Question

Describe the pathophysiology of diabetes mellitus including alterations in metabolic pathways and changes to basement membranes. Corticosteroids have many adverse reactions. Prepare a list of adverse reactions. For each adverse reaction, determine nursing assessments or nursing measures essential to monitoring the adverse reaction or to treating the adverse reaction. What is the rationale for each assessment or nursing measure?

Answer 1

pathophysiology of diabetes mellitus

• in the kidneys, thickening of the glomeruli capillary basement membrane.
• ECM i.e. extracellular matrix around the mesangial cells becomes expanded.
• basement membrane that underlies PCT i.e. proximal convoluted tubule epithelium also undergoes thickening.

Adverse reactions of corticosteroids -

• corticosteroids cause retention of sodium salts and fluids in the body that results in weight gain and swelling of legs i.e. edema.
• corticosteroids can also cause high blood pressure problems.
• due to sodium salt retention, a reduction in the potassium level.
• ulcers in the stomach, glaucoma, and cataracts might happen due to corticosteroids.
• headache, muscle weakness, menstrual irregularities are some of the more common problems associated with corticosteroids.

some of the nursing assessments for monitoring the adverse reaction of corticosteroids are -

• for glaucoma and cataracts. teaching practices about the regular eye examination is very important.
• nursing assessments also include encouraging a well-balanced diet and with low calorie for hypertension and weight gaining problems.
• refer foods that are rich in potassium - such as raisins, bananas, etc.