Watch More! Unlock the full videos with a FREE trial
Add to Study plan
Master
Included In This Lesson
Study Tools
Diabetes Assessment (Picmonic)
Diabetes Education (Picmonic)
Diabetes Interventions (Picmonic)
Diabetes Pathochart (Cheat Sheet)
DKA Pathochart (Cheat Sheet)
Example Care Plan_Diabetes Mellitus (Cheat Sheet)
Blank Nursing Care Plan_CS (Cheat Sheet)
Access More! View the full outline and transcript with a FREE trial
Example Nursing Diagnosis for Diabetes Mellitus (DM)
- Imbalanced Nutrition: More than Body Requirements: Diabetes may result in overeating or poor dietary choices. This diagnosis addresses nutritional excess.
- Risk for Unstable Blood Glucose: Patients with diabetes are at risk for unstable blood glucose levels. This diagnosis emphasizes blood glucose management.
- Deficient Knowledge: Some patients may lack knowledge about diabetes management. This diagnosis focuses on patient education and self-care.
Transcript
Let's create a care plan for Diabetes Mellitus. Diabetes is when the blood glucose aka the sugar and the blood is unable to move into the cells. It helps make ATP or energy, and the body makes insulin to assist with this process. Insulin is just the hormone that allows the sugar in the blood to move across the cell so the body can use it to create energy. Or there are two types of diabetes: type one and type two. What we want to consider as nurses is we want to make sure that we check the blood glucose levels and treat as needed. And we want to assess for signs of hyper or hypoglycemia. And we want to educate the patient on insulin administration. It's very important to teach them how to use the glucometer. The desired outcome is to have blood sugar control with minimum side effects.
When the patient comes in, they are going to feel a certain way, depending on whether their blood sugar is high or whether it's low. Some of the things that they are going to tell us if they are hyperglycemic or they have high blood sugar, is they are going to complain of what we call the three P’s. So these are the three P’s and that is polydipsia, polyphagia,and polyuria. And pretty much what those mean is polydipsia is thirsty. They're going to have excessive thirst. Polyphagia; they're going to be hungry. They're always eating. If you notice, and they're going to have polyuria, they're going to always be urinating. They're going to sometimes dump out a liter to two liters per day. They're going to have blurred vision, dry mouth, increased tiredness, leg pain, and nausea and vomiting. If a patient comes in with hypoglycemia or their blood sugar is less than 70 it's a low BG.
They're going to have some lethargy or weakness. They may be confused. They're going to have some numbness around the mouth and be nervous. They're going to be hungry. They're going to have headaches, nightmares, and they may also be groggy. Some things that we want to observe as nurses, we just want to keep these little mnemonics, okay. Let's do hyperglycemia. We always say, if they're hot and dry, then the sugar is high. If they're cold and clammy, then give them some candy. So they're going to be sweaty. Okay. They're going to have tachycardia. They're going to be irritable. The words are going to slur when they are hypoglycemic. Okay? Here's some things that we want to be considered and that education is very important. So we want to teach patients that they need to monitor their blood glucose levels by using a glucometer. They want to call their primary care physician. If they have blood glucose levels that are higher than their targets. So hyperglycemia is technically anything over a 180. We want to teach the patient how to use the glucometer and how to record the results for the next doctor's appointment. We also want to educate about nutritional changes. A lot of things with diabetes can be managed diet wise. We can collaborate with the dietician. The patient does need to learn how to count carbs and which foods to avoid. Patient’s sugars should be checked. Once the patient wakes up before meals and before going to bed, we want to teach the patient about monitoring their feet because the patient has decreased blood flow due to the diabetes, neuropathy could occur and make the feet something that the patient really needs to watch. Wounds are very hard to heal. So if they are having a hard time with their feet or they can't feel their feet, their wounds will be worse than with someone without diabetes.
We want to monitor their blood pressure. We want to make sure that they are administering antihypertensives and diuretics to keep their blood pressure within normal limits. We want to keep it around 120/80. Hypertension can lead to end organ damage and renal disease. We're just going to touch on some of the different insulins that a patient could use if they are prescribed by their physician. So just keep in mind the different types and action times rapid-acting. This is usually something that we use just for quick coverage. We call it a sliding scale, a fast-acting. We also have intermediate acting and then long acting such as Lantus and Levemir. We also have a Humalog NovoLog. Those are the rapid acting NPH. Okay. These are some of the key points that you want to keep in mind when developing this care plan.
So the pathophysiology: diabetes is when the blood sugar in the blood is unable to move it to the cells. It helps make energy. Some of the things the patient’s going to tell us: polydipsia polyuria polyphagia, the three P’s. They would also complain of weakness. If their sugar is low, they're going to be clammy. Some objective things that they're going to show on the monitor. And they're going to show an increased heart rate. You're going to look at them. They're going to be clammy sweaty. They're also going to have weakness. Glucose management is very important. The patient needs to learn how to manage their blood glucose at home. They may be prescribed insulin coverage if needed. Also, they want to be put on warm precautions. They're very prone to wounds, so they want to check their feet daily. They need to report any new neuropathy and they want to avoid tight-fitting shoes. We love you guys; go out and be your best selves today. And, as always, happy nursing.
When the patient comes in, they are going to feel a certain way, depending on whether their blood sugar is high or whether it's low. Some of the things that they are going to tell us if they are hyperglycemic or they have high blood sugar, is they are going to complain of what we call the three P’s. So these are the three P’s and that is polydipsia, polyphagia,and polyuria. And pretty much what those mean is polydipsia is thirsty. They're going to have excessive thirst. Polyphagia; they're going to be hungry. They're always eating. If you notice, and they're going to have polyuria, they're going to always be urinating. They're going to sometimes dump out a liter to two liters per day. They're going to have blurred vision, dry mouth, increased tiredness, leg pain, and nausea and vomiting. If a patient comes in with hypoglycemia or their blood sugar is less than 70 it's a low BG.
They're going to have some lethargy or weakness. They may be confused. They're going to have some numbness around the mouth and be nervous. They're going to be hungry. They're going to have headaches, nightmares, and they may also be groggy. Some things that we want to observe as nurses, we just want to keep these little mnemonics, okay. Let's do hyperglycemia. We always say, if they're hot and dry, then the sugar is high. If they're cold and clammy, then give them some candy. So they're going to be sweaty. Okay. They're going to have tachycardia. They're going to be irritable. The words are going to slur when they are hypoglycemic. Okay? Here's some things that we want to be considered and that education is very important. So we want to teach patients that they need to monitor their blood glucose levels by using a glucometer. They want to call their primary care physician. If they have blood glucose levels that are higher than their targets. So hyperglycemia is technically anything over a 180. We want to teach the patient how to use the glucometer and how to record the results for the next doctor's appointment. We also want to educate about nutritional changes. A lot of things with diabetes can be managed diet wise. We can collaborate with the dietician. The patient does need to learn how to count carbs and which foods to avoid. Patient’s sugars should be checked. Once the patient wakes up before meals and before going to bed, we want to teach the patient about monitoring their feet because the patient has decreased blood flow due to the diabetes, neuropathy could occur and make the feet something that the patient really needs to watch. Wounds are very hard to heal. So if they are having a hard time with their feet or they can't feel their feet, their wounds will be worse than with someone without diabetes.
We want to monitor their blood pressure. We want to make sure that they are administering antihypertensives and diuretics to keep their blood pressure within normal limits. We want to keep it around 120/80. Hypertension can lead to end organ damage and renal disease. We're just going to touch on some of the different insulins that a patient could use if they are prescribed by their physician. So just keep in mind the different types and action times rapid-acting. This is usually something that we use just for quick coverage. We call it a sliding scale, a fast-acting. We also have intermediate acting and then long acting such as Lantus and Levemir. We also have a Humalog NovoLog. Those are the rapid acting NPH. Okay. These are some of the key points that you want to keep in mind when developing this care plan.
So the pathophysiology: diabetes is when the blood sugar in the blood is unable to move it to the cells. It helps make energy. Some of the things the patient’s going to tell us: polydipsia polyuria polyphagia, the three P’s. They would also complain of weakness. If their sugar is low, they're going to be clammy. Some objective things that they're going to show on the monitor. And they're going to show an increased heart rate. You're going to look at them. They're going to be clammy sweaty. They're also going to have weakness. Glucose management is very important. The patient needs to learn how to manage their blood glucose at home. They may be prescribed insulin coverage if needed. Also, they want to be put on warm precautions. They're very prone to wounds, so they want to check their feet daily. They need to report any new neuropathy and they want to avoid tight-fitting shoes. We love you guys; go out and be your best selves today. And, as always, happy nursing.
View the FULL Transcript
When you start a FREE trial you gain access to the full outline as well as:
- SIMCLEX (NCLEX Simulator)
- 6,500+ Practice NCLEX Questions
- 2,000+ HD Videos
- 300+ Nursing Cheatsheets
“Would suggest to all nursing students . . . Guaranteed to ease the stress!”
