Nursing Care Plan On Diabetes
Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. Due to its progressive nature, management of diabetes requires lifelong commitment from the patient and family members. This care plan will help you devise a comprehensive nursing approach for managing this condition at home.
Assess for hypoglycemic reactions in the blood glucose measurements and response to the symptoms of hyperglycemia.
Hypoglycemia, or low blood sugar, is the most common complication of diabetes. Hypoglycemia may occur when the patient has not eaten for more than six hours and/or is exercising vigorously without eating a snack before exercise. Symptoms include:
- Pale skin
- Sweating and/or clammy skin
- Nausea or vomiting (some people will throw up)
Teach the patient and family members all the home care techniques including, insulin administration, dietary management, care of equipment, urine and blood glucose monitoring.
Teach to Recognize and report symptoms of hypo-hyperglycemia.
Teach to Recognize and Report Symptoms of Hypoglycemia
- Teach the patient about hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Explain that both conditions are serious, but that hypoglycemia can sometimes be life-threatening.
- Instruct the patient on how to check his or her glucose levels at home using a glucose meter or test strip kit. Tell him or her when to check their levels and what to do if they are high or low.
- Teach the patient how to recognize symptoms of hypoglycemic episodes: hunger, sweating, shakiness, dizziness and confusion. Explain that these symptoms should not be ignored since they could lead to unconsciousness or even coma if left untreated for too long!
If a patient has a poor history of compliance with therapy, explain why it is important to follow the prescribed regimen.
If you are a nurse and the patient has a poor history of compliance with therapy, it is important to explain why it is necessary to follow the prescribed regimen. Patients often experience an increase in metabolic control with the use of oral antidiabetic agents. When pharmacological treatment fails or cannot be tolerated, patients may need insulin replacement therapy. The initial stages of insulin treatment are often accompanied by hypoglycemia and hyperglycemia because of fluctuating blood glucose levels and inadequate time for adjustments in food intake before insulin administration.
The consequences of noncompliance with diabetes management include increased morbidity from diabetic complications such as blindness (retinopathy), renal failure (nephropathy), cardiovascular disease resulting in myocardial infarction or stroke, peripheral vascular disease resulting in amputation, lower limb gangrene or foot ulcers leading to sepsis; psychosocial problems like depression and anxiety due to lack of self-esteem caused by illness; increased medical costs due to hospital admissions for acute complications; mortality due to medication errors due to poor understanding about how medications work on their own merit as well as their interactions with other drugs that an individual may be taking simultaneously
Many diabetic patients are not oriented to time, place or person when they have a severe hypoglycemic reaction.
Diabetic patients may experience a poor memory and confusion due to the excessive thirst and frequent urination. This can cause them to have a poor sense of direction, time, place and person.
Many diabetic patients do not remember recent events or conversations during a hypoglycemic reaction because their brains are so affected by low blood glucose levels.
Teach the patient about the role of exercise in management of DIABETES MELLITUS and instruct in the type and amount of activity.
- Teach the patient about the role of exercise in management of DIABETES MELLITUS and instruct in the type and amount of activity.
- Exercise is an important component of the overall management of diabetes mellitus. The patient can expect more energy, less fatigue and better blood glucose control after regular exercise.
- The type, intensity and duration should be individualized based on each patient’s medical history, physical condition, response to exercise (including any complications from treatment), goals for glycemic control; appropriateness for specific lifestyle changes; and expectations for success with exercise participation (such as motivation).
- Regular aerobic exercise has been shown to improve insulin sensitivity; reduce levels of triglycerides (fatty acids); slow progression from impaired glucose tolerance to Type 2 Diabetes Mellitus; improve cardiovascular autonomic neuropathy associated with autonomic neuropathy associated with Type 1 Diabetes Mellitus or Type 2 Diabetes Mellitus; decrease body fat percentage by improving muscle mass through increased lean body mass while reducing total fat mass especially around waist circumference area where visceral fat accumulates causing metabolic syndrome which includes high blood pressure high cholesterol low HDL “good” cholesterol high triglycerides low LDL “bad” cholesterol
Diabetes can be managed successfully at home
Home care is important for patients with diabetes. Home care involves medication, diet and exercise as well as monitoring blood glucose levels. The goal of home care is to provide education about how to manage diabetes on a daily basis.
The patient’s physician or nurse educator should discuss the following topics:
- What are the symptoms of hyperglycemia? Hypoglycemia? When should I call my physician or nurse educator?
- Do you know what type(s) of insulin you take and when to use it? Are there special instructions for administering your insulin (e.g., mixing with juice)? How often do I need to test my blood glucose level after meals (or at bedtime)? What do the results mean if they are high or low?
Maximize the effectiveness of your diabetes management plan by using these tips:
- Keep a logbook with information about medications taken, their doses and timing; blood glucose readings; exercise sessions; eating habits like snacks eaten throughout the day; hospital visits related to complications caused by this disease (such as infections). This will help keep track of what happened when it happened so that solutions can be found quickly when another similar situation occurs again later down the road .
The family of a patient with Diabetes Mellitus has many responsibilities, including helping the patient to learn and understand all aspects of the disease. It is important that they understand what signs and symptoms to look for and when to seek immediate medical care. This will reduce the amount of time spent in hospitals or emergency rooms by increasing self-care activities at home.