a patient who is taking metformin to treat type 2 diabetes mellitus

🔥+ a patient who is taking metformin to treat type 2 diabetes mellitus 09 Jul 2020 In all three cases, the pancreas either does not produce enough insulin, a hormone that regulates blood sugar, or the body's cells fail to respond ...

a patient who is taking metformin to treat type 2 diabetes mellitus Type 1 diabetes (T1D), previously known as juvenile diabetes, is a form of diabetes in which ... Type 1 diabetes can be distinguished from type 2 by testing for the presence of ... Type 1 diabetes makes up an estimated 5–10% of all diabetes cases. ... subcapsular cataract is an uncommon symptom in those with type 1 DM.

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What are the nursing care plans and nursing diagnosis for diabetes mellitus (DM)?

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In this nursing care plan guide are 13 nursing diagnosis for Diabetes Mellitus. Learn about the nursing interventions, goals, and nursing assessment for Diabetes Mellitus.

What is Diabetes Mellitus? 

Diabetes mellitus (DM) is a chronic disease characterized by insufficient production of insulin in the pancreas or when the body cannot efficiently use the insulin it produces. This leads to an increased concentration of glucose in the bloodstream (hyperglycemia). It is characterized by disturbances in carbohydrate, protein, and fat metabolism.

Sustained hyperglycemia has been shown to affect almost all tissues in the body and is associated with significant complications of multiple organ systems, including the eyes, nerves, kidneys, and blood vessels.

Nursing Care Plans for Diabetes Mellitus

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Here are 13 nursing care plans (NCP) and nursing diagnoses for diabetes mellitus (DM):

  1. Risk for Unstable Blood Glucose
  2. Deficient Knowledge
  3. Risk for Infection
  4. Risk for Disturbed Sensory Perception
  5. Powerlessness
  6. Risk for Ineffective Therapeutic Regimen Management
  7. Risk for Injury
  8. Imbalanced Nutrition: Less Than Body Requirements
  9. Risk for Deficient Fluid Volume
  10. Fatigue
  11. Risk for Impaired Skin Integrity
  12. Other Possible Nursing Care Plans
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Deficient Knowledge

Deficient Knowledge: Absence for 1 last update 09 Jul 2020 or deficiency of cognitive information related to specific topic.Deficient Knowledge: Absence or deficiency of cognitive information related to specific topic.

May be related to 

  • Unfamiliarity with insulin injection
  • Dietary modifications
  • Exercise for normoglycemia
  • Unfamiliarity with information
  • Interpretation

Possibly evidenced by

  • Requests of information
  • Statements of concern
  • Inadequate follow-through of instructions
  • Development of preventable complications

Desired outcomes

  • Before discharge, patient will demonstrate knowledge of insulin injection, symptoms, and treatment of hypoglycemia and diet.
Nursing InterventionsRationale
Explain that long-acting insulin (Lantus) only need to be injected once or twice daily.Long-acting insulin does not have a peak of action. Insulin glargine is effective over 24 hours.
Explain that regular prandial insulins (Humulin) should be injected 30 mins before meals.

Rapid acting insulins (Novolog, Humalog) may be injected before or after eating.

Dosage may be adjusted based on the actual amount of food ingested because rapid acting insulins can be given after a meal.
Explain that insulin dosages may need to be adjusted.Insulin dosage should be reduced when fasting for surgery, when not eating, or when hypoglycemia occurs. Illness or infection may increase insulin requirements.
Teach patient to rotate insulin injection sites.Multiple injections in the same site may cause fat deposits.
Explain the importance of inserting the needle perpendicular to the skin.This ensures deep subcutaneous administration of insulin.
Verify that the patient understands and demonstrates the technique and timing of home monitoring of glucose.Monitoring provides data on the degree of glucose control and identifies the need for changes in the insulin dosage.
Teach patient to follow a diet that is low in simple sugars, low in fat, and high in fiber and whole grains.A diet low in fat and high in fiber helps to control cholesterol and triglycerides. Three daily meals and an evening snack is recommended. Refined and simple sugars should be reduced, and complex carbohydrates, such as cereals, rice, should be increased.
Teach patient that anxiety, tremors, and slurred speech are signs of hypoglycemia.These are indicators of hypoglycemia, which causes seizures, coma, and death.
Teach patient to treat hypoglycemia with crackers, a snack, or glucagon injection.Hypoglycemia should be treated with a carbohydrate snack. If the patient is unconscious, glucagon should be given IM by a caregiver.
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References and Sources

References and recommended sources for this care plan guide for Diabetes Mellitus:

  • Ackley, B. J. (2008). Evidence-based nursing care guidelines: Medical-surgical interventions. Elsevier Health Sciences.
  • Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
  • Brunner, L. S., & Suddarth, D. S. (2004). Medical surgical nursing (Vol. 2123). Philadelphia: Lippincott Williams & Wilkins. [Link]
  • Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
  • Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
  • Rosenberg, C. S. (1990). Wound healing in the patient with diabetes mellitus. The Nursing clinics of North America25(1), 247-261. [Link]
  • White, P. (1974). Diabetes mellitus in pregnancyClinics in perinatology1(2), 331-348.

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