Proceso de atención de enfermería en paciente con complicaciones de diabetes mellitus tipo 2

Abstract

According to the OMS, in the year of 2015 diabetes mellitus caused the death of 1.6 million people, and in fact it is expected that the morbidity rate will increase to approximately 600 million by the year 2035. Diabetes mellitus is a chronic disease degenerative that occurs when there is an imbalance in the production of insulin, which is mainly characterized by high blood glucose concentrations and that is related to predisposing factors and environmental factors that can aggravate the clinical picture. In addition, the risk that some of your extremities (upper and / or lower) is 40 times higher in a patient with diabetes, 25 times higher is the risk of developing chronic renal failure, 20 times greater is the risk for the person to develop blindness, 2 to 5 times the risk of acquiring a stroke, and finally 2 to 3 times the risk for an acute myocardial accident. The present case deals with an 80-year-old patient who comes to the Teófilo Dávila Hospital in the city of Machala on 20-09-18, presenting necrotic tissue on the right toe that extends into the second, third and plantar region of said foot by which goes to this house of health and its entrance is decided. On 26-09-18 he underwent amputation of his right lower limb, received his first dialysis session on 01-10-18 without incident, on 08-10-18 he presented a tonic-clonic seizure of 30 seconds with Glasgow scale of 14/15, tachycardia and communicated to doctor, who decides to suspend dialysis, and a hemathemesis of 20cc, on October 16, 18-18, has an infectious urinary focus (leukocytosis) and on 19-10-18 is discharged, with a hospital stay of 29 days. The general objective was to analyze the case of a patient with diabetic foot treated at the Hospital Teófilo Dávila, by reviewing the clinical history and the search of bibliographic reference to design nursing care plans based on the Theory of self-care deficit established by Dorothea Orem. The present study is descriptive-qualitative. A bibliographic search was carried out in Pub Med, Scielo, Redalyc, Finlay, Medigraphic, Elsevier, among others. Obtaining as results the following complications: Arterial Hypertension, Chronic Renal Insufficiency, Diabetic Foot that culminated with the supracondylar amputation of the lower right limb. The conclusions of this analysis of the case of amputation of the diabetic foot required a comprehensive intervention. The main determining factor of the patient's complication was the time of evolution of Diabetes Mellitus, the theory of self-care established by Dorothea Orem in patients with diabetic foot is essential to guarantee quality care, besides promoting its autonomy in carrying out activities Although in this case the nursing system used was totally compensatory due to the amputation of its affected member, the nursing care process at the hospital level has deficiencies in compliance, because it is evidenced in the nursing reports.