Nursing Management

                      I.        NURSING DIAGNOSIS

  • Decreased Cardiac Output
    • Inadequate blood pumped by the heart due to cellular dysfunction caused by insulin resistance or uncontrolled blood glucose levels.
  • Ineffective Tissue Perfusion
    • Consistent elevation of blood glucose levels causes endothelial damage that leads to impaired oxygenation and perfusion of the tissues at the capillary level.
  • Risk For Unstable Blood Glucose Level
    • Patients with diabetes are susceptible to unstable glucose levels related to insufficient knowledge or poor disease management.
  • Imbalanced nutrition
    • less than body requirements related to insufficient caloric intake to meet growth and development needs and the inability of the body to use nutrients.
  • Risk for impaired skin integrity related to slow healing process and decreased circulation.
  • Risk for infection related to elevated glucose levels.
  • Deficient knowledge related to complications of hypoglycemia and hyperglycemia.
  • Deficient knowledge related to appropriate exercise and activity.

 

                    II.        NURSING CARE

  • Ensure adequate and appropriate nutrition
    •  A diabetic patient requires a program that provides adequate nutrition for normal growth while maintaining normal blood glucose levels. A balanced diet must be considered when planning a meal, taking into account patient preferences, cultural norms, and lifestyle. If a meal is missed, the patient should eat a complex carbohydrate and protein snack.
  • Prevent skin breakdown
    • Teach the patient to inspect the skin daily and treat even minor skin breaks; encourage daily bathing; teach the patient to thoroughly dry the skin after bathing; and pay close attention to any area where skin touches skin, such as the groin, axilla, or other skin folds; emphasize good foot care.
  • Prevent skin infection
    • Diabetic patients may be more susceptible to urinary tract and upper respiratory tract infections; teach the patient to be on the lookout for signs of a urinary tract infection; instruct them to report any signs of a urinary tract or upper respiratory tract infection to their care provider; insulin should never be skipped during illness; and fluid intake should be increased.
  • Regulate glucose levels
    •         The patient's blood glucose levels must be monitored to ensure that they remain within normal limits; the blood glucose level must be determined at least twice a day, before meals; and encouragement and support should be provided, including assisting the patient in expressing fears and acknowledging that the fingerstick hurts and that it is acceptable to dislike it.

  • Provide health teachings about the management of hypoglycemia and hyperglycemia
    •          If the blood glucose level exceeds 240mg/dl, the urine may be tested for ketones; be aware of the most likely times for an increase or decrease in the blood glucose level in relation to the insulin the patient is receiving.

 

                  III.        HEALTH TEACHINGS

Without insulin, blood sugar or glucose levels rise and can harm the body.

  • It's important to regularly check your blood sugar and use insulin as needed.
  • Daily self-care helps control blood sugar and reduce health problems.
  • Stick to your diabetes meal plan.
  • Exercise helps keep blood sugar stable.
  • Regularly test your blood sugar levels.
  • Collaborate with your healthcare team to create a diabetes care plan that suits you.

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