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All Journal MAHESA : Malahayati Health Student Journal Malahayati International Journal of Nursing and Health Science
Maryam, Nina
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Dentistry Health Professions Nursing Public Health

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Refractory hyperglycemia in a geriatric patient with diabetic ketoacidosis: A critical care nursing case report Pranata, Yodha; Winara, Winara; Rizkianti, Intan; Maryam, Nina; Prawesti, Ayu
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 7 (2025): Volume 8 Number 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i7.1005

Abstract

Background: Refractory hyperglycemia in diabetic ketoacidosis (DKA) presents a critical challenge in geriatric patients due to multifactorial physiological and clinical complexities. Early recognition and integrated management are essential, with critical care nursing as a pivotal component. Purpose: This case report aims to describe and analyze the multifactorial causes of refractory hyperglycemia in a geriatric DKA patient, highlighting the importance of early detection, comprehensive correction, and collaborative nursing roles. Method: A descriptive analytic approach was employed to examine the clinical course of a 75-year-old woman with DKA and persistent hyperglycemia. Data were collected from direct patient observation, systematic physical examinations, laboratory assessments, imaging, and multidisciplinary clinical records. Daily therapeutic interventions and patient responses were meticulously documented. Results: Persistent hyperglycemia resulted from several interacting factors: the impact of glucocorticoids on glycemic control, effects of severe pulmonary infection on insulin resistance, the role of electrolyte disturbances in exacerbating hyperglycemia, the relationship between heart failure and diuretic use, the impact of malnutrition and sarcopenia on insulin resistance, and the need for an integrated therapeutic approach. Each factor contributed to increased insulin resistance and complicated glycemic control. Conclusion: Optimal management of refractory hyperglycemia in elderly DKA patients requires early identification and simultaneous correction of underlying factors, supported by intensive critical care nursing and multidisciplinary collaboration.
The Impact of Virtual Reality Simulation Training on Nurses’ Competency in Disaster Management: A Scoping Review Pranata, Yodha; Winara, Winara; Susanti, Vera; Pratitis, Izzati Adha; Peni, Inggried Angelica Valentina Wiliyams; Maryam, Nina; Pamungkas, Sultan Muhammad Wahyu; Trisyani, Yanny
MAHESA : Malahayati Health Student Journal Vol 6, No 3 (2026): Volume 6 Nomor 3 (2026)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v6i3.21312

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ABSTRACT Nurses are pivotal in disaster management. Suboptimal preparedness impairs response, communication, and patient safety. Virtual Reality-based training can enhance clinical skills, readiness, and decision-making, yet logistical and cost challenges persist. This scoping review aims to map evidence on the impact of Virtual Reality Simulation (VRS) in enhancing nurses’ competency in disaster management. The methodology framework utilized in this scoping review followed Arksey and O'Malley's approach. Literature was systematically searched across PubMed, Scopus, and EBSCO using keywords: nurses, Virtual Reality Simulation Training, nurses’ competency, and disaster management. Inclusion criteria required English-language publications. All extracted data were systematically tabulated to facilitate comparative analysis and thematic synthesis. A total of 164 articles were identified, nine studies met the inclusion criteria and were selected for this scoping review. VR training consistently improved nurses’ disaster preparedness, response capabilities, knowledge, and satisfaction compared to traditional methods. Immersive VR enhances practical skills, decision-making, and engagement, despite challenges related to resources, infrastructure, and standardization. VR-based training enhances nurses’ disaster preparedness more effectively than conventional methods. Despite its benefits, the widespread adoption of this approach is hindered by infrastructure, resource demands, and technical limitations in developing realistic simulation environments. Keywords: Disaster Management, Disaster Preparedness, Nurse’s Competency, Simulation Training, Virtual Reality.
Co-Authors Pamungkas, Sultan Muhammad Wahyu Peni, Inggried Angelica Valentina Wiliyams Pranata, Yodha Pratitis, Izzati Adha Priambodo, Ayu Prawesti Rizkianti, Intan Susanti, Vera Winara, Winara Yanny Trisyani