Nursing Care Plan for Diabetes Mellitus
Nursing care plans for Diabetes Mellitus, Diabetes mellitus is a disorder in which the level of blood glucose is persistently raised above the normal range. Diabetes mellitus is a syndrome with disordered metabolism and inappropriate hyperglycemia due to either a deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate. Diabetes mellitus occurs in two primary forms: type 1, characterized by absolute insufficiency, and the more prevalent type 2, characterized by insulin resistance with varying degrees of insulin secretory defects. Diabetes mellitus is a group of metabolic diseases characterized by elevated levels of glucose in the blood (hyperglycemia) resulting from defects in insulin secretion, insulin action, or both (ADA], Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 2003.
Diabetes Mellitus Assessment
- Family Health History, Are there families who suffer from illnesses such as client?
- Patient Health History and Previous Treatment, How long suffered from DM client, how to handle, get what kind of insulin therapy, how to take the medicine whether regular or not, what is done to cope with illness clients.
- Activity / Rest: Tired, weak, hard Moves / walking, muscle cramps, decreased muscle tone.
- Circulation, Is there a history of hypertension, AMI, claudication, numbness, tingling in the extremities, ulcers on the feet long healing time, tachycardia, changes in blood pressure
- Ego Integrity, Stress, anxiety
- Elimination, Changes in the pattern of urination (polyuria, nocturia, anuria), diarrhea
- Food / Fluids, Anorexia, nausea, vomiting, do not follow the diet, weight loss, thirst, the use of diuretics.
- Neurosensori, Dizziness, headache, numbness, muscle weakness numbness, paraesthesia, visual disturbances.
- Pain / Leisure, Abdominal strain, pain (is / weight)
- Respiratory, Cough with or without purulent sputum
- Security, Dry skin, itching, skin ulcer.
1. High risk of nutritional deficiencies: lack of demand
2. Lack of fluid volume
3. Disruption of skin integrity
4. A risk of injury
Intervention for Diabetes Mellitus
1. High risk of nutritional deficiencies: lack of demand reduction associated with oral input, anorexia, nausea, increased metabolism of proteins, fats.
Destination: the patient’s nutritional needs are met
Patients can digest the amount of calories or the right nutrients
Stable weight or additions to the range typically
* Measure your weight every day, or according to the indication.
* Determine the diet and eating patterns of patients and compare it with food that can be spent on patients.
* Auscultation bowel sounds, noted the existence of abdominal pain / abdominal bloating, nausea, vomit food that has not had time to digest, maintain a state of fasting according to the indication.
* Provide a liquid diet containing foods (nutrients) and the electrolyte immediately if the patient is able to tolerate the oral.
* Involve the patient’s family at this meal digestion according to the indication.
* Observe the signs of hypoglycemia such as changes in level of consciousness, skin moist / cold, rapid pulse, hunger, sensitive stimuli, anxiety, headaches.
* Collaboration blood sugar checks.
* Collaboration delivery of insulin treatment.
* Collaboration with dieticians.
2. Lack of fluid volume associated with osmotic diuresis.
Destination: liquid or hydration needs of patients are met
Patients showed an adequate hydration evidenced by stable vital signs, palpable peripheral pulse, skin turgor and capillary filling good, right individual urine elimination and electrolyte levels within normal limits.
* Monitor vital signs, note the change ortostatik TD
* Monitor the breathing pattern as the respiratory kusmaul
* Review the frequency and quality of breathing, use of aids breathing muscles
* Review the peripheral pulse, capillary filling, skin turgor and mucous membranes
* Monitor intake and expenditure
* Maintain fluid to provide at least 2500 ml / day within tolerable limits heart
* Note things such as nausea, vomiting and distension of the stomach.
* Observations of increased fatigue, edema, irregular pulse
* Collaboration: give normal fluid therapy with or without copy dextrosa, monitor laboratory examination (Ht, BUN, Na, K).
3. Integrity of skin disorders associated with changes in metabolic status (peripheral neuropathy).
Destination: the integrity of skin disorders can be reduced or showed healing.
Wound condition showed improvement and non-infected tissue
* Review the wound, the epitelisasi, color changes, edema, and discharge, the frequency of dressing change.
* Review of vital signs
* Review of pain
* Perform wound care
* Collaboration delivery of insulin and medication.
* Collaboration antibiotics as indicated.
4. A risk of injury associated with decreased visual function
Destination: patients do not experience injury
Criteria Results: patients can meet their needs without experiencing injury
* Avoid slippery floors.
* Use a low bed.
* Orient clients to the room.
* Help clients in daily activities
* Help patients in ambulasi or change positions.