About
Inability of the pancreas to produce any insulin in response to elevated blood sugar levels. Thus, the client will have elevated blood sugar levels unless replacement insulin is given. Usually juvenile onset. No exact cause is known, although it seems to be caused by an autoimmune disorder where the body starts to attack normal cells that produce insulin.
Assess
Age of onset ( juvenile, youth), history of autoimmune disorders or illness, polyuria, polydipsia, polyphagia, blood sugar levels, dietary plan, irritability, fatigue, poor wound healing, weight changes, presence of glucose or ketones in urine, Hgb A1C.
Complications
Stroke, hyperlipidemia, coronary artery disease, HTN
Kidney disease, blindness, poor wound healing
Hyperglycemia ( DKA); hypoglycemia
Diagnosis
- Deficient fluid volume related to failure of regulatory mechanism
- Ineffective health maintenance related to deficient knowledge of disease process, management, and dietary changes
- Imbalanced nutrition: less than body requirements related to the body's inability to metabolize and use glucose for energy
Goals
- The client will demonstrate understanding of medication therapy and treatment.
- The client will be able to self-administer insulin and perform blood glucose monitoring.
- The client will identify components of diet plan and participate in selecting appropriate food selections for meals.
Interventions
- Monitor blood sugars, electrolytes, and response to treatments.
- Monitor extremities for wounds, ulcers, circulation.
- Administer medications ( insulin) as ordered.
- Teach client how to draw up insulin in a syringe and administer insulin appropriately.
- Teach client methods to reduce the risk of infection, lipodystrophy related to frequent injections.
- Teach client dietary considerations according to the American Diabetic Association current guidelines.
- Teach client sick day plans, exercise considerations, and s/s of hypoglycemia and hyperglycemia to monitor.
- Teach client potential complications poorly controlled diabetes.
- Teach client appropriate techniques to perform capillary blood glucose monitoring.
- Observe client doing self-administration of insulin and performing capillary blood glucose monitoring.
- Encourage client to develop support system to help with dealing chronic illness.
- Teach client to monitor extremities frequently and institute measures to reduce injury.
- Monitor for signs/ symptoms of complications.
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