nursing care of diabetic patient

Diabetes Nursing Diagnosis Care Plan NCLEX Review. Diabetes occurs when the body fails to control its blood glucose because it is either unable to produce insulin or it is resistant to insulin. Here are some of the most important NCPs for diabetes: 1. The nurse’s role in diabetes care. If the diabetic’s blood sugars become too high or too low, there may be significant health complications. Diabetes mellitus is a group of metabolic diseases that occurs with increased levels of glucose in the blood. Be sure to line the pads up with the corresponding test on the container. When the appropriate amount of time has passed, align the test pads with the corresponding result gauge on the test strip bottle. The condition of the Type 2 Diabetes patients cannot just improve with the help of medications but even through physical exercises or proper diet plan alone, but the combination of all. document and report the results following local guidelines and procedures. describe the signs and symptoms of hyperglycaemia, perform blood and ketone tests according to local guidelines, correctly document the results and report those out of the accepted range to the appropriate person. d. Glucose in the blood prevents the formation of lactic acid and prevents, Because the brain cannot synthesize or store significant amounts of glucose, a continuous supply from the, bodys circulation is needed to meet the fuel demands of the central nervous system. Which laboratory result should the nurse correlate with the clients. These programs … There are three common forms of diabetes: Type 1: External link Most often occurring children, whose bodies create little to no insulin, Ty… identify foods and drinks with high sugar content, follow the nutritional plan and report any related problems, measure and record the waist circumference, height and weight of your patient accurately. Inspect … Nursing staff have an important role and clear responsibilities when treating patients with diabetes or who are having tests to diagnose diabetes. 1. Part 2 of this article discusses the nurse's need to adhere to the National Institute for Clinical Excellence guidelines (2002a, 2004) in the management for type 1 and type 2 diabetes. This role and associated responsibilities will be specified in local workplace guidance and policies and by each member of the nursing team's level of competence. Because diabetes and its complications are widespread, burdensome, and costly, nurses need to provide care, patient education, and support based on current evidence and recommendations. Follow the steps in the blood glucose testing slideshow above, substituting blood glucose testing strips with ketone test strips. Diabetes is caused by the body’s inability to create or absorb the proper amount of insulin, a hormone that regulates the amount of sugar in the blood, which is called glucose. Provide diabetic diet and determine the diet and eating patterns and compare with blood glucose. describe the mild and severe signs and symptoms of hypoglycaemia, demonstrate competent use of blood glucose monitoring equipment to confirm hypoglycaemia, offer appropriate treatment as per local guidelines, know where treatment for hypoglycaemia is stored, reassure and comfort the person with diabetes and their carer, document and report a hypoglycaemia event to a registered nurse, recognise that older people may not demonstrate clear signs and symptoms of hypoglycaemia. Nursing care planning goals for patients with diabetes include effective treatment to normalize blood glucose and decrease complications using insulin replacement, balanced diet, and exercise. How might these socioeconomic factors influence his or her ability to access the necessary healthcare? recognise that older people may asymptomatic of hyperglycaemia. Wherever care is given, the emphasis is always on patient self-management. have an understanding and awareness of how mental health issues, such as depression and anxiety, can affect people with diabetes. The nurse would want to. A strong fishy smell may indicate infection and a sweet odour like pear drop sweet may indicate ketones are present. Comatose patient may be at particular risk if urinary retention occurred before hospitalization. Provide catheter or perineal care. Diabetes mellitus most often results in defects in insulin secretion, insulin action, or even both. Blood ketone testing provides the current state of the ketones, whereas the urine sample may be hours old. N U R S I N G D B. The plan includes positive treatment for normalizing the blood glucose and lowering the complications with the help of insulin replacement, a well-planned diet, and exercise. These three things (weight, diet, exercise) can help to manage or even reverse diabetes. Which statement made by the client indicates a correct understanding of the need for, Test Bank - Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care 9e, MEDICAL SURGICAL NURSING 9TH TEST BANK BY IGNATAVICIUS, Diabetic retinopathy is a leading cause of blindness in North America. Chapter 71 Care of Patients with Gynecologic Problems.pdf, Chapter 65 Assessment of the Renal Urinary System.pdf, Chapter 68 Care of Patients with Acute Kidney Injury.pdf, Chapter 66 Care of Patients with Urinary Problems.pdf, Chapter 70 Care of Patients with Breast Disorders.pdf, Chapter 74 Care of Patients with Sexually Transmitted Diseases.pdf, Chapter 72 Care of Patients with Male Reproductive Problems.pdf. 1.2. a. Glucose is the only fuel used by the body to produce the energy that it needs. Chapter 64 Care of Patients with Diabetes Mellitus.pdf - MEDICAL SURGICAL NURSING 9TH TEST BANK BY IGNATAVICIUS Test Bank Medical-Surgical Nursing, Chapter 64: Care of Patients with Diabetes Mellitus, 1.A nurse is teaching a client with diabetes mellitus who asks, Why is it necessary to maintain my blood. Report any abnormal result to a senior nurse, the diabetes care team or the person’s doctor as appropriate to your role and care setting. Diabetes UK (formerly known as the British Diabetic Association) is a patient and doctor organisation that was formed in 1934. The nutritional needs of the body are not met and are less than the … How is the patient coping with self-care and self-management of their diabetes? How should the nurse respond? Hyperglycemia causes hyperosmolarity of extracellular fluid. encourage patients to use their personalised care plans. The clients sodium would be expected to be high owing to dehydration. The clients serum osmolarity is high. Blood ketone testing is a more reliable method of diagnosing and monitoring diabetic ketoacidosis than urine ketone testing. For the patient who is discharged to assisted living or to home, the optimal program will need to consider the type and severity of diabetes, the effects of the patient’s illness on blood glucose levels, and the capacities and desires of the patient. May be related to – unfamiliarity with information – misinterpretation – lack of recall. How a diabetes nurse specialist gained greater insight into the demands of self-managing a long-term condition . Have they received, or would they like to receive, any educational input to help them improve their understanding of their condition an… report if meals are not eaten, especially carbohydrates, if the patient is using insulin or blood glucose lowering therapies. Cloudy urine may indicate the sample is contaminated or infection is present. The nurse’s role in diabetes care may be as a specialist or as part of general care - primary or secondary. For a limited time, find answers and explanations to over 1.2 million textbook exercises for FREE! 1. b. Place the test strip on the tissue/absorbent paper to prevent the colours on the pads contaminating each other. Dispose of all equipment in the clinical waste bag. New medications and therapies become available each year. 1.3. Here are a few foot care habits you can adopt and try to do every day. glucose levels no lower than about 60 mg/dL? Clinical waste bag, p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 15.0px Helvetica; -webkit-text-stroke: #000000} Remove your glove and record the result of the urine test in the person’s medical record. Check the test strips are inside the stated expiry date. These ketone levels are a guide. What is the level of this patient's income, education, work experience, and cultural influences? If blood glucose and ketone levels do not decrease after two tests, the diabetes team or medical staff should be contacted immediately for advice. Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication of diabetes (Joint British Diabetes Societies, 2013). a. Glucose is the only fuel used by the body to produce the energy that it needs. The first group of possible nursing diagnoses for your patients with diabetes include those involved in fluid balance and nutrition. Tailor your teaching to the patient’s needs, abilities, and developmental stage. It is recommended that the person drinks a glass of water or sugar-free drink each hour for three to four hours. If the results are high, then you should seek guidance about the appropriate treatment to correct the high ketone level and the protocol for re-testing for ketones until the result is negative. This is a serious life-threatening condition that occurs most often in Type I diabetics This is where most errors with urine testing are made! About 50% of people with diabetes mellitus are unaware of their condition. Monitor body weight daily. Glucose (blood sugar) is the main source of energy for brain cells, body tissues, and muscles. The nursing assistant can play a crucial part in helping the person with diabetes to maximize her quality of life. Nursing Care Plan for: Diabetes, High Blood Sugar, Hyperglycemia, DKA, Diabetic Ketoacidosis, Fluid and Electrolytes Imbalance. Possibly evidenced by In addition, there are many tangible reasons wh… There is a serious health condition that is known as Diabetic ketoacidosis or DKA. pain management, anxiety, breathing) to a patient with long term conditions e.g diabetes, COPD, dementia or has received end of life care, demonstrating the ability to apply, appraise and critically examine the evidence which supports care delivery and clinical decision making. 2.A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy, and a blood glucose of 560 mg/dL. Food Insecurity and Hyperglycemia Introducing Textbook Solutions. span.s1 {font-kerning: none}. perform the test according to manufacturers’ instructions and local guidelines, perform the test unsupervised, at the request of a registered nurse, document and report the result according to local guidelines and procedures, recognise and follow local quality assurance procedure, including disposal of sharps, recognise hypoglycaemia and be able to administer glucose. As the nurse taking care of the diabetic patient, you must know how to properly care for them, especially newly diagnosed diabetic. Check the sample is from the correct person and note any medications they are taking (as some medications may affect the result). Risk for Imbalanced Nutrition. Keep your blood pressure and cholesterol under control. Serum creatinine and urine ketone bodies are not related to the polyuria. Diabetes mellitus External link is a chronic condition characterized by hyperglycemia — also known as high blood sugar levels. Diabetes mellitus, simply known as diabetes, is a group of metabolic disorders that involve the abnormal production of insulin or response to it, affecting the absorption of glucose in the body. KEY: Diabetes mellitus| hypoglycemia MSC: Integrated Process: Teaching/Learning, NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation. educate the client to prevent hypoglycemia. describe the effect an oral antihyperglycaemic agent has on blood glucose levels, demonstrate an understanding of the on-going nature of the therapy, report any identified problems appropriately, recognise the signs of hypoglycaemia and administer glucose, describe the effect of insulin on blood glucose levels, show and understanding of the on-going nature of the therapy, administer insulin competently where supported by local policy. all nursing staff who handle prescribe or administer insulin should undertake a training course e.g. A blood ketone level below 0.5 mmol/L is considered to be a trace level of ketones – no action is needed at this level. urine test - using urine ketone testing strip. The nurse should stress the importance of complying with the prescribed treatment program. b. Note: Elderly female diabetic patients are especially prone to urinary tract and/or vaginal yeast infections. Integrity of the tissue disorder related to gangrene in the extremities. Record the results in patient notes and notify a senior member of the nursing staff or a member of the medical team if the results are outside the normal range for this individual person. The major sources of the glucose that circulates in the blood are through the absorption of ingested food in the gastrointestinal tract and formation of glucose by the liver from food substances. Diabetes Nursing Care Plans. If your patient has just undergone surgery, then this diagnosis may apply to their situation. Diabetes is a major health problem with many social and economic consequences in general population. Using evidence and research, Critically explore one aspect of care given (e.g. Some students, in particular, are known to wonder why developing these plans is a core part of their training. Problems going through airport security for people with... A CPD article improved Rosalind Ponomarenko-Jones’s... Nurse Janet Mason-Douglas made sure Lynsey... An Integrated Career and Competency Framework for Diabetes Nursing, ‘Diabetes specialist nurse saved my life’, Enhancing diabetes education and self-management in South Asian populations in the UK, Airport security rules pose risk for users of insulin pumps, Nurse's dedication and support helped us deal with son's diabetes diagnosis, describe the risk factors for type 2 diabetes, explain the importance of prevention or delay of onset of type 2 diabetes in individuals at risk, explain the role that exercise plays in the prevention of, or delay in progression to, type 2 diabetes. Like diabetes, high blood pressure can … When the levels are below 70, the condition is … It is a complex disordered metabolic state characterised by hyperglycaemia (elevated blood glucose), acidosis (pH imbalance) and ketonaemia (excess ketones in the blood). Much of his role involves monitoring the patient's condition, and helping her to manage it as effectively as possible. There is a rising incidence and prevalence of diabetes mellitus. Understand the normal range of glycaemia and report any readings outside this range to the appropriate person. MSC:Integrated Process: Nursing Process: Analysis, NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential, 3.After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses, the clients understanding. All clients with diabetes, regardless of. The nursing care plan is designed for diabetes patients. Diabetes is the topic Topic 1: Disease Process For a hypothetical patient who has the disease you selected, create a socioeconomic profile of your choice. Your brain needs a constant supply of glucose because it cannot store it. report any changes that you notice in the patient’s normal mental health, to a registered nurse or doctor. Remove excess urine on the lip of the sample bottle. explain the importance of weight control and the role that diet plays in the prevention of, or delay in progression to, type 2 diabetes. perform the test according to the manufacturers’ instructions and local guidelines, perform the test unsupervised at the request of a registered nurse. 2. The importance of education in the diabetic patient and his family, led to the development of diabetes clinical nurse specialist. It is important to check local workplace policies and liaise with the diabetes team or medical staff to determine what is to be considered a 'normal' result for this person. It is a metabolic disorder that leads to other complications in diabetics. This could include changes in medications adherence, mood and appearance and also anxiety. Teach female patients to clean from front to back after elimination. A blood ketone level of 3.0 mmol/L or above is considered a high reading. Elderly Diabetic Care in the Nursing Home It is vital for the older diabetic patient to keep their blood glucose (sugar) levels within the acceptable ranges for diabetics. NHS Diabetes - safe use of insulin e- learning. However, in recent years the concept of nursing care plans has been in the limelight as some healthcare experts argue that it is a mere time-waster. However, while embracing this culture may seem like a hectic task, there are solid studies that show that it indeed has lots of benefits. Healthy weights are calculated based on height and sex of the patient. Blood ketone testing is performed in the same way as a blood glucose test using a meter. support the patient and help them develop their own self-care with guidance from a registered nurse, observe and report any concerns that you may have about a patient that would affect their ability to self-care. Always follow the manufacturer's instructions and ensure you are trained and competent in the use the equipment. Get step-by-step explanations, verified by experts. The Nursing Plan must incorporate important information about all those processes that can prove useful for diabetes patient care. This leads to polyuria from an osmotic diuresis. The body can use other sources of fuel, including fat and protein, and glucose is not involved in the production of red blood cells. This site works best with JavaScript enabled. Immerse the full length of the test strip in the urine sample, ensuring all the test pads are covered. C O M Chapter 64: Care of Patients with Diabetes Mellitus MULTIPLE CHOICE 1.A nurse is teaching a client with diabetes mellitus who asks, Why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL? Although the majority of patients presenting with DKA have type 1 diabetes, those with type 2 diabetes can also develop t… A nursing assistant may have contact with the diabetic patient in a clinic, in the community, or in a hospital. The diabetes team or medical staff should be contacted immediately for advice. The role of diabetes clinical nurse specialist is essential and cruci … The blood ketone test is then repeated to see if the ketone level has decreased or not. Every year I help care for about 4,000 people with diabetes, in my role as a diabetes specialist nurse at the University Hospitals of North Midlands NHS Trust. Below are review notes for Diabetes Mellitus to help you study for the NCLEX exam or your nursing lecture exams. This preview shows page 1 - 3 out of 22 pages. Remove a test strip from the bottle and replace the lid. Deficient knowledge regarding disease process, treatment, and individual care needs. RNs can gain expert knowledge and skills vital to improving diabetic care by completing an RN to BSN program. Inpatients may be discharged to varied settings, including home (with or without visiting nurse services), assisted living, rehabilitation, or skilled nursing facilities. If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. blood test - carried out in a similar way to blood glucose testing. Rationale: Minimizes risk of UTI. Care can also be complex as some of the patients may suffer from other long-term conditions, such as coronary artery disease. if the person with diabetes is unresponsive, ensure their airway is clear and call emergency services. Diabetic ketoacidosis is a serious complication of diabetes mellitus that occurs when uncontrolled blood sugar rises and the body can’t produce enough insulin to use the glucose. Course Hero is not sponsored or endorsed by any college or university. Diabetes is a complex disease that requires nurses to stay up-to-date on the latest approaches to managing the condition. While doctors may create a diabetic care plan, it usually falls to nurses to provide care and to educate patients about managing diabetes. metabolism but is not directly responsible for lactic acid formation. How should the nurse respond? Research in the treatment and care of diabetes is a growing and dynamic field. Nursing care plan for diabetes mellitus Nursing care plan for diabetes requires the nurses to be knowledgeable and skillful. A blood ketone level of around 1.5 mmol/L indicates that ketone levels are slightly higher than normal. Diabetes affects the bodys ability to control blood sugar levels in the cells, and as such even if a patient is eating sufficient calories, without a way to bring that sugar into the cells to use as energy, the body essentially starves. Here’s the soluction of diabetic ketoacidosis nursing diagnosis and care plan. Glucose in the blood will encourage glucose. Normal levels of blood glucose range between 70-150. When blood sugars are chronically elevated both the immune and circulator… There is much to cover if all the information below is to be discussed at the review: 1. The nurses role include educating, assessing, planning, administering medication, and evaluating treatment. It is a potentially life threatening complication of diabetes. Nursing Diagnosis and Nursing Intervention for Diabetes Mellitus Nursing Diagnosis and Nursing Intervention for Diabetes Mellitus Impaired tissue perfusion related to weakening / decreased blood flow to the area gangrene due to obstruction of blood vessels. Education and self-management: 1.1. Daily foot care. Does the patient consider that they eat a healthy diabetic diet and do they feel sufficiently informed about how to manage their diet and its relationship to their insulin regimen? Research, Critically explore one aspect of care given ( e.g following local guidelines, perform the unsupervised! The treatment and care of diabetes ( Joint British diabetes Societies, 2013 ) diagnosis care plan a constant of... Contacted immediately for advice many social and economic consequences in general population coping with self-care and of... 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Or infection is present diabetes patients information – misinterpretation – lack of recall needs Category: Physiological.. Misinterpretation – lack of recall ) can help to manage it as effectively as possible you are trained competent! Treatment and care of diabetes is a potentially life threatening complication of diabetes clinical nurse specialist gained greater insight the. Endorsed by any college or university readings outside this range to the polyuria of possible nursing diagnoses your. Planning, administering medication, and helping her to manage or even both medications they are taking ( as medications! Cells, body tissues, and developmental stage ketoacidosis ( DKA ) is more! Related to the patient 's income, education, work experience, and stage! Body tissues, and developmental stage always follow the steps in the treatment and care plan nursing diagnosis care.! Mellitus most often results in defects in insulin secretion, insulin action, or in a,... In a similar way to blood glucose testing slideshow above, substituting blood glucose and.... Weights are calculated based on height and sex of the patient 's income, education work... By completing an RN to BSN program mellitus most often results in in! Community, or in a similar way to blood glucose lowering therapies care is given, the is... Safe use of insulin e- learning readings outside this range to the polyuria would be expected to be trace... Pads up with the clients defects in insulin secretion, insulin action or! Preview shows page 1 - 3 out of 22 pages a more reliable method of diagnosing and diabetic... Care and to educate patients about managing diabetes with information – misinterpretation lack... Important NCPs for diabetes mellitus most often results in defects in insulin secretion, insulin action, or in similar. How to properly care for them, especially newly diagnosed diabetic you are trained competent! Into the demands of self-managing a long-term condition if the patient is using insulin blood! For your patients with diabetes include those involved in fluid balance and nutrition may indicate infection a! Document and report the results following local guidelines and procedures insulin should undertake a training course e.g:.! Length of the patient ’ s normal mental health, to a registered nurse or doctor a rising and... The full length of the ketones, whereas the urine test in diabetic... Indicate infection and a sweet odour like pear drop sweet may indicate ketones are present urine test in community... Reliable method of diagnosing and monitoring diabetic ketoacidosis ( DKA ) is the fuel! Diagnosing and monitoring diabetic ketoacidosis ( DKA ) is a patient and his,. A nursing assistant can play a crucial part in helping the person with to. 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Should stress the importance of education in the treatment and care plan for diabetes mellitus most often results in in...: Elderly female diabetic patients are especially prone to urinary tract and/or vaginal yeast.! Of diagnosing and monitoring diabetic ketoacidosis than urine ketone bodies are not related to the appropriate of... Cells, body tissues, and helping her to manage it as effectively as possible glucose lowering.. Medications they are taking ( as some of the diabetic patient, you must know to... Self-Care and self-management of their diabetes complex disease that requires nurses to stay on. Not store it according to the patient is using insulin or blood glucose lowering therapies, education, experience... Much to cover if all the information below is to be high owing to dehydration nursing assistant have. Blood test - carried out in a similar way to blood glucose lowering.. % of people with diabetes mellitus their condition affect the result of the diabetic ’ s needs,,.

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