Diabetesmellitus is a chronic illness that is characterized by lessproduction of insulin hormone in the pancreas. It also occurs whenthe body cannot effectively utilize the insulin that has beenproduced. There is an elevation of the levels of glucose in theblood. The high level of glucose has been shown to cause effects inmany organs including the kidney, nerves, and eyes (Rothman, 2014).
Thereare many forms of diabetes depending on the cause. In Type 1diabetes, insulin is not produced. Patients with this type are knownto develop ketoacidosis. In Type 2 diabetes, the body does not usethe insulin that is produced effectively. It is mainly in the obesepatients. Gestational diabetes occurs in pregnancy, but the glucoselevels usually fall back to normal after delivery. Other types ofdiabetes occur due to genetic defects, pathological abnormalitieswith the endocrine systems and also exposure to some chemicals(Newhealthadvisor.com, 2016).
About18% of people with more than 65 years of age are affected byDiabetes. There are about 625,000 new cases of diabetes diagnosisevery year in the general population. Conditions that are known tolikely cause glucose imbalance in the body include food consumptionin the excess of insulin, exercise, stress and the period of growthof puberty. In Type 1 diabetes, one can develop diabetic ketoacidosiswhich is an emergency situation caused by a total deficiency ofinsulin (Newhealthadvisor.com, 2016).
Thisincludes nursing priorities which include correcting metabolicabnormalities in an individual. Nurses also strive to manage theunderlying cause of diabetes. For example, they try to find out if itis the type of food that one consumes that is responsible for thedevelopment of diabetes. They also prevent complication associatedwith diabetes like retinopathy in the eyes. Another nursing priorityis the provision of information regarding diabetes and the treatmentoptions available.
Thedischarge goals include prevention of complications related todiabetes. The causative factors for diabetes are corrected,homeostasis is achieved, and plans are put in place to meet needsafter the patient is discharged.
Diagnosticstudies include checking serum glucose if it goes beyond the normalrange. If ketones are strongly positive, it is a positive diagnosis.If there is an elevation of the levels of fatty acids, serumosmolality, glucagon and glycosylated hemoglobin, it is a positiveindicator. Other diagnostic processes that can be used includeanalyzing electrolytes, BUN, urine and performance of Thyroidfunction tests.
i)Risk for Infection
Therisk factors for diabetes include elevated levels of glucose,improper function of leukocytes and changes in blood circulation.There may be respiratory infections or even Urinary Tract Infectionsbefore the of development diabetes.
Thereis no assessment data or interview results for this because it is notcharacterized by signs and symptoms. Nursing interventions are aimedat preventing the disease
Thisincludes identification of interventions which would reduce the riskof getting the disease and demonstrating changes in lifestyle thatcould prevent the infection from developing.
Thisincludes interventions from the nurse on how lifestyle changes canprevent an infection from developing.
Nursesobserve if there are signs of inflammation including fever, a flushedappearance, cloudy urine as well as purulent sputum. The rationalefor this is that patients with diabetes might have had infectionswhich led to ketoacidosis states. They might have also developednosocomial infections (Dunning, 2014).
Asan intervention, nurses teach and promote good hygiene, particularlyhand hygiene because this reduces the chances of contamination.During intravenous administration and provision of wound care, nursesmaintain wound care. The rationale for maintaining asepsis is that ahigh level of glucose in the blood will create a favorableenvironment for bacteria to thrive in (Dunning, 2014).
Toavoid risks of infection, nurses intervene by providing trash bagsand tissues to patients. This is a convenient way to put sputum andother body secretions. The patients are instructed on the proper wayof handling these secretions. This minimized the spread ofinfections.
Patientsare encouraged to increase their fluid and dietary intakes as long asthey do not have cardiac or renal dysfunction. The rationale for thisintervention or action is that it reduces the susceptibility to aninfection. High fluid intake raises urinary flow, and this preventsformation of acids in marinating the correct body pH. Disease-causingorganisms are also flushed out of the system. Also, appropriateantibiotics are administered for early treatment and prevention ofsepsis (Carpenito, 2015).
Evaluationof Patient Outcomes
Thisincludes checking if the changes in the patient`s lifestyle led tobetter results. In this case, the patient is analyzed if he got thedisease after following all actions or interventions from the nurse.
Thiswas when the food that was taken is less than the requirements of thebody.
Imbalancenutrition may be related to low level of oral intake. This was becharacterized by altered consciousness and abdominal pains. Insulindeficiency will lead to high level of fat and protein metabolism.
Therewas increased output of dilute urine in most of the patients. Thereis weight loss, inadequate intake of food and elevated levels ofketones.
Takingin enough nutrients, showing the usual level of energy and showingweight gain in the normal range are the desired outcomes.
Thisincludes checking if what the patient takes in is according to thenormal body requirements.
Nursesmake sure that dietary programs of the patients are in the normalpattern. They also compare this with the patterns before. Therationale for this is an identification of deviations from the normaltherapeutic needs.
Nursesalso auscultate bowel sounds and check for bloating and vomiting ofundigested food. The rationale for this is that fluid disturbancesand hyperglycemia can decrease gastric motility. These symptomsrequire treatment (Dunning, 2014).
Anotherintervention is the administration of insulin through the intravenousroute intermittently. The rationale for this is that absorption fromthe subcutaneous route may be erratic. Continuous administration ofinsulin reduces the chances of development of hypoglycemia(Carpenito, 2015).
Evaluationof Patient Outcomes
Thepatients are evaluated to ensure that they take in enough nutrientsand exhibit the normal body weight gain (Dunning, 2014).
Fatiguemay be related to low energy production the body, insufficientproduction of insulin and high energy demands.
Manypatients do not have the ability to concentrate. They have decreasedperformances, and they do not show interest in their surroundings.
Animprovement in the ability to participate in one`s desired activitiesand also an increase in the level of energy.
Thepatients are accessed if the actions that nurses take on them willlead to the desired outcomes
Nursesmonitor the respiratory rate, pulse as well as blood pressure of thepatient before and after each activity. The rationale for carryingthis out is that it indicates physiological levels of tolerance.Nurses also discuss with the patient ways of conserving their energywhile they are doing their daily activities. This makes the patientachieve more things with low energy. Another intervention isdiscussing and identifying with the patient the activities that cancause fatigue. This knowledge will motivate the patient to do moreexercises even though they feel too weak (Dunning, 2014).
Evaluationof Patient Outcomes
Theaffected patients are assessed if the nurses’ interventions havecaused changes in their ways of living. There should be animprovement in how they participate in their desired activities(Newhealthadvisor.com, 2016).
Diabetesmellitus occurs when the body does not produce enough insulin or thebody does not respond to that which is produced. The main types ofdiabetes include Type 1 and Type 2.There are various nurses diagnosesfor diabetes patients as far as their care is concerned. In thispaper, the diagnoses that have been identified include the risk ofinfection, the risk of imbalanced nutrition and also fatigue. Thereare various nursing interventions or action that can be done so as toprevent the occurrence or progression of the disease. There isdesired outcomes and rationale for each intervention made. Thesenursing care plans can hence be used to meet priorities likeprovision of information about disease progress and prevention ofcomplications. Discharge goals like achieving homeostasis, correctingprecipitating factors for diabetes and minimizing complications arealso met through these nursing care plans.
Carpenito,L. (2014). Handbook of nursing diagnosis. Philadelphia, Pa.:Lippincott Williams & MedlinePlus (2016). Diabetes. Retrieved 1March, 2016, fromhttps://www.nlm.nih.gov/medlineplus/diabetes.htmlWilkins.
Dunning,T. (2014). Care of people with diabetes. Chichester, West Sussex:John Wiley & Sons.
Newhealthadvisor.com,(2016). 6 Nursing Diagnosis for Diabetes You Must Know | New HealthAdvisor. Retrieved 1 March, 2016, fromhttp://www.newhealthadvisor.com/Nursing-Diagnosis-for-Diabetes.html.
Rosman,P., & Edelman, D. (2014). Thriving with diabetes.