Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to impaired insulin secretion, insulin action, or both. The pathophysiology of diabetes involves multiple factors that contribute to the development and progression of the disease. Firstly, in type 1 diabetes, an autoimmune process leads to the destruction of insulin-producing beta cells in the pancreas. This results in a deficiency of insulin and requires external insulin administration. On the other hand, type 2 diabetes is primarily characterized by insulin resistance, where the body’s cells become less responsive to insulin. Insulin is a hormone produced by the beta cells of the pancreas, and its main function is to regulate glucose metabolism. In diabetes, the lack of insulin or the body’s inability to use it effectively leads to hyperglycemia. Persistently high blood glucose levels can have detrimental effects on various organs and systems in the body. The effects of diabetes on the body are many. It can lead to macrovascular complications, such as cardiovascular disease, stroke, and peripheral vascular disease. Also, microvascular complications may arise, affecting small blood vessels in the eyes, kidneys, and nerves. Diabetes can also increase the risk of infections, slow wound healing, and cause diabetic neuropathy and nephropathy

1. Assessment: Gather relevant patient data, including physical, psychological, social, and cultural aspects. Perform a comprehensive health history and physical examination. Utilize assessment tools and techniques to collect objective and subjective data. Document and organize the collected data systematically.

2. Diagnosis: Analyze the assessment data to identify health problems, risks, or potential complications. Formulate nursing diagnoses based on the identified issues. Ensure that the diagnoses are accurate, concise, and specific.

Collaborate with other healthcare professionals when necessary. 3. Planning: Establish patient-centered goals and outcomes in collaboration with the patient.

Develop a nursing care plan that includes evidence-based interventions and strategies. Prioritize nursing actions based on the urgency and importance of each goal. Ensure that the care plan is feasible, realistic, and adaptable. 4. Implementation: Execute the planned nursing interventions effectively and efficiently.

Provide safe and compassionate care while considering the patient's preferences. Document the implementation process and any modifications made. Collaborate with the interdisciplinary healthcare team to deliver comprehensive care.

5. Evaluation: Assess the patient's response to the nursing interventions and the achievement of goals. Compare the actual outcomes with the expected outcomes. Modify the care plan if needed based on the evaluation findings. Document the evaluation results and communicate them to the healthcare team.

1. Hemostasis: This initial stage begins immediately after the injury occurs. Blood vessels constrict to reduce blood flow and prevent excessive bleeding. Platelets aggregate to form a temporary clot. The clotting process releases various growth factors and cytokines, initiating the subsequent stages of healing.

2. Inflammatory phase: This phase typically lasts for 2-3 days. Inflammation occurs as a response to tissue injury. Vasodilation and increased vascular permeability allow immune cells to migrate to the wound site. Neutrophils arrive first to eliminate debris and prevent infection. Macrophages then remove dead tissue and release additional growth factors to stimulate healing.

3. Proliferative phase: This phase generally occurs between days 3 and 20. New blood vessels form to supply oxygen and nutrients to the wound. Fibroblasts produce collagen, which provides structural support for wound healing. Epithelial cells migrate from the wound edges to resurface the wound. Granulation tissue forms, consisting of new blood vessels, fibroblasts, and extracellular matrix.

4. Maturation phase: This final phase can last for several months to years. Collagen fibers reorganize and remodel, increasing the wound's tensile strength. Scar tissue forms, but it may not possess the same strength and flexibility as the original tissue. The scar gradually becomes more refined and fades over time.

Grandiose delusions; the patient believes s/he is somebody great /important ,knowledgeable or powerful contrary to the social cultural ,religious background and experiences.

Delusion of guilty and worthlessness; the patient believes s/he is not worth to live even though there’s nothing to justify this belief.

Delusions of jealousy; the patient believes that spouse/partner is being unfaithful even when there is no evidence to suggest so.

Delusion of persecution: the patient believes they’re being deliberately wronged, conspired or harmed by another person or agency even when there’s no evidence to suggest so.

Religious delusions; the individual believes he or she has a special link with God that is out keeping with people of the same religious belief.

Delusions of control, influence or phenomenon; these are three types; belief that the person performs activities as a result of an extreme force.

- Hypertension: increases strain on heart.
- Smoking: damages blood vessels.
- Obesity: increases risk of diabetes.
- Sedentary lifestyle: contributes to obesity.

Sepsis is a potentially life-threatening condition that occurs when the body’s response to an infection becomes unregulated, leading to widespread inflammation and organ dysfunction.