Grand Canyon University W 5 Evidence Based Practice Diabetes Presentation hey I am in charge of putting together a group project power point that I need ba

Grand Canyon University W 5 Evidence Based Practice Diabetes Presentation hey I am in charge of putting together a group project power point that I need back to me no later than 7 pm eastern standard time on Sunday so that I can submit it to the group for their review before I turn it in. I have all of their data for you to look at that they were responsible for collecting. Some of them put their responses to the question they chose to answer in power point form, but I would just use the data and make a new organized power point so it all looks uniform. This is the last project for this class and I hate group projects. I am then off for 2 weeks. Forum for CLC – Evidence-Based Practice Project: Intervention Presentation on Diabetes



Empagliflozin (Jardiance) is an SGLT-2 inhibitor
o
SGLT-2 inhibitors block glucose reabsorption in the kidney
o
Cause glucose excretion resulting in diuretic effect
o
Taken orally once daily with or without food
o
Dosage is 10-25 mg
o
Patients must have a GFR of at least 45 to use
o
Minimal risk for causing hypoglycemia
o
First drug approved by FDA to reduce risk of cardiovascular death in adults with Type II DM
Target patient population has both Type II DM and CVD, HF or CV risk
o
CV death is 70% higher in diabetic patients than non-diabetic patients
o
Presence of both DM and CVD increases the risk of death
Research Findings
o
7020 patients treated over average of 3.1 years
o
Patients with DM at high risk for CV events had lower rate of death
o
38% risk reduction in death from CV causes
o
35% risk reduction in hospitalization for HF
o
32% risk reduction in death from any cause
Hey everyone! Katlyn, thanks for noticing we need a research article! I had not caught that. One of my besties is a
primary care pharmacist. I asked what she thought and she had a couple of suggestions:
1. Metformin-it is the oldest oral DM medication, but still the best. The goal with it is to prevent DM and
preserve pancreatic function. We would need to pick a patient population though. Here is an article on preDM and metformin for prevention:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498279/ We would need another article or some evidence in
particular population.
1.
Jardiance- this med has changed our policy at the VA. It is found to help patients that have DM and CVD or
heart failure. It is considered ground breaking for treatment in patients who have both. So, I think if we use
this the patient population might be patients who have both? Not sure. Here is some info on it. A study and
supporting articles:
https://www.nejm.org/doi/full/10.1056/NEJMoa1504720
https://www.acc.org/latest-in-cardiology/clinical-trials/2015/09/17/10/11/empa-reg-outcome
https://www.ajmc.com/newsroom/jardiance-gets-cv-indication-for-adults-with-type-2-diabetes
1. Children who are type 1-there is only 1 treatment for this: insulin. I did not look for articles on this.
****** The above websites go along with the above bullet points submitted by one student *****
This is a Collaborative Learning Community (CLC) assignment.
As a group, identify a research or evidence-based article published within the last 5 years that focuses
comprehensively on a specific intervention or new treatment tool for the management of diabetes in adults or
children. The article must be relevant to nursing practice.
Create a 10-15 slide PowerPoint presentation on the study’s findings and how they can be used by nurses as an
intervention. Include speaker notes for each slide and additional slides for the title page and references.
Include the following:
1. Describe the intervention or treatment tool and the specific patient population used in the study.
2.
Summarize the main idea of the research findings for a specific patient population. The research presented
must include clinical findings that are current, thorough, and relevant to diabetes and nursing practice.
3.
Provide a descriptive and reflective discussion of how the new tool or intervention can be integrated into
nursing practice. Provide evidence to support your discussion.
4.
Explain why psychological, cultural, and spiritual aspects are important to consider for a patient who has been
diagnosed with diabetes. Describe how support can be offered in these respective areas as part of a plan of
care for the patient. Provide examples.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published
within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
While APA style is not required for the body of this assignment, solid academic writing is expected, and
documentation of sources should be presented using APA formatting guidelines, which can be found in the APA
Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with
the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for
assistance.
Psychological, cultural, and spiritual aspects
PSYCHOLOGICAL FACTORS IN DIABETES
Emotional distress in Diabetes
Emotional reaction
Diabetes Distress





• Overwhelmed for
self management
• Frustrated
• Difficulty in
communication
• Distress on
differential food
in the family
Shock
Denial
Anger
Guilt
Anxiety
Phobia Reactions





Fear of
Starting on
insulin
Needles
Hypoglycemia
Late
Complications
Obsessive
behavior
• Poor glycemic control
• Self-care behavior and treatment adherence
• Reduced quality of life
• Increased diabetes related complication
Psychiatric disorder




Depression
Anxiety
Delirium
Eating disorder
• Diabetes is a lifelong metabolic condition that effects individuals coping with it,
including physical, social and emotional well-being.
• Psychosocial issues which are more prevalent in patients with diabetes can have a
significant detrimental effect on the well-being and social life of patients if left
unaddressed.
• Nurses can simply acknowledge an individual’s emotional needs, refer them for
counseling, etc.
• In the US and in other nations across the globe, type 2 diabetes impacts racial /
ethnic minorities at an unprecedented pace.
• Racial / ethnic minorities typically have higher Type 2 diabetes prevalence levels
and all of the symptoms relative to mainstream groups.
• Cultural barriers include: lack of knowledge, fear and distrust, stereotyping,
assumed similarity, nonverbal communication, authority, physical touch/contact,
verbal languages and styles.
• Nurses can break the barriers by patient education
• Spirituality is often seen as a coping strategy. Spirituality is an
important part of a person’s well-being, which must be integrated
according to individual needs.
• In Western and Asian countries spirituality is used together with food,
exercise and medicine.
• Religious practice are important while considering diabetes
management, as we need to consider the medical safety of the
individual.
Reference
Kalra, S., Jena, B. N., & Yeravdekar, R. (2018). Emotional and Psychological Needs of
People with Diabetes. Indian journal of endocrinology and metabolism, 22(5), 696–704.
https://doi.org/10.4103/ijem.IJEM_579_17. Retrieved form
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166557/
Sridhar, G.R. Diabetes, religion and spirituality. Int J Diabetes Dev Ctries 33, 5–7 (2013).
https://doi.org/10.1007/s13410-012-0097-8. Retrieved from
https://link.springer.com/article/10.1007/s13410-012-0097-8#citeas
1.
Provide a descriptive and reflective discussion of how the new
tool or intervention can be integrated into nursing practice.
Provide evidence to support your discussion.
Katlyn Svor
Impact on Nursing Practice
Jardiance (empagliflozin) is a relatively safe drug for type II diabetics to take who also have cardiovascular disease, but
there are some precautions that nurses need to be aware of when administering this drug to their patient.
-Check blood sugars routinely to check for hypoglycemia
Jardiance is antidiabetic drug and therefore decreases blood glucose levels excreting through the urine and feces and it
has a half life of 12.4 hours (Jardiance (empagliflozin) dosing, indications, interactions, adverse effects, and more, 2020)
Blood sugars and patient assessment should be done routinely while starting this drug to ensure hypoglycemia does
not occur. Nurses should also educate patients on signs and symptoms of hypoglycemia.
Impact on Nursing Practice
Jardiance is excreted in the urine so it causes an increased risk of genital infection, increased risk of
Urinary Tract Infection (UTI), caution with uncircumcised males.
Jardiance is excretes glucose through urine so genital infection has been seen as more common side effect of the
drug. A recent study involving a randomized controlled trial showed there was an increased risk of genital infection
occurring, however the risk of UTI still remains uncertain (Liu, Li, Li, Jia, Deng, Chen & Sun, 2017).
Teaching should be given on proper peri-care, adequate hygiene and adequate cleaning in uncircumcised males as
they are at a more increased risk of developing infection than their circumsized counterparts.
Impact on Nursing Practice
Risk of hypotension, encourage adequate fluid intake, check basic metabolic profile (BMP) before and
after initial dose. Also Stop taking before scheduled surgery.
While an SGLT2 Inhibitor is not a diuretic, it can behave like one at times. It is important to encourage adequate fluid intake so
hypotension does not occur and vital signs should be monitored when initiating doses, and be sure to be with them when they
get up to prevent falls related to orthostatic hypotension, and encourage patients to get up “slowly” to prevent syncope.
A BMP should ideally be taken before and after beginning Jardiance to monitor for low glucose and potassium levels as well as
Creatine and GFR. Patients with high creatinine and low GFR should not be taking Jardiance as it could cause further kidney
damage.
Per recommendation from the FDA patients should stop taking Jardiance 3-4 days before surgery to prevent the risk of diabetic
ketoacidosis (Healio, 2020).
References
Healio. (2020, March 17). FDA: Suspend SGLT2 inhibitors before surgery. Retrieved April 16, 2020, from
https://www.healio.com/endocrinology/diabetes/news/online/{b723bc2f-2dfd-4ae0-b159-a5872ff4979d}/fda-suspendsglt2-inhibitors-before-surgery
Jardiance (empagliflozin) dosing, indications, interactions, adverse effects, and more. (2020, March 18). Retrieved
April 16, 2020, from https://reference.medscape.com/drug/jardiance-empagliflozin-999907#10
Liu, J., Li, L., Li, S., Jia, P., Deng, K., Chen, W., & Sun, X. (2017). Effects of SGLT2 inhibitors on UTIs and genital
infections in type 2 diabetes mellitus: a systematic review and meta-analysis. Scientific Reports, 7(1). doi:
10.1038/s41598-017-02733-w

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