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Nursing diagnosis for diabetes, nursing care plan goals include: nursing the patients and responding to their call, needs, and abilities (by staying beside their bed like the family members). Nursing is indispensable (even after taking a balanced diet, physical activity, and effective medical treatment prescribed by the physician) in order to normalize blood glucose and reduce related complications. More importantly, nursing involves priority on complying with prescribed treatment programs. In this connection, nursing diagnosis/ nursing care plan/ nursing intervention comes into play. Diabetes is a disease in which the body fails to control blood sugar levels. This occurs when the body is unable to produce enough insulin or the body is resistant to insulin. In consequence, this leads to increased concentration of glucose in the bloodstream known as hyperglycemia.
The condition is characterized by disturbances in carbohydrate /protein/fat metabolism. Sustained hyperglycemia is believed to affect almost all the tissues in the body. Hyperglycemia also invites significant complications in multiple organ systems including
Nursing diagnosis is a part of a nursing procedure. It is a clinical judgment made on the patient’s feelings/ experiences/ responses to actual or potential; health problems. Nursing diagnosis fosters the nurse’s independent action (pertaining to the patient’s comfort and relief) in contrast to the nurse’s dependent intervention (pertaining to the physician’s order for prescribed medications).
A nursing care plan is a document or record of actions and responsibilities (which a patient may need). The care plan includes a set of actions applied to support nursing diagnosis (identified by nursing assessment). The nursing procedure has 5 stages. Assessment is the 1st stage of the nursing procedure, the rest 4 are:
Assessment involves critical thinking skills and relevant data collection (both subjective and objective).
In the treatment plan for diabetic patients, nursing interventions involve the following procedures.
3.3.1) Closely monitor blood glucose level to detect hypoglycemia (low blood glucose level).
3.3.2) Instruct the patient about the importance of accuracy in insulin preparation and meal timing (to avoid hypoglycemia)
3.3.3) Assess the patient for the signs and symptoms of hypoglycemia (early symptoms include: sweating/ tremor/ tachycardia i.e... rapid heart rate caused by the problem in the heart’s electrical system/ palpitation/ nervousness from the release of adrenaline when blood glucose falls rapidly. Adrenaline is a hormone produced by both adrenal glands and a small number of neurons in the medulla oblongata. And later symptoms include headache/ confusion/ irritability/ slurred speech/ lack of coordination /staggering gait arising from depression of central nervous system when glucose level falls drastically).
3.3.4) Treat hypoglycemia promptly (with fast-acting carbohydrates) Add ½ cup (or 4 oz.) juice / 1 cup skim milk / 3 glucose tablets (glucose is the fuel that feeds the body) /4 sugar cubes / 5-6 pieces of hard candy (may be taken orally)/ nutrition bar (specially designed for diabetes. It supplies glucose from sucrose, starch and protein sources with some fat to delay gastric emptying. This may prevent relapse) / 1 mg glucagon (the effects of glucagon is just the opposite of the effects of insulin. Glucagon is given to raise a very low level of blood glucose to a normal level. Glucagon is used if the patient cannot ingest a sugar treatment. The family members along with the nurse must administer the injection. If the patient fails to respond to glucagon within 15 minutes, then an IV bolus of 50 ml. of 50% dextrose solution can be given).
3.3.5) Instruct the patient to carry portable treatment equipment (to control hypoglycemia) at all times.
3.3.6) Assess the patient for cognitive or physical impairment that may interfere with the ability to accurately administer insulin.
3.3.7) Exercise should be encouraged (well before meals or early in the morning before breakfast) to prevent hypoglycemia.
3.3.8) Instruction may be given to the patient to wear an identification bracelet or card (that may help for prompt treatment during a hypoglycemic emergency).
In this connection, the patient may be informed about the action/ use /adverse effects of anti-diabetic agents.
4.1) Nurses are the nearest, most trusted, and dependable healthcare professionals. They remain with the patients like a shadow (sometimes at home and mostly in the hospital/ clinic) until and unless the patient is fully cured. Nurses simultaneously play the role of
4.2) Nurses not only extend medical service to the patient. Patients may experience stress/ fear/despair in the wake of suffering from disease/injuries/ surgery. In addition to medical needs, a nurse often has to extend service (like a family member) with affection and consolation to meet the emotional need of the patient.
4.3) In nursing ethics, nursing care for older patients (irrespective of diabetic or non-diabetic) is more complex. Veritably, the sufferings and complications relating to various health problems increase with aging. In order to extend due care and services to older people, sustainable home-based care is essential. (For instance, in the Netherlands, the Ministry of Health, Welfare and Sports commissioned a nationwide program for the older people between 2008- 2016. The main objective of the program was to promote proactive integrated healthcare for older people with complex healthcare needs.
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