Question

Write two Nursing Care plan with t woNursing Diagnosis for A 78yrs old female,an African American she is newly diagnose wiyh Type 2 Diabetes,past medical history hypertention,coronary artery disease CAD and she also had Pressure Ulcer on her right Gluteal.Her blood sugar today at the clinic is 650,her vital signs are as follows BP170/101,Pulse126,Temperature 101.8,Oxygen 92, you are trhe nurse today you are ask to follow up on these vital signs.   

1.What type of insulin will be incoperate in her plan of care

2.What kind of educate will be given to her as a newly diagnose diabetic patient

3.Focus on blood glucose testing, educate on how to do it   

4.What should she report to the provider? Give five things under the nursing intervention that she should report because she has a wound complication related to Diabetes

Answer 1

Two nursing diagnosis and their interventions are:-

1.Nursing diagnosis - Hyperglycemia related to uncontolled/ unaware management of disease.

Nursing interventions :-

- Assess the blood sugar level and other vital signs .

- Assessment of general condition of patient

- Inform the physician about hyperglycemia

- Start the insulin therapy according to the sliding scale

- Monitor the sugar level every hourly and adjust insulin according to that .

2. Nursing diagnosis- Impaired skin integrity related to immobility

Nursing interventions :-

- Assess the site for the severity of would anddo the wound dressing every day

- Change the position of the patient 2hourly

- Use of comfort devices to maintain proper positioning

- Provide back care

- Encourage increased fluid intake

- Provide diet rich in protein and vitamin C for early healing.

3. Nursing diagnosis - Anxiety related to loss of control ,fear of inability to manage diabetes , and it's complications

Nursing interventions :-

- Assess the level of understanding of the patient and family and provide them information regarding diabetes ,its signs , management and complications in a language understood by them .

- Encourage them to express there feelings , questions ,it will help in reducing anxiety .

- Teach the patient and family members how to do the blood sugar test at home and how to give insulin according to the sliding scale .

- Provide psychological and emotional support.

- Teach the the warning signs and when to reach the hospital if any complications occurs .

1. Basically ,type 2 diabetes is treated with oral hypoglycemic agents , exercise and diet control . Regular insulin will be incorporated in her plan of care if not controlled by oral hypoglycemic agents .

2. Patient and family members will be taught about the disease condition its signs , management and complications . How do to check blood sugar at home and give insulin as per the sliding scale and what are the warning signs and symptoms to reach hospital. Use a language which is simple ,clear and understandable by the patient and family.

3. Teaching patient how to do the blood sugar monitoring :-

Articles needed - needle or lancets , blood sugar monitoring machine and strips , cotton swabs , spirit swabs .

Steps :-

- First select the finger ,mostly done in the index finger then clean it with spirit swabs and then allow it dry .

- After drying properly ,give a prick with then Lancet at the side of the finger (side of the fingers have less nerve endings results in less pain )

- Then drop the blood on the machine strips and wait for the result.

4. Five things under nursing interventions that should be included because she has wound complications related to diabetes are:-

- the bed sore will take more time to heal

- avoid moisture

- maintain strict compliance to treatment regimen to avoid wound complications of becoming gangrene

- encourage diet rich in protein and vitamin C for early healing

- teach how to do wound dressing at home .