cells. When a high percentage is estimated in the test like above 6.5 percent, the professionals can conclude that the patient is suffering from diabetes (Wili et al. 2015). Autoantibody test then needs to be conducted following which the professionals can confirm the type of diabetes in individuals. There are four types of auto-antibodies which act as markers of the beta cell autoimmunity in type 1 diabetes. They contain islet cells antibodies or ICA against cytoplasmic proteins in the beta cells that should account for about 69 to 90% of the affected individual. Then the second antibodies are the antibodies to glutamic acid decarboxylase or the GAD- 65 that should be found to 80% of individuals with type 1 diabetes. The next set of antibodies are the IA-2A to protein tyrosine phosphatase which shoul d be between 54 to 75 5 for ensuring the children are suffering from diabetes (Tauschman et al. 2016). Besides Insulin antibodies also called the IAA are seen to inversely correlating with age of the onset of the diabetes. Researchers say that these are the first markers of risk of diabetes in young children and are found in 7%5 of the young children who are diagnosed with type 1 diabetes. Besides, the healthcare professionals on a regular basis can conduct fasting blood glucose level. This helps to check the blood glucose level of the patient when he comes for follow-ups in the later periods. This test is said to be always reliable and provide the most accurate results in the morning. Oral glucose tolerance test can be also conducted. In normal person, the food that is ingested by the body is broken down into nutrients. Such nutrients are absorbed from the intestines into the blood stream. Thereby, the level of glucose rises in the blood, which thereby stimulate the beta cells of the islets of Langerhans in the pancreas to release insulin. This insulin is mainly seen to act as a key that stimulate the cells to accept the insulin. Once the cells get stimulated, then only the glucose can enter the cells following which respiration takes place thereby reasoning energy for the activities of the cells. However, in case of the affected individuals, the normal pathway of insulin production is hampered (Sherr et al. 2016). In type 1 diabetes, the pancreas of the individuals is seen to lose the ability to make insulin. Researchers are of the opinion that in such individuals, the immune systems get modified in ways by which they start attacking the and destroying the cells which are responsible for the production of insulin . Researchers are not sure of the exact reason that results in the occurrence of the disorder. However, they have stated of a gene in the affected individuals that contribute to the occurrence of the disorder (Russell et al. 2016). In the case of the affected children, the islets cells of the pancreas are seen to get destroyed and therefore the child produced little or no insulin at all. Therefore, glucose is seen to increase in the bloodstream of the child thereby making the child vulnerable to different life threatening disorders. A number of symptoms remain associated when children who suffer from this disorder. As in the case study, the child also suffered from increased thirst and frequent urination. When excess of sugar gets built up in the blood of the child, the bloodstream is seen to pull fluid from the tissues. Therefore, the child is often seen to get thirsty (Simri et al. 2014). Therefore, they tend to drink more water and as result tend to urinate more than usual. Even researchers have stated that young toilet trained children can wet their beds when symptoms get severe. Another symptom that also is noticed in the children as well as also noticed in Alex is extreme feeling of hunger. Researchers are of the opinion that without enough insulin, glucose cannot enter in the cells of the children. Therefore, the muscles and the organs of the child also lack energy that helps in triggering of intense humor. Therefore, in case of Alex, severe hunger has also been noted in the children. Ketones are also seen to be present in urine that is also observed in the patient named Alex. This situation is said to be diabetic ketoacidosis. When there is not enough insulin in blood, sugar cannot enter the cells for energy. The blood sugar level rises for which the body tries to begin to break down the fat for energy production. This procedure causes toxic acids production in the form of ketones. When there is excess accumulation of ketones in the blood, they are see n to spill over the urine. When such symptom is left untreated, it results in life threatening condition (Haller et al. 2015). Therefore, Alex was also having ketones in the urine. The ketoacidosis may lead to occurrence of vomiting and nausea in individuals. Over the time, diabetes is seen to affect other parts of the body. When vagus nerve gets affected, it disrupts the speed by which stomach empties food in the small intestine. Food stays in the stomach for longer time an and results in creating a block for which it cannot enter the small intestine. Food hardens in stomach that creates gastroparesis. It may cause abdominal pain, nausea, vomiting and many others. It is not confirmed whether Alex is having the mentioned disorder or not but symptoms may show the occurrence of the disease. Therefore, it becomes extremely important for the healthcare professionals to develop knowledge about the symptoms and the rationale behind occurrence of the symptoms (Karges et al. 2014). This wou ld ultimately help in developing care plans that will help in addressing the symptoms and overcoming them successfully. The first priority of the nursing care and management is insulin management. Researchers are of the opinion that mixture of the insulin in the same syringe, type of insulin, site of the insulin injection as well as individual patient response differences all can affect the peak, onset as well as duration of the insulin activity. The different types of insulin that are used in children and can also be used for Ales are the short acting insulin, rapid acting insulin analog, long acting insulin analogs as well as intermediate acting insulin. These individual can be used individually as well as in combination. They are delivered by the procedures of syringe or even through pen and pump. Insulin requirements are mainly seen to be based on age, body weight as well as pubertal status of the children (Bohn et al. 2016). As Alex is a child, who is newly diagnosed with diabetes type 1 should require an initial daily dose of 0.51.0 units/kg. Children like Alex may need multiple daily injectio ns that might include different combinations of insulin types as they might sometimes consume high amount of snack. Pumps are seen to be of increasing use in the pediatric population. Besides all these, the nursing professionals should also provide importance to development of individualized insulin regimen for Alex depending on the particular needs and requirements of Alex. Besides the use of pumps, adult support at both schools and homes are found to be essential for not only with diabetes management but also with the pump treatment until the child is independent enough to manage the diabetes independently. Therefore, in case of Alex also similar considerations are needed to be made (Barnard et al. 2014). The nursing professionals should not only ensure proper monitoring of the blood glucose level or the patient but also ensure to teach the patient and their parents for self monitoring blood glucose procedure. This is the best procedure to measure blood glucose levels rapidly as well as accurately (Patterson et al. 2014). Researchers state that successful self-management of blood glucose level should be the ultimate goal of all patients with insulin dosing decisions that will be based on the interpretation of the blood glucose results. Researchers have also stated that they have found effective correlation between frequency of monitoring as well as glycemic control (Nasr et al. 2015). Therefore, not only healthcare professionals but also the parent should understand the importance of the multiple blood glucose measurements that should be done each day. This helps in the determination of patterns of hypoglycemia as well as hyperglycemia and provides data for insulin dose adjustments pr eprandial, postprandial and overnight levels of glucose are to be effectively monitored. Researchers are of the opinion that preschool and early school aged children are not able to identify and report episodes of hypoglycemia and therefore special attention should be given in case. Therefore, frequent monitoring of the blood glucose level is necessary to keep children like Alex out of the danger. Use of blood glucose meters containing memory chip are used nowadays which also have advantage of getting printouts. Interpretation of this blood glucose result followed by their dose calculations are major importance for achievement of the good metabolic control. The child should also learn with her carer about the type of food that should be taken like diet rich in fruits, whole grains, vegetables and others foods that are rich in nutrition and low in fat and calories. Intake of carbohydrate by the child should be limited and restricted (McKnight et al. 2015). Restrictions should also be imposed on intake of sweets and animal products. Often it may become difficult for Alex mother to understand how much food to be incorporated in the meal and therefore a dietician can be referred to for guidance. Children with diabetes type 1 are expected to make physical activity as one of the most important part of the daily routines and therefore Alex should also be encouraged by his parents to take part in regular physical activities. Researchers are of the opinion that physical activities may result in lowering of the blood glucose level and sometimes it may fall beyond the normal level resulting in hypoglycemia (silverstein et al. 2015). Therefore, parent should be careful and manage the fall in the level of glucose by modifying diet accordingly. From the above discussion, it becomes quite clear that diabetes type 1 may occur in children due to autoimmune effects that may result in increase of blood sugar levels and causing life threatening situations. Different symptoms any follow like increased thirst, hunger, ketones in urine, vomiting, abdominal pain and others. Proper monitoring of glucose, insulin medication, diet, exercise and other interventions can be taken up by the professionals and can be also taught to the patient and family members to endure quality life of patients. References: Barnard, K. D., Wysocki, T., Allen, J. M., Elleri, D., Thabit, H., Leelarathna, L., ... and Hovorka, R. 2014. Closing the loop overnight at home setting: psychosocial impact for adolescents with type 1 diabetes and their parents.BMJ Open Diabetes Research and Care,2(1), e000025. Bohn, B., Rosenbauer, J., Icks, A., Vogel, C., Beyer, P., Rtschle, H., ... and Fink, K. 2016. Regional disparities in diabetes care for pediatric patients with type 1 diabetes. A cross-sectional DPV multicenter analysis of 24 928 German children and adolescents.Experimental and Clinical Endocrinology and Diabetes,124(02), 111-119. Butwicka, A., Frisn, L., Almqvist, C., Zethelius, B., and Lichtenstein, P. 2015. Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study.Diabetes care,38(3), 453-459. Dabelea, D., Mayer-Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., ... and Liese, A. D. 2014. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009.Jama,311(17), 1778-1786. Haller, M. J., Gitelman, S. E., Gottlieb, P. A., Michels, A. W., Rosenthal, S. M., Shuster, J. J., ... and Mathews, C. E. 2015. Anti-thymocyte globulin/G-CSF treatment preserves cell function in patients with established type 1 diabetes.The Journal of clinical investigation,125(1), 448-455. Karges, B., Rosenbauer, J., Kapellen, T., Wagner, V. M., Schober, E., Karges, W., and Holl, R. W. 2014. Hemoglobin A1c levels and risk of severe hypoglycemia in children and young adults with type 1 diabetes from Germany and Austria: a trend analysis in a cohort of 37,539 patients between 1995 and 2012.PLoS medicine,11(10), e1001742. McKnight, J. A., Wild, S. H., Lamb, M. J. E., Cooper, M. N., Jones, T. W., Davis, E. A., ... and Almdal, T. 2015. Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison.Diabetic Medicine,32(8), 1036-1050. Miller, K. M., Foster, N. C., Beck, R. W., Bergenstal, R. M., DuBose, S. N., DiMeglio, L. A., ... and Tamborlane, W. V. 2015. Current state of type 1 diabetes treatment in the US: updated data from the T1D Exchange clinic registry.Diabetes care,38(6), 971-978. Nasr, M. B., DAddio, F., Usuelli, V., Tezza, S., Abdi, R., and Fiorina, P. 2015. The rise, fall, and resurgence of immunotherapy in type 1 diabetes.Pharmacological research,98, 31-38. Nimri, R., Muller, I., Atlas, E., Miller, S., Fogel, A., Bratina, N., ... and Phillip, M. 2014. MD-Logic overnight control for 6 weeks of home use in patients with type 1 diabetes: randomized crossover trial.Diabetes Care,37(11), 3025-3032. Patterson, C., Guariguata, L., Dahlquist, G., Soltsz, G., Ogle, G., and Silink, M. 2014. Diabetes in the younga global view and worldwide estimates of numbers of children with type 1 diabetes.Diabetes research and clinical practice,103(2), 161-175. Russell, S. J., Hillard, M. A., Balliro, C., Magyar, K. L., Selagamsetty, R., Sinha, M., ... and Damiano, E. R. 2016. Day and night glycaemic control with a bionic pancreas versus conventional insulin pump therapy in preadolescent children with type 1 diabetes: a randomised crossover trial.The Lancet Diabetes and Endocrinology,4(3), 233-243. Sherr, J. L., Hermann, J. M., Campbell, F., Foster, N. C., Hofer, S. E., Allgrove, J., ... and Holl, R. W. 2016. Use of insulin pump therapy in children and adolescents with type 1 diabetes and its impact on metabolic control: comparison of results from three large, transatlantic paediatric registries.Diabetologia,59(1), 87-91. Silverstein, J., Cheng, P., Ruedy, K. J., Kollman, C., Beck, R. W., Klingensmith, G. J., ... and Cengiz, E. 2015. Depressive symptoms in youth with type 1 or type 2 diabetes: results of the pediatric diabetes consortium screening assessment of depression in diabetes study.Diabetes care,38(12), 2341-2343. Tauschmann, M., Allen, J. M., Wilinska, M. E., Thabit, H., Stewart, Z., Cheng, P., ... and Hovorka, R. 2016. Day-and-night hybrid closed-loop insulin delivery in adolescents with type 1 diabetes: a free-living, randomized clinical trial.Diabetes Care,39(7), 1168-1174. Willi, S. M., Miller, K. M., DiMeglio, L. A., Klingensmith, G. J., Simmons, J. H., Tamborlane, W. V., ... and Lipman, T. H. 2015. Racial-ethnic disparities in management and outcomes among children with type 1 diabetes.Pediatrics, peds-2014.