Date of Learning: 10/05/2024
Time: 09:30 – 16:30
Title of learning activity: GI & Nervous system
Diary of Learning activity
Today’s class focused on the gastrointestinal (GI) system. Key concepts covered include the anatomy and physiology of the digestive tract, from the mouth to the anus, emphasizing the role of organs such as the stomach, small intestine, and large intestine in digestion and absorption of nutrients. Understanding the functions of accessory organs like the liver, pancreas, and gallbladder in digestion was also crucial. Anatomy and function of the stomach: Studied the structure of the stomach, including its mucosal layers and gastric glands responsible for secreting gastric juice containing hydrochloric acid and digestive enzymes. Small intestine absorption: Explored the mechanisms of absorption in the small intestine, focusing on villi and microvilli structures, and the role of enzymes and transporters in nutrient uptake.
In today’s session, we delved into the pathophysiology, clinical manifestations, and management of diabetes mellitus (DM), a metabolic disorder characterized by hyperglycaemia due to insulin deficiency, insulin resistance, or both. Types of DM: Differentiated between type 1, type 2, and gestational diabetes, understanding their distinct etiologist and risk factors. Insulin secretion and action: Reviewed the role of pancreatic beta cells in insulin secretion and the action of insulin on glucose uptake in peripheral tissues. We discussed acute complications such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS), as well as chronic complications like neuropathy, nephropathy, retinopathy, and cardiovascular disease. We explored pharmacological and non-pharmacological interventions for DM management, including insulin therapy, oral hypoglycaemic agents, lifestyle modifications, and patient education.
Today’s focus was on the acute complications of diabetes mellitus, specifically diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS). Both conditions result from severe hyperglycaemia but differ in their underlying pathophysiology and clinical presentation. Examined the pathogenesis of DKA, characterized by insulin deficiency leading to hyperglycaemia, ketosis, and metabolic acidosis. Explored the clinical features of DKA, including polyuria, polydipsia, Kussmaul breathing, and fruity breath Odor. We explored the pathophysiology of HHS, characterized by profound hyperglycaemia and hyperosmolarity in the absence of significant ketosis. Discussed the clinical manifestations of HHS, such as extreme dehydration, altered mental status, and neurologic symptoms. We reviewed the principles of managing DKA and HHS, emphasizing the importance of fluid resuscitation, insulin therapy, electrolyte replacement, and addressing underlying precipitating factors.
During the afternoon session we explored the nervous System and some of the complications of this system, such as Stroke, Brain Injury, and Seizures We reviewed the structure and function of the central nervous system (CNS) and peripheral nervous system (PNS), including the brain, spinal cord, and peripheral nerves. We explored the different types of stroke (ischemic and haemorrhagic), their etiology, risk factors, clinical manifestations, and management strategies, including thrombolytic therapy and rehabilitation. We discussed about the mechanisms of TBI, including closed head injury and penetrating trauma, and their associated complications such as intracranial haemorrhage, cerebral edema, and diffuse axonal injury. We also examined the pathophysiology of seizures, characterized by abnormal electrical activity in the brain, and the classification of seizures into focal and generalized types. Reviewed the management of seizures, including antiepileptic medications, lifestyle modifications, and seizure precautions.
KSBs addressed:
| K1 | Understand the code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC 2018), and how to fulfill all registration requirements |
| K2 | Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health |
| K3 | Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care |
| K12 | Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being |
| K13 | Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes |
| K14 | Understand the importance of health screening |
| K15 | Understand human development from conception to death, to enable delivery of person-centred safe and effective care |
| K16 | Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care |
| K17 | Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care |
| K27 | Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies |
| K28 | Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions |
| K29 | Understand the different ways by which medicines can be prescribed |
| K30 | Understand the principles of health and safety legislation and regulations and maintain safe work and care environments |
| K31 | Understand how inadequate staffing levels impact on the ability to provide safe care and escalate concerns appropriately |
| S1 | Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements |
| S2 | Keep complete, clear, accurate and timely records |
| S3 | Recognise and report any factors that may adversely impact safe and effective care provision |
| S4 | Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills |
| S5 | Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018) |
| S6 | Act as an ambassador for their profession and promote public confidence in health and care services |
| S7 | Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges |
| B1 | Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences |
| B2 | Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice |
| B3 | Be adaptable, reliable and consistent, show discretion, resilience and self-awareness |