223 Nursing Assessment, Management and Treatment of Autoimmune Diseases
● Insulin pump : About the size of a small cell phone, insulin pumps provide a basal dose of short or rapid- acting insulin per hour. When blood sugar is high, the patient calculates the dose and the insulin in the pump delivers the bolus. system that requires minimal patient intervention. It is a combination of the technology of a pump with that of a continuous glucose monitor. ● Inhaled insulin : Inhaled insulin is taken by using an oral inhaler to deliver ultra-rapid-acting insulin at the start of meals. Inhaled insulin is used in conjunction with an injectable long- acting insulin. ● Artificial pancreas : The artificial pancreas is a hybrid closed-loop Additional treatment interventions in- clude having personalized meal plans designed to meet nutritional needs, con- trol blood glucose levels, and help pa- tients maintain ideal body weight. With the guidance of healthcare providers, patients should participate in regular ex- ercise. Patients should be cautioned that physical activity lowers blood glucose levels. Thus, blood glucose levels should be monitored frequently. Patients may need to adjust their meal plans or insu- lin to compensate for increased physical activity (Mayo Clinic, 2021c; Rebar et al., 2019). Nursing interventions Nursing interventions focus on edu- cation and emotional support. Patients and families need education pertaining to meal planning, exercise, and insulin administration. Emotional support is also critical to the success of any treatment regimen (Rebar et al., 2019). Patients and families also need infor- mation about potential complications,
how to recognize them, and what to do if they occur. It is recommended that fam- ilies pay special attention to the issue of complications. Teachers should be in- formed that a child is diabetic and they must be aware of emergency procedures. In some cases, patients experiencing complications (such as DKA) may not be able to articulate the need for help or de- scribe their symptoms at the time. It is, therefore, absolutely essential that fami- ly members and other caretakers be able to intervene correctly in the event that complications occur (Rebar et al., 2019). DKA is a medical emergency and must be treated immediately. Systemic lupus erythematosus Systemic lupus erythematosus (common- ly referred to as lupus) is a chronic, inflam - matory, autoimmune disorder that affects the connective tissues (Rebar et al., 2019). The determination of incidence and prev- alence of lupus is a challenge. There are several issues that make it difficult to collect accurate data. These include the following (Lupus Foundation of America, 2020; National Resource Center on Lu- pus, 2021): ● Difficulty in deciding what constitutes a case of lupus. There are multiple types of lupus and they have overlapping signs and symptoms. ● There is no specific test for the diagnosis of lupus. An estimated 40% of people with lupus report that their healthcare providers initially said that they had some disorder other than lupus. ● Twenty-three percent of patients were told that their problems were psychological, not physical. ● No two cases of lupus are the same, which makes it difficult to recognize and diagnosis the disease.
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