About
Inability for the pancreas to secrete enough insulin in response to elevated blood sugar levels. Usually adult onset greater than 40 years old. Linked to obesity, sedentary lifestyle. Leads to other chronic diseases including hyperlipidemia, coronary artery disease, kidney disease, poor wound healing, blindness, and peripheral neuropathy.
Assess
Age of onset ( adult or middle adult), history of illness or infection, polyuria, polydipsia, polyphagia, blood sugar levels, dietary plan, irritability, fatigue, poor wound healing, weight gain, obesity, presence of glucose or ketones in urine, Hgb A1C, history of cardiovascular disease or comorbidities including hypertension, high cholesterol, CAD, etc.
Complications
Stroke, hyperlipidemia, coronary artery disease, htn
Kidney disease, blindness, poor wound healing
Hyperglycemia ( DKA, HHNS); hypoglycemia
Diagnosis
- Imbalanced nutrition: less than body requirements related to the body's inability to metabolize and use glucose for energy
- Imbalanced nutrition: more than body requirements related to excessive intake of food
- Ineffective health maintenance related to deficient knowledge regarding disease process, medical management, risks for complications, and dietary changes
- Risk for impaired skin integrity related to decreased or lost pain perception in extremities
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 ( oral hypoglycemics, insulin) as ordered.
- Teach client how to draw up insulin in a syringe and administer appropriately as indicated.
- 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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