Initial Discussion Post:
Base your initial post on the scenario listed below, your readings and research on this topic.
The registered nurse is caring for a 15-year-old patient who was just diagnosed with
Type 1 Diabetes Mellitus. The patient reported that he plays for his high-school soccer
team and “passed out” during a game. As the RN begins to teach the patient about self-
monitoring of blood glucose, dietary considerations and insulin injections, the patient
states, I am not going to do this, stick myself with needles every day for the rest of my life.
Can’t you just give me pills? The patient also expresses concern about his status with the
team now that he is sickly.
After reflecting on the above scenario, discuss the following points
Discuss an approach the RN can take to assist this patient to cope with this new diagnosis
that will result in understanding of the disease and compliance with treatment.
What factors would the RN need to consider?
Discuss which steps of the teaching-learning process were likely not employed.
How might it have been approached differently?
Being newly diagnosed with diabetes can be overwhelming and confusing due to the
several things that a patient needs to learn and understand. However, for millions of diabetic
patients learning about their diabetes is the first step towards living a longer and healthier life.
According to Shaw (2014), Registered Nurses (RNs) play an important role of educating
individuals that have just been diagnosed with diabetes encouraging them that they can live
longer if they follow important guidelines for managing diabetes. First, the RN should let the
patient understand what type 1 diabetes is and how its symptoms present by highlighting the
classic symptoms associated with diabetes such as excessive thirst and hunger, fatigue,
unexplained weight loss, nausea, and vomiting. She should encourage the patient that he is not
the only one suffering from type I diabetes.
Most youth with type 1 diabetes do not adhere to clinical guidelines (Wood et al, 2013).
Therefore, the nurse can use examples of patients of almost similar age to the patient and are
coping well with diabetes. The nurses should also explain to the patient that insulin injections are
the central treatment for type I diabetes and for the patient to lead a quality life she should adhere
to her medication.
For proper management of type I diabetes, some of the factors that the RN should focus
on mainly includes control of blood glucose, insulin management, nutrition, exercise, and
support (Atkinson, Eisenbarth & Michels, 2014). The nurse should advise the patient to measure
his blood glucose levels regularly and administer insulin appropriately. Exercise on the other
hand is a significant component of proper care for type I diabetes as it aids the body to respond
with more stable levels of blood glucose (Haas et al., 2013). However, patients should be
cautioned against extreme exercise which lowers their glucose levels considerably. Additionally,
the nurse should aid the patient understand how various foods affect blood glucose and enlighten
them on how to come up with solid meal plans (Chiang et al., 2014). She should also encourage
the patient to seek help from other people with the same condition and be free to visit the
medical center in case of any clarification.
The steps of the teaching learning process that were most likely not well employed are
the implementation and the evaluation steps. In the implementation step, the nurse should have
delivered content in a manner that is more organized with the aid of planned teaching strategies.
The evaluation step could be improved if the nurse questioned the patient on some aspects such
as why insulin is important in management of type I diabetes and more so the rationale of giving
it as an injection instead of pills.
Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014). Type 1 diabetes. The
Lancet, 383(9911), 69-82.
Chiang, J. L., Kirkman, M. S., Laffel, L. M., & Peters, A. L. (2014). Type 1 diabetes through the
life span: A position statement of the American Diabetes Association. Diabetes
Care, 37(7), 2034-2054.
Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., … & McLaughlin, S.
(2013). National standards for diabetes self-management education and support. Diabetes
care, 36(Supplement 1), S100-S108.
Shaw, R. J., McDuffie, J. R., Hendrix, C. C., Edie, A., Lindsey-Davis, L., Nagi, A., … &
Williams, J. W. (2014). Effects of nurse-managed protocols in the outpatient
management of adults with chronic conditions: a systematic review and meta-
analysis. Annals of internal medicine, 161(2), 113-121.
Wood, J. R., Miller, K. M., Maahs, D. M., Beck, R. W., DiMeglio, L. A., Libman, I. M., … &
T1D Exchange Clinic Network. (2013). Most youth with type 1 diabetes in the T1D
Exchange Clinic Registry do not meet American Diabetes Association or International
Society for Pediatric and Adolescent Diabetes clinical guidelines. Diabetes care, 36(7),