Nursing Care Plan for Diabetes Mellitus

Definition of Diabetes Mellitus

Diabetes mellitus is a heterogeneous group of disorders characterized by increased levels of glucose in the blood or hyperglycemia.

Diabetes Melllitus is a collection of symptoms that arise in a person caused by the presence of elevated levels of sugar (glucose) blood due to insulin deficiency both absolute and relative terms.


Signs and Symptoms of Diabetes Mellitus

A common complaint of patients with Diabetes Mellitus such as polyuria, polydipsia, polyphagia in Diabetes Mellitus is generally no. Instead the patient is often disturbing complaints from complications of chronic degenerative blood vessels and nerves. In Diabetes Mellitus elderly there are pathophysiological changes due to aging process, so that the clinical picture varies from asymptomatic cases to cases with extensive complications. A recurring complaint is the presence of impaired vision due to cataracts, tingling in the limbs and muscle weakness (peripheral neuropathy) and injuries to the legs which are difficult to recover with treatment prevalent.

According Supartondo, the symptoms caused by diabetes mellitus in the elderly are often found are:

1. Cataract
2. Glaucoma
3. Retinopathy
4. Itching around the body
5. Pruritus Vulvae
6. Bacterial infections of skin
7. Fungal infections in the skin
8. Dermatopati
9. Peripheral neuropathy
10. Visceral neuropathy
11. Amiotropi
12. Neurotrophic ulcer
13. Kidney disease
14. Peripheral vascular disease
15. Coronary disease
16. Cerebral vascular disease
17. Hypertension

Management of Diabetes Mellitus

The main goal of therapy of diabetes mellitus is trying to normalize the activity of insulin and blood glucose levels in an attempt to reduce vascular complications, and neuropathy. Therapeutic purposes in any type of diabetes is to achieve normal blood glucose levels.

There are 5 components in the management of diabetes:

1. Diet
2. Exercise
3. Monitoring
4. Therapy (if needed)
5. Education

Nursing Assessment of Diabetes Mellitus

1. Family Health History

Are there families who suffer from diseases such as client?

2. Patient Medical History and Previous Treatment

How long a client suffering from diabetes, how to handle, gets what type of insulin therapy, how to take her medicine whether regular or not, what is being done to address the client's illness.

3. Activity / Rest:

Tired, weak, difficult Moving / walking, muscle cramps, decreased muscle tone.

4. Circulation

Is there a history of hypertension, AMI, claudication, numbness, tingling in the extremities, foot ulcers are healing old, tachycardia, changes in blood pressure

5. Ego integrity

Stress, anxiety

6. Elimination

Changes in the pattern of urination (polyuria, nocturia, anuria), diarrhea

7. Food / fluid

Anorexia, nausea, vomiting, do not follow the diet, weight loss, thirst, use of diuretics.

8. Neuro-sensory

Dizziness, headache, tingling, numbness in the muscle weakness, paresthesias, visual disturbances.

9. Pain / Leisure

Abdomen tense, pain (moderate / severe)

10. Breathing

Cough with / without purulent sputum (tergangung presence of infection / no)

11. Security

Dry skin, itching, skin ulcers.


Nursing Diagnosis for Diabetes Mellitus

1. Imbalanced Nutrition : Less Than Body Requirements
2. Deficient Fluid Volume
3. Impaired skin integrity
4. Risk for injury

Related Articles :

Nursing Interventions for Diabetes Mellitus

Nanda Nursing Diagnosis List for Diabetes Mellitus

Diabetes Mellitus Nanda NIC NOC

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Depression Nursing Diagnosis and Interventions

Risk for Violence: Self-Directed or Other-Directed


Nursing Interventions for Depression

1. The general objective: There was no violence for Self-Directed or Other-Directed
2. Specific objectives
   • Clients can build a trusting relationship
     
     Action:
     
     
     • Introduce yourself to the patient
     • Do interactions with patients as often as possible with empathy
     • Listen to the notice of the patient with empathy and patient attitude more use non-verbal language. For example: a touch, a nod.
     • Note the patient talks and give a response in accordance with her wishes
     • Speak with a low tone of voice, clear, concise, simple and easy to understand
     • Accept the patient is without comparing with others.
   • Clients can use adaptive coping
     
     Action:
     
     
     • Give encouragement to express feelings and say that nurses understand what patients perceived.
     • Ask the patient the usual way to overcome feeling sad / painful
     • Discuss with patients the benefits of commonly used coping
     • Together with patients looking for alternatives, coping.
     • Give encouragement to the patient to choose the most appropriate coping and acceptable
     • Give encouragement to patients to try coping that have been selected
     • Instruct the patient to try other alternatives in solving problems.
   • Clients are protected from violent behavior to self and others.
     
     Action:
     
     
     • Monitor carefully the risk of suicide / violence themselves.
     • Keep and store the tools that can be used by patients for violent behavior, self / others, in a safe place and locked.
     • Keep materials that endanger the patient's appliance.
     • Supervise and place the patient in the room that easily monitored by peramat / officer.
   • Clients can improve self-esteem
   Action:
   • Help to understand that the client can overcome despair.
   • Assess and mobilize internal resources of individuals.
   • Help identify sources of hope (eg, peer relationships, beliefs, things to be resolved).
   • Clients can use the social support
     
     Action:
     
     
     • Review and make use of individual external sources (the people closest to, the health care team, support groups, religion).
     • Assess support system beliefs (values, past experiences, religious activities, religious beliefs).
     • Make referrals as indicated (eg, counseling, religious leaders).
   • Clients can use the drug correctly and precisely
     
     Action:
     
     
     • Discuss about the drug (name, dosage, frequency, effect and side effects of taking medication).
     • Help using the drug with the principle of 5 correct (right patient, medication, dose, manner, time).
     • Encourage talking about effects and side effects are felt.
     • Give positive reinforcement when using the drug properly.

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Hypertension Nursing Care Plan : Assessment, Diagnosis and Interventions

Hypertension Nursing Assessment

Assessment is the main basis of the nursing process. Assessment is the first step in one of the nursing process (Gaffar, 1999). Activities undertaken in the assessment is gathering data and formulating priority issues. In the assessment - a careful collection of data about clients, their families, the data obtained through interviews, observation and examination.

The data collected can be divided into two (Kelliat, Budi Ana., 1995) :

1. Data base
2. Specific data relating to the current situation of the client which can be determined by the nurse, client or family.

The purpose of nursing assessment is to collect data, classify data and analyze the data. Thus concluded a nursing diagnosis (Gaffar, 1999).

Hypertension Nursing Diagnosis

1. Risk for Decreased Cardiac Output related to Increased afterload, vasoconstriction and myocardial ischemia.
2. Acute pain related to increased cerebral vascular pressure.

Hypertension Nursing Intervention

Nursing Diagnosis :

Risk for Ineffective Tissue Perfusion: Peripheral, Renal, Gastrointestinal, Cardiopulmonary related to impaired circulation

Nursing Intervention for Hypertension

• Maintain bed rest, elevate head of bed
• Assess blood pressure at admission in both arms, sleeping, sitting with arterial pressure monitoring if available
• Maintain fluid and drugs.
• Observe the sudden hypotension.
• Measure inputs and expenditures
• Monitor electrolytes, BUN, creatinine.
• Ambulation according to ability; avoid fatigue

Risk for Decreased Cardiac Output related to Hypertension
 
Nursing Care Plan for Hypertension in Pregnancy

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Ineffective Breathing Pattern NIC NOC

Nursing Diagnosis for Ineffective Breathing Pattern

Definition: The exchange of air inspiration and / or expiration inadequate.

Ineffective breathing pattern related to

• Hyperventilation
• Hypoventilation syndrome
• Damage muskuloskletal
• Neuromuscular Dysfunction
• Fatigue muscles of respiration

Data:

• Changes in chest movement
• Bradipnea, tachypnea
• Decrease in inspiratory and expiratory pressures
• Breath nostril
• The use of auxiliary respiratory muscles
• Increased vital signs

Nursing Interventions for Ineffective Breathing Pattern
a. Airway Management:

• Open the airway with headtilt, chinlift, jaw thrust
• Set the position to maximize ventilation
• Use tools airway
• Perform chest physiotherapy
• Teach breath deeply and cough effectively
• Auscultation of breath sounds
• Give bronchodilators (Collaboration)

b. Oxygen therapy

• Provide humidification system of oxygen equipment
• Monitor the flow of oxygen and the amount given
• Monitor signs of oxygen toxicity

c. Monitoring of respiration

• Monitor the frequency, rhythm and depth of breathing
• Monitor the use of auxiliary respiratory muscles

d. Monitoring of vital signs

• Monitor blood pressure, pulse, respiratory rate, temperature
• Monitor blood pressure during sleep, sit, stand up if indicated
• Monitor signs and symptoms of hypothermia or hyperthermia
• Monitor rhythm and breath sounds

Ineffective Breathing Pattern related to Cardiac Tamponade

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