Insight into Diabetes

Diabetes simply means having high levels of glucose (sugar) in your blood. It is a health condition which is caused by poor or no ability of the body to break down glucose which we consume on daily basis. According to diabetes.org.uk there are 3.3 million in the UK diagnosed with Diabetes and an extra 590,000 who have the condition, but don’t know it. On a worldwide scale 9% of the population (estimated at 347 million people) aged 18+ have the condition (WHO, 2015).

Type 1 diabetes is when your body does not produce any insulin, the hormone which breaks down sugar in our body. Usually, people diagnosed with type 1 were either born that way or have been diagnosed in their childhood or early adulthood with it. People with type 1 diabetes are dependent on insulin and need insulin injections/pump to regulate their sugar levels within a healthy range.

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Type 2 diabetes is a progressive condition when the body produces insulin, however, cannot use it efficiently. It, usually, occurs in adults above the age of 40 and is linked to obesity, lack of exercise, and an unhealthy diet. If not managed adequately diabetes can lead to slower wound healing, leg ulcers, visual impairment including blindness, kidney failure, and cardiovascular problems.

Gestational diabetes occurs in some women during pregnancy. Even though their body produces insulin it is not enough to break down all the sugar consumed. This type of diabetes ends after the baby is born, however, it is a sign that there is a higher risk for these women to develop diabetes Type 2 later on in life.

Prevention and management of diabetes type 2 includes a healthy diet, healthy weight, lots of exercise and monitoring your sugar levels. Sometimes, medications and insulin injections might be necessary.

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Useful links:
https://www.diabetes.org.uk/
http://www.who.int/mediacentre/factsheets/fs312/en/
http://www.nhs.uk/Conditions/Diabetes/Pages/Diabetes.aspx

Discover UEA!

Today there was an Open Day at UEA! Classmates from my course and me worked as Student Guides and were answering various questions about Health Sciences and Nursing in particular. I think it’s such a great opportunity for prospect students to explore UEA and gain an insight of what it is like being a student here. In relation to Nursing, people were mostly interested in what placement feels like, travelling to placement, accommodation, Student Finance, NHS Student Bursaries, and student life in Norwich.WP_20150620_008

Usually, people who would like to visit on an Open Day need to book a place in advance through the UEA website. Upcoming dates for an Open Day are: 4th July 2015, 12th September 2015 and 24th October 2015.

WP_20150620_003An open day might look something similar to this video posted by UEA on their YouTube page. Have a look here.

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Nursing students are located at the Edith Cavell building which is about 15~20min walk from the centre of campus but there is,usually, a free bus on Open Days for visitors. At Edith Cavell Building there were different talks about the different courses and what the university has on offer, including Nursing Sciences (Adult, Child, Mental Health and Learning Disabilities), Midwifery, Operating Department Practice, and Paramedic Sciences.

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In addition, Health Sciences includes courses in Physiotherapy, Speech and Language Therapy and Occupational Therapy which are located at the Queen’s Building on Main Campus.

WP_20150620_001Lastly, but not least, Medicine is also a great course available at UEA. Medical students are located at the Norwich Medical School (Medical Building) on main campus.

To sum up, I would strongly recommend booking your place for an Open Day and discover what UEA has on offer for you! Everyone is really friendly and helpful, and student guides including me received very positive feedback from visitors at the end of the day.

PREPARATION FOR THE OSCE: PHYSIOLOGICAL MEASUREMENTS

When you are doing the physiological measurements staition on your OSCE remember to firstly, introduce yourself and identify the patient (eg. name & date of birth). Secondly, explain the procedure and establish a valid consent. Thirdly, carry out procedure and follow infection prevention and control policies (eg. hand-washing).

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source: https://www.spservices.co.uk/item/Brand_BraunThermoScanPro4000TympanicThermometer_48_0_4807_1.html

—Normal range is between 36.0 and 37.5 degrees C. Temperature can be measured tympanically, orally, axillary or rectally. High temperature can be a sign of infection, arthritis, heat stroke, etc. Some useful terminology: —Hypothermia – a reduced body temperature of 35 degrees or less —Pyrexia – a raised temperature. —The three grades of pyrexia are Low (normal temperature to 38 degrees), Moderate/high (38 to 40 degrees) and hyperpyrexia (40 degrees and over). —Rigor – shaking or exaggerated shivering that occurs with a raised temperature.—

PULSE (rate, rhythm & amplitude) X2604-P-57

source: http://img.tfd.com/mk/P/X2604-P-57.png

Normal pulse rate is between 55 ~ 100 beats per minute in people above the age of 10. In children and babies pulse is faster. Various factors can affect pulse rate including: fever, heart problems, infection, pyrexia, hypovolaemia, levels of fitness, anxiety, shock and medications. Useful terminology: —Tachycardia – resting pulse of >100 bpm (beats per minute) in adults. —Bradycardia – pulse of <60 bpm.

RESPIRATION (depth, pattern & sounds) Normal breathing rate is between 12 ~ 20 breaths per minute. Factors affecting the breathing rate include: anaemia, pneumonia,asthma, —COPD, severe bleeding, stress/anxiety, medications etc. Some useful terminology: —Bradypneoa   slower than the normal   (Tachypnoea  – faster than normal  (>20 resps per   minute) —Dyspnoea  breathing is difficult [conscious patient] —Orthopnoea – dyspnoea occurring when the patient   lies flat —Apnoea – temporary cessation of breathing

BLOOD PRESSURE (BP) (systolic & diastolic) blood-pressure-2source: http://www.fit8.co.uk/wp-content/uploads/2013/11/blood-pressure-2.jpg

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source: http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressurechart

Above is a chart explaining the ranges of BP in adults. —Hypertension – BP greater than 140/90mmHg. —Causes include obesity, chronic kidney disease, high alcohol intake, smoking, adrenal/thyroid disorders. —Hypotension – low BP (systolic below 100 mmHg). Causes include pregnancy, dehydration, underactive thyroid, heart failure, blood loss, anaphylaxis

Lastly, record results and take any necessary action.Capture

PREPARATION FOR THE OSCE: ‘ABCDE’ ASSESSMENT

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In my previous post I wrote about safe administration of drugs. Today, I’ll write about the ABCDE clinical assessment that is used in emergency situations. 

Before you rush to help the patient always check if it’s safe and there is no danger for your own safety, such as vehicles if on the road, slippery floor, etc. Here we go:

Airway – is the airway open? are there any obstructions/vomit/blood? proceed with the ‘head-tilt, chin-lift’ if no risk of neck trauma or ‘jaw trust’ if neck trauma is suspected, in order to see if the patient is breathing. CALL FOR HELP; within 10 seconds you have to assesses if there is breathing or not, and if not proceed with CPR algorithm, however, if there is breathing proceed with the ABCDE assessment.

Breathing – look if the chest is raising, listen (for breathing sounds, wheezing, stridor etc.) and feel (place your hands on the chest if necessary to feel if the chest if raising evenly on both sides, is the breathing abnormal, for example, shallow or rapid, is the patient using accessory muscles?) Count the respirations for 1 minute, check the oxygen saturation in the blood (SO2) and administer oxygen if necessary

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Circulation – check the pulse for 1 min and feel if it’s regular and strong or abnormal, use ECG machine if available to check the sinus rhythm, check the capillary refill (apply pressure on one of the finger nails for 5 sec and see if there is refill within 2 sec), check the colour & temperature of the skin (pale, rashes, does it feel hot/cold etc.), check the body temperature with a thermometer, check the blood pressure, check the urine output if possible and look for signs of haemorrhage.

Disability – check the AVPU score (alert/voice/pain/unconscious), , check the blood sugar levels, check the pupils with a light torch and if they react to light, are they even, do a head to toe assessment, try to gather some past medical history regarding medications, allergies, chronic conditions, (eg. asthma, diabetes, heart problems, etc.), pain they might be feeling

Environment/Exposure –  protect the patient’s dignity and avoid exposing them, prevent body heat loss by placing a blanket on the patient, put them in the recovery position if the patient is unconscious but is breathing, continue checking the vital signs until help arrives. Ask the patient if you’d like to contact their family or friend.

For more info click here: https://www.resus.org.uk/resuscitation-guidelines/a-systematic-approach-to-the-acutely-ill-patient-abcde/