HEALTH ALTERATION: A CASE STUDY OF GESTATIONAL DIABETES

Health Alterations

Based on the ABCDE framework, the priority problems for Ms Cho Chang is breathing and circulation. Notably, the respiratory rate of 20 breaths per minute is on the maximum for normal respiratory range, hence the depreciating oxygen concentration at 96% is an indication of a disturbance in the gaseous exchange processes. On the other hand, the heart rate of 95 beats per minute indicates tachycardia.

Diabetes refers to a group of chronic metabolic disorders characterized by impaired production or utilization of insulin, which leads to high blood glucose levels (American Diabetes Association 2017, p. S114). In pregnancy, diabetes is generally classified as pre-gestational and gestational diabetes.

Pharmacologic Interventions The initial intervention in this scenario should aim to correct the hyperglycemia and attendant complications. According to Poomalar (2015), the pharmacologic choices used during pregnancy used to achieve glycemic control and restore euglycemia are insulin and its analogues, as well as selected oral antihyperglycemic drugs such as metformin and glyburide

Non-Pharmacologic Interventions The effectiveness of management using insulin depends on supportive non-pharmacologic approaches. These include the provision of the necessary nutrients, to sustain a normalized blood glucose level, prevent recurrence of ketoacidosis, and support appropriate weight gain

Diabetes care and discharge planning should integrate the complex interplay of educational, social, physical, external systems, and psychological aspects in the management of diabetes (Berry, Johnson, Q.B & Stuebe 2015, p.91). The discharge planning should begin within a day of admission and involves collecting information about knowledge on diabetes, self-management skills, and the expected change in functionality.

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