Abrina, Mary Antonette

Andal, Alexandra Marie

Bacani, Baby Jane
Bayhon, Francis Michelle
Buendicho, Zena Joyce
Lim, Ian Maverick
Osalla, Jemina Guenevere
Sebello, Marie Adelle
 Melvin, a 32-year-old, always complains of his increasing
need for water. He also feels an increasing need to urinate every
now and then, and always feels hungry. There is tingling on his
extremities and numbness. His once clear vision is now
experiencing cloudiness. He already feels tired just a few hours
after waking up even though he does not have any job and only
stays at home. The wound on his right knee has been there for
weeks but no improvement is seen. His post meal blood sugar
level is 252 mg/dl.
 What possible type of diabetes does Melvin has and
what are his signs and symptoms?

Melvin presented with signs and symptoms associated

with diabetes mellitus. Taking his age, 32 years old, into
consideration, we were able to deduce that he probably has
type 2 DM. This is a chronic condition used to be known as
adult- onset diabetes because it is the type often diagnosed
to adults. However, it is recommended to obtain more data
from the patient to explore the pathophysiology of his disease
further, as it is also possible for an adult to have type 1
diabetes known as Latent Autoimmune Diabetes in Adults
(LADA).
 What possible type of diabetes does Melvin has and
what are his signs and symptoms?

Signs and symptoms of type 2 DM develop slowly and

could be felt for years before diagnosis. In Melvin’s case,
together with the obtained increased post meal blood sugar,
he is experiencing classic symptoms such as fatigue and the
3 P’s namely polydipsia, polyuria, and polyphagia.
Additionally, he reported diabetes complications which
include tingling and numbness on extremities that suggests
nerve damage, cloudy vision indicating retina damage, and
unimproved wound on his right knee thus indicating poor
circulation.
 Based on Melvin’s Blood Sugar Value,
what classification or level is his diabetes?

The patient's condition would be classified as type 2 diabetes

based on his blood sugar level (previously referred to as non-insulin- 252
dependent diabetes mellitus). Type 2 diabetes is most frequent in
obese persons over the age of 30, while it is becoming more common
in younger adults (CDC, Diabetes Surveillance, 2002). 
Approximately 90% to 95% of patients with diabetes have type 2
diabetes (CDC, Data Factsheet, 2002), which is caused by reduced
insulin sensitivity (insulin resistance) and impaired beta cell activity,
resulting in decreased insulin production (Quinn, 2001a). 
Type 2 diabetes is discovered by chance in the majority of cases
(about 75%). (eg, when routine laboratory tests or ophthalmoscopic
examinations are performed). One consequence of undiagnosed
diabetes is that long-term diabetic consequences (for example, eye
illness, peripheral neuropathy, and peripheral vascular disease) may
have occurred prior to the actual diagnosis of diabetes (ADA, Expert
Committee on the Diagnosis and Classification of Diabetes Mellitus,
2003).
 Create a comprehensive NCP based on Melvin’s condition.
Assessment Diagnosis Planning Interventions Evaluation
Subjective: Impaired skin integrity Short Term: Independent: Short Term:
N/A related to decreased After 30 minutes of Inspect skin on a daily After 30 minutes of
circulation, alteration in nursing interventions, the basis, describing wound or nursing interventions, the
Objective: metabolism, and patient will participate in lesion characteristics and patient was able to
changes observed. To
- wound on his right knee alteration in sensation prevention measures and participate in prevention
provide comparative
has been there for weeks (resulting from diabetes treatment programs and baseline and opportunity for measures and treatment
but no improvement is mellitus) as evidenced by the patient’s wound will timely interventions thus programs and the
seen a wound on the right be cleaned reducing likelihood of patient’s wound was
- tingling on  his  knee that has no progression of skin cleaned
extremities  and  improvement, and Long Term:  breakdown.
numbness tingling and numbness After 2-5 days of nursing Long Term:
on extremities. interventions the patient Keep the wound area clean After 5 days of nursing
will display progressive and dry To reduce risk of interventions the patient
improvement in wound dermal trauma, improve displayed progressive
healing. circulation, and promote improvement in wound
comfort 
healing.
Apply appropriate dressing
to protect the wound and/or
surrounding tissues
GOAL MET!
Reposition client on regular
schedule. To reduce stress
on pressure points and to
promote circulation to
tissues
Assessment Diagnosis Planning Interventions Evaluation
Avoid or limit use of plastic
material. Remove wet and
wrinkled linens promptly.
Moisture potentiates skin
breakdown

Educate the patient and

significant others about
proper skin care. Educating
patients and significant
others about methods to
maintain skin integrity
enhances their sense of
self- efficacy and prevents
skin breakdown.

Assist the client/SO(s) in

understanding and following
medical regimen and
developing a program of
preventive care and daily
maintenance. To enhance
commitment to plan,
optimizing outcomes. 
Assessment Diagnosis Planning Interventions Evaluation
Collaborative:
Collaborate with dietitian as
appropriate. The dietician
can help the patient in food
preferences to meet
adequate nutritional and
hydration goals.

Collaborate with other

healthcare providers
(physician, infection or
wound specialist. To assist
with developing plan of care
for problematic or potentially
serious wounds.
 https://www.health.harvard.edu/a_to_z/type-2-diabetes-mellitus-a-to-z
https://www.webmd.com/diabetes/blood-sugar-complications
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-
20351193#:~:text=Overview,circulatory%2C%20nervous%20and%20immune%20systems.
Cnrn, R. P. J. H. L., PhD Rn, K. C. H., & Overbaugh, K. (2021). Brunner & Suddarth’s Textbook of
Medical-Surgical Nursing (Brunner and Suddarth’s Textbook of Medical-Surgical) (Fifteenth, North
American ed.). LWW.

References