Diabetes Nursing Diagnosis and Nursing Care Plan

Diabetes Nursing Care Plans Diagnosis and Interventions

Diabetes NCLEX Review and Nursing Care Plans

Diabetes mellitus, simply known as diabetes, is a group of metabolic disorders that involve the abnormal production of insulin or response to it, affecting the absorption of glucose in the body.

Glucose (blood sugar) is the main source of energy for brain cells, body tissues, and muscles. There are different types of diabetes, but all of them lead to the buildup of excess glucose in the bloodstream.

This condition can cause serious complications if left uncontrolled. Diabetes cannot be cured, but is manageable through treatment and lifestyle changes.

Types of Diabetes

  1. Prediabetes. This occurs when the blood glucose level is higher than normal, but not as high enough to diagnose as diabetes. People with prediabetes may eventually have type 2 diabetes if the condition is left untreated.
  2. Type 1 Diabetes. Also known as insulin-dependent diabetes, type 1 diabetes is an autoimmune disorder that results from the antibodies’ attack to the pancreas. When the pancreas is damaged, it cannot make insulin. Type 1 diabetes was used to be called juvenile diabetes, as most cases begin during childhood.
  3. Type 2 Diabetes. Also called non-insulin dependent diabetes, type 2 diabetes happens when the pancreas is able to create some insulin, but not enough to lower the amount of glucose in the blood. Insulin resistance is also evident in this type of diabetes. Most cases of diabetes mellitus are type 2, and most people who have type 2 diabetes are overweight or obese.
  4. Gestational Diabetes. Pregnant women might experience insulin resistance, usually during the second or third trimester. Once the baby is delivered, gestational diabetes usually goes away. The baby is at a higher risk than the mother, as the glucose can travel via the placenta. This can make the baby overweight or have trouble breathing. Cesarean section might be necessary to deliver the baby.

Despite having a similar name, diabetes insipidus is not a type of diabetes mellitus. Both of them have polyuria (increased amount of urine) and polydipsia (excessive thirst).

However, diabetes insipidus involves the inability to retain hormone due to the dysfunction of the antidiuretic hormone vasopressin.


Signs and Symptoms

  • Polydipsia – Increased / excessive thirst
  • Polyuria  – Frequent urination and increased amount of urine
  • Polyphagia – Extreme hunger
  • Fatigue
  • Irritability
  • Blurred vision
  • Slow-healing wounds or sores
  • Presence of ketones in the urine
  • Unexplained weight loss – especially in type 1 diabetes
  • Tingling and/or numbness of extremities

Causes

The pancreas is a gland located below the stomach and is responsible for producing and secreting the hormone insulin into the bloodstream. Insulin facilitates the entry of blood glucose into the cells of the body, which results to the lowering of its amount in the bloodstream.

Normally, when the blood glucose level goes down, the insulin production is also slowed down in the pancreas.

In Type 1 diabetes, the immune system produces antibodies that destroy the insulin-producing cells of the pancreas, leaving the organ to produce little or no insulin to help transport the glucose into the cells that need it. On the other hand, the cells of people with prediabetes and type 2 diabetes develop insulin resistance.

The pancreas is not able to create enough insulin to surpass this insulin resistance, resulting to the buildup of glucose in the blood. In gestational diabetes, the placenta secretes hormones that are vital for pregnancy but may form insulin resistance in the mother’s cells.

Complications

Untreated or poorly controlled diabetes may lead to the development of serious complications that may disabling or fatal to the patient. These include:

  1. Heart diseases and stroke. The high glucose levels in the blood may damage the blood vessel walls, including the arteries of the heart. This increases the risk for angina, coronary artery disease, diabetic cardiomyopathy, myocardial infarction (heart attack), and stroke (brain attack).
  2. Diabetic coma. This is a reversible form of coma resulting from either a severely high blood sugar level ( diabetic ketoacidosis in type 1 diabetes;  hyperosmolar nonketotic coma in type 2 diabetes) or low blood sugar levels (hypoglycemia in type 1 diabetes with insulin replacement doses).
  3. Neuropathy. Capillaries can be damaged by excess glucose in the blood. This deprives the nerves the nourishment they need. It eventually causes nerve damage or neuropathy, as evidenced by tingling and/or numbness of fingers and toes, spreading upward to the whole extremities.
  4. Nephropathy. Kidneys can also be damaged due to poorly controlled diabetes.
  5. Retinopathy. Excess glucose may damage the blood vessels located in the eye.
  6. Foot infections. Poor blood flow and/or nerve damage in the feet increase the risk for blisters and cuts. If the wounds are infected, the diabetic patient may eventually require amputation due to poor wound healing.

Other complications may include skin problems, hearing impairment, depression, and Alzheimer’s disease.

Gestational diabetes may cause the baby to grow overly large, a condition known as macrosomia. The mother is also at high risk for pre-eclampsia, a fatal condition during pregnancy.

Diagnosis

  1. Diabetes Screening – blood sugar screening
  2. Age 45 and above
  3. Body mass index of greater than 23 (regardless of age)
  4. Women who has experienced gestational diabetes – screening every 3 years
  5. Prediabetes patients – screening every year
  6. Blood tests
  7. Glycated hemoglobin (A1C) test – to check the average blood glucose level in the last 2-3 months; non-fasting

– A1C below 5.7 – normal

– A1C between 5.7 and 6.4 – prediabetes

-A1C greater than 6.5 – diabetes

  • Random blood sugar test – blood sugar level of 200 mg/dL or 11.1 mmol/L suggests diabetes
  • Fasting blood sugar test – fasting overnight; blood sugar level of greater than 7mmol/L in 2 different test days suggests diabetes
  • Oral glucose test – fasting overnight; patient is asked to drink a sugary liquid, then the nurse tests the blood sugar level for the next 2 hours; a level of more than 200 mg/dL or 11.1 mmol/L suggests diabetes

Treatment

  1. Dietary changes. Low fat, low calories, and high fiber foods are ideal for diabetic patients. The patient is usually referred to a dietitian to ensure that a meal plan that suits the patient’s health goals and preferences is created.
  2. Increase in physical activity. Exercise decreases the blood glucose level as the demand for glucose (energy) in the cells increases with physical activity. It is recommended to have at least 30 minutes of aerobic exercise.
  3. Oral medications. Metformin is prescribed for Type 2 diabetes patients to increase the body’s sensitivity to the effect of insulin.
  4. Insulin therapy. Type 1 diabetes patients require insulin injections to lower the blood sugar levels.
  5. Blood glucose monitoring. To ensure that the patient does not experience hyperglycemia (high blood glucose level) or hypoglycemia (low blood glucose level), patients are educated to check their blood sugar about 3 to 4 times a day, or more depending on their treatment plan.
  6. Transplant of Pancreas. Type 1 diabetes patients may be eligible for a pancreas transplantation.

Nursing Diagnosis for Diabetes

Nursing Care Plan for Diabetes 1

Nursing Diagnosis: Risk for Unstable Blood Glucose

              Desired Outcome: The patient will maintain a blood glucose level of less than 180 mg/dL and an A1C level below 5.7

Nursing Interventions for DiabetesRationale
Assess for signs of hyperglycemia or hypoglycemia.To determine the appropriate treatment in maintaining target blood glucose levels. Symptoms of Hyperglycemia:
3P’s (polyphagia, polyuria, and polydipsia), fatigue or blurred vision Hypogylcemia: dizziness, headache, fatigue, diaphoresis, and tachycardia
Monitor blood glucose levels. (Frequency of blood glucose checks depends on the treatment plan.)To ensure that the blood glucose level is within target range.
Administer diabetic medication (oral and/or insulin therapy) as prescribed.To keep the glucose levels within normal range, effectively controlling diabetes and reducing the risk for blood vessel damage, nerve damage, kidney injury, and other complications of diabetes.
Encourage the patient to adhere to his/her dietary plan.Low fat, low calories, and high fiber foods are ideal for diabetic patients.
Encourage the patient to increase physical activity, particularly aerobic exercise.Exercise decreases the blood glucose level as the demand for glucose (energy) in the cells increases with physical activity.

Nursing Care Plan for Diabetes 2

Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to insulin deficiency, as evidenced by unexplained weight loss, increased urinary output, dilute urine, high blood glucose levels, fatigue, and weakness

Desired Outcome: The patient will be able to achieve a weight within his/her normal BMI range, demonstrating healthy eating patterns and choices.

Nursing Interventions for DiabetesRationale
Explain to the patient the relationship between diabetes and unexplained weight loss.To help the patient understand why unexplained weight loss is one of the signs of diabetes.
Create a daily weight chart and a food and fluid chart. Discuss with the patient the short term and long-term goals of weight loss.To effectively monitory the patient’s daily nutritional intake and progress in weight loss goals.
Help the patient to select appropriate dietary choices to follow a high fiber, low fat diet.Low fat, and high fiber foods are ideal for diabetic patients.  
Refer the patient to the dietitian.To provide a more specialized care for the patient in terms of nutrition and diet in relation to newly diagnoses diabetes.  

Nursing Care Plan for Diabetes 3

Nursing Diagnosis: Deficient Knowledge related to new diagnosis of Type 2 diabetes as evidenced by patient’s verbalization of “I want to know more about my new diagnosis and care”

Desired Outcome: At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of Type 2 diabetes and its management.

Nursing Interventions for DiabetesRationales
Assess the patient’s readiness to learn, misconceptions, and blocks to learning (e.g. denial of diagnosis or poor lifestyle habits)To address the patient’s cognition and mental status towards the new diagnosis of diabetes and to help the patient overcome blocks to learning.
Explain what diabetes is, its types (specifically type 2 diabetes mellitus), and how it affects the vital organs such as the heart, kidneys, brain, and blood vessels. Avoid using medical jargons and explain in layman’s terms.To provide information on diabetes and its pathophysiology in the simplest way possible.
Educate the patient about hyperglycemia and hypoglycemia.  Inform him/her the target range for his/her blood sugar levels to be classified as “well-controlled”.To give the patient enough information on the risks of blood sugar control (e.g. too much insulin dose may result to hypoglycemia, while too little insulin dose may lead to hyperglycemia). It is important to inform the patient the desired range for blood glucose level because this helps the patient and healthcare provider decide on the appropriate insulin dosage.  
Demonstrate how to perform blood sugar monitoring.To empower patient to monitor his/her blood sugar levels at home.  
Inform the patient the details about the prescribed medications (e.g. drug class, use, benefits, side effects, and risks) to control blood sugar levels, and explain how to properly self-administer each of them. Ask the patient to repeat or demonstrate the self-administration details to you.To inform the patient of each prescribed drug and to ensure that the patient fully understands the purpose, possible side effects, adverse events, and self-administration details.
Use open-ended questions to explore the patient’s lifestyle choices and behaviors that can be linked to the development of diabetes. Teach the patient on how to modify these risk factors (e.g. smoking, excessive alcohol intake, high sodium and/or cholesterol diet, obesity, sedentary lifestyle, etc).To assist the patient in identifying and managing modifiable risk factors related to diabetes.

Nursing Care Plan for Diabetes 4

Nursing Diagnosis: Fatigue related to decreased metabolic energy production as evidenced by overwhelming lack of energy, verbalization of tiredness, generalized weakness, blood sugar level of  210 mg/dL, and shortness of breath upon exertion

Desired Outcome: The patient will demonstration active participation in necessary and desired activities and demonstrate increase in activity levels.

Nursing Interventions for DiabetesRationales
Assess the patient’s activities of daily living, as well as actual and perceived limitations to physical activity. Ask for any form of exercise that he/she used to do or wants to try.To create a baseline of activity levels and mental status related to fatigue and activity intolerance.
Encourage progressive activity through self-care and exercise as tolerated. Explain the need to reduce sedentary activities such as watching television and using social media in long periods. Alternate periods of physical activity with rest and sleep.To gradually increase the patient’s tolerance to physical activity.
Teach deep breathing exercises and relaxation techniques.   Provide adequate ventilation in the room.To allow the patient to relax while at rest. To allow enough oxygenation in the room.
Refer the patient to physiotherapy / occupational therapy team as required.To provide a more specialized care for the patient in terms of helping him/her build confidence in increasing daily physical activity.

Nursing Care Plan for Diabetes 5

Nursing Diagnosis: Risk for Fluid Volume Deficit due to osmotic diuresis

Desired Outcome: The patient will demonstrate adequate hydration and balanced fluid volume

Nursing Interventions for DiabetesRationales
Assess vital signs and signs of dehydration.Hyperglycemia may cause Kussmaul’s respirations and/or acetone breath. Hypotension and tachycardia may result from hypovolemia, or low levels of intravascular volume.
Commence a fluid balance chart, monitoring the input and output of the patient.To monitor patient’s fluid volume accurately and effectiveness of actions to monitor signs of dehydration.
Start intravenous therapy as prescribed. Encourage oral fluid intake of at least 2500 mL per day if not contraindicated.To replenish the fluids lost from polyuria and to promote better blood circulation around the body.
Educate the patient (or guardian) on how to fill out a fluid balance chart at bedside.To help the patient or the guardian take ownership of the patient’s care, encouraging them to drink more fluids as needed, or report any changes to the nursing team. 
Monitor patient’s serum electrolytes and recommend electrolyte replacement therapy (oral or IV) to the physician as needed.Sodium is one of the important electrolytes that are lost when a person is passing urine. Hyponatremia or low serum sodium level may cause brain swelling.

Nursing Care Plan for Diabetes 6

Nursing Diagnosis: Risk for Disturbed Sensory Perception

Desired Outcome: The patient will recognize any changes in sensory perception and effectively cope with them.

Nursing Interventions for DiabetesRationales
Assess vital signs and perform an initial head-to-toe assessment, particularly checking visual acuity, presence of tingling or numbness in the extremities, and response to pain stimuli.Retinopathy and peripheral neuropathy are some of the complications of diabetes.  
Educate the patient for the need to monitor and report any visual disturbances or other sensory changes.To facilitate early detection and management of disturbed sensory perception.
Create a daily routine for the patient, as consistent as possible.To keep the patient in touch with reality and maintain safety.
Monitor blood sugar levels regularly.Uncontrolled levels of blood glucose may lead to serious complications such as neuropathy and retinopathy.

Nursing Care Plan for Diabetes 7

Nursing Diagnosis: Risk for Infection

Desired Outcome: The patient will be able to avoid the development of an infection.

Nursing Stat Facts
Nursing Stat Facts
Nursing Interventions for DiabetesRationales
Assess vital signs and observe for any signs of infection.Ketoacidotic state in diabetic patients may increase their risk for infection.
Perform an initial head-to-toe assessment, particularly checking for the presence of any wounds and cuts.Diabetic patients suffer from slow wound healing. Any wound or cut needs to be managed early and appropriately to prevent infection which may spread and may lead to amputation of the affected toe, finger, or limb.
Educate the patient for the need to monitor and report any signs of infection or new wounds and cuts.To facilitate early detection and management of infection and to provide proper wound management as needed.
Teach the patient how to perform proper hand hygiene.To maintain patient safety and reduce the risk for cross contamination.
Provide careful skin care. Massage the limbs and keep the skin dry. Provide wrinkle-free linens.To reduce the risk of skin breakdown that may lead to infection. To facilitate a better peripheral blood circulation.

Nursing Care Plan for Diabetes 8

Powerlessness

Nursing Diagnosis: Powerlessness related to a long-term and progressive illness and probable dependence on significant others secondary to diabetes mellitus as evidenced by expressions of having little control over circumstances, reluctance to convey actual feelings, apathy, disengagement, not participating in treatment and decision-making, and depression about bodily deterioration or complications.

Desired Outcomes:

  • The patient will be able to recognize feelings of powerlessness.
  • The patient will be able to find healthy strategies to deal with emotions.
  • The patient will be able to assist in the planning of own care, and assume ownership for self-care tasks.
Nursing Interventions for DiabetesRationale
Assess the patient’s previous problem-solving abilities. Discuss with the patient the importance of identifying how the patient handled the problems in the past and determine how the patient became in control of the situation.Knowing the patient’s personality might aid in determining therapeutic goals. When a patient’s way of control is internal, they usually desire to take charge of their own treatment plan. Patients who have an external way of control want to be looked after by others and may place blame for their situation on other forces.
Allow the patient to verbalize feelings and advise the patient that it is normal to feel and react that way.Patients can better problem-solve and seek help if they recognize that their reactions are normal. Diabetic management is a full-time task that serves as a constant reminder of disease and the dangers it poses to a patient’s health.
Allow the patient’s significant other to express their worries about the patient’s condition and explore methods in which they will find it easy to assist the patient.This method Increases the patient’s sense of involvement and allows the significant other to problem-solve ways to help the patient avoid recurrence.
Encourage the patient and the significant other to share their feelings regarding the hospitalization and disease.This will allow the healthcare provider to identify issues that bother the patient and significant others. Thus, it will make problem-solving easier.
Allow the patient and significant other to verbalize expectations and goals on the disease and treatment plan in general.Frustration and a lack of control can occur from unrealistic expectations or pressure from others or oneself. These can affect the patient’s coping abilities.
Determine if the patient and the significant other have changed in their relationship.    Diabetic control needs constant energy and thinking, which might cause a relationship’s focus to shift. The emergence of psychological issues that influence one’s self-concept might add to the stress.
Encourage the patient to make decisions about the treatment plan, such as ambulation, activity schedules, and so on.This will show the patient that some decisions from them can be considered and applied for their care.
Encourage the patient to perform self-care and provide positive reinforcement for efforts.Allows the patient to have a feeling of control over the situation.  

Nursing Care Plan for Diabetes 9

Risk for Impaired Skin Integrity

Nursing Diagnosis: Risk for Impaired Skin Integrity related to neuropathy and decreased sensation and circulation caused by peripheral neuropathy and arterial obstruction secondary to diabetes mellitus.

Desired Outcome: The patient will demonstrate ways to properly care for the feet and the patient will maintain an intact skin on the legs and feet while still admitted to the hospital.

Nursing Interventions for DiabetesRationale
If the patient is on the bed, Allow the patient to use a foot cradle, space boots on ulcerated heels, elbow protectors, and mattresses that provide pressure relief.This will avoid applying pressure to pressure-sensitive areas.  
Perform a foot wash on the patient with mild soap and warm water on a daily basis. Before putting the patient’s feet in the water, always make sure to check the temperature.Burns and skin damage are more likely to happen because the patient’s feeling on the foot area is impaired.      
Encourage the patient to keep the feet warm by wearing white cotton socks. Make sure that the patient’s socks and stockings are changed every day.This will keep moisture from causing further complications. The white cloth makes it easy to see if there is any presence of blood or exudates.  
Advise the patient to perform proper foot care. Teach the patient to apply a light moisturizer to the feet and after softening toenails with a bath, cut them straight across.Moisturizers prevent skin cracking by softening and lubricating dry skin while cutting the nails straight will help to avoid ingrown toenails, which can lead to infection.  
Advise the patient that it is not allowed to walk around barefoot.Walking barefoot can cause trauma, which could lead to ulceration and infection.
Explain to the patient the importance of washing the feet with lukewarm water and mild soap on a daily basis.This is a good way to implement and teach foot hygiene. Infections can be significantly reduced with proper foot hygiene.
Inspect the patient’s feet daily for the presence of trauma, redness, and breaks on the skinIf these signs are present, it is indicative that the patient needs preventive care.  

Nursing Care Plan for Diabetes 10

Risk for Ineffective Therapeutic Regimen Management

Nursing Diagnosis: Risk for Ineffective Therapeutic Regimen Management related to new-onset illness, treatment management that is not well understood, and a difficult medical management secondary to diabetes mellitus.

Desired Outcome: The patient will demonstrate awareness of diabetic self-care techniques,

will express verbally the comprehension of the diabetes disease process and its possible complications, and the patient will be able to perform all necessary procedures accurately and give discuss reasons for the actions.

Nursing Interventions for DiabetesRationale
Discuss with the patient about the previous management done to keep up with the diabetic treatment plan.  It can be a good place to start when trying to comprehend a patient’s diabetes management regimen’s complications or challenges. The patient may describe feelings of helplessness as a result of attempting to manage medications, food, exercise, blood glucose monitoring, and other preventative measures.
Evaluate the patient’s self-management abilities, including blood glucose monitoring techniques.The amount and type of education management required for the patient is determined by self-management skills.
Determine what circumstances may have affected the patient’s ability to stick to the medication routine.    Limited vision may make it difficult for the patient to appropriately prepare and deliver insulin. Limited mobility and a lack of fine motor control might make it difficult for the patient to administer insulin and check blood glucose levels. In addition, limited joint mobility or a prior handicap may make it difficult for the patient to evaluate the bottom of the feet.
Ask the patient’s financial health-care resources, and if there is any help available for financial needs.  For patients with limited financial resources, the cost of medication and supplies for blood glucose monitoring may be a barrier.
Explain to the patient about the treatment and make sure that the patient briefly understood the treatment plan.For some individuals, diabetes care information might be overwhelming and difficult to follow.  
Always provide positive feedback for the patient’s changed self-care behaviorsRather than emphasizing on ignored health habits, positive reinforcement encourages the patient to stick to the treatment plan. To change a patient’s health or lifestyle practices, avoid using fear or scare tactics.
Determine and confirm the patient’s understanding of hyperglycemia, its symptoms, causes, therapy, and prevention.Patients who are previously diagnosed with diabetes who have elevated blood glucose levels should have their diabetes treatment evaluated.

Nursing Care Plan for Diabetes 11

Ineffective Coping

Nursing Diagnosis: Ineffective Coping related to poor ability in understanding the disease process, inadequate social support, inadequate perception of control and insufficient resources secondary to diabetes mellitus as evidenced by negative self-image, grief, a lack of problem-solving abilities, and fatigue.

Desired Outcomes:

  • The patient will be able to declare the ability to cope and when necessary, seeks assistance.
  • The patient will show problem-solving abilities and engage in society at a normal level.
  • The patient will be free of self-destructive actions and the patient will be able to address needs, communicate them and negotiate with others.
Nursing Interventions for DiabetesRationale
Examine the patient about the presence of distinguishing qualities.  Stress can cause a wide range of behavioral and physiological responses, which can indicate how difficult it is to cope.
Assist the patient in identifying personal abilities and expertise, as well as setting realistic goals.Patients who are involved in decision-making are more likely to progress toward independence.
Allow the patient to communicate their worries, anxieties, feelings, and expectations.Actual or perceived threats can be expressed verbally, which can assist lessen fear and facilitate continuous discussion.
Advise the patient to demonstrate feelings of acceptance and comprehension. False assurances should be avoided at all times.Problem-solving and good coping are aided by an open connection. False reassurances are never useful to the patient and only serve to alleviate the care provider’s distress.
Encourage the patient to make decisions and take part in the planning of their care and activities.Participation provides the patient a sense of control and boosts their self-esteem.  
Encourage the patient to recognize and value own qualities and strengths.    Patients may not be able to perceive their own strengths during a crisis. Increasing awareness can help you make better use of your strengths.
Provide the patient a thorough explanation of the desired information and avoid giving more than what the patient can manage.Patients who aren’t functioning well have a harder time absorbing knowledge and may require additional help at first.  
Provide the patient and family facts and explanation before giving care and providing any procedure.    Families want knowledge and answers in distressing situations. The patient and family will be better prepared to understand the condition and its outcomes if they are given information.
Discuss with the patient about the previous stressors and effective coping techniques.Describing earlier experiences helps to build successful coping mechanisms while also assisting in the elimination of dysfunctional coping mechanisms.
Apply distraction methods during procedures that may cause fear to the patient.Distraction is utilized to divert focus away from a feared treatment and toward an enjoyable experience.

Nursing Care Plan for Diabetes 12

Risk for Risk-Prone Behavior

Nursing Diagnosis: Risk for Risk-Prone Behavior related to negative self, poor comprehension several stress factors, lack of social support and negative perceptions about healthcare secondary to diabetes mellitus.

Desired Outcomes:

  • The patient will be able to demonstrate an increase in self-care interest and participation.
  • The patient will develop the ability to take responsibility for his/her own needs.
  • The patient will be able to identify stressors that cause difficulty adapting to changes in health status and take particular steps to address them.
  • The patient will be able to begin making lifestyle modifications that will allow adaptation to current circumstances.
Nursing Interventions for DiabetesRationale
Conduct a physical and psychosocial examination to the patient.Physical and psychosocial assessments are used to establish the extent of the patient’s current condition’s limitation.
Listen to the patient’s perspective of incompetence or reluctance to adapt to present situations. Examine historical and current significant support systems such as family, church, groups, and organizations.This is used to identify available resources that can be used in the treatment plan.
Assess the patient and significant others about emotions that indicate a lack of adjustment such as overwhelming anxiety, dread, rage, worry and denial.The development of coping behaviors is limited, therefore primary caregivers provide support and serve as role models.  
Determine the patient’s inability or lack of willingness to explore available resources. Examine available documents and resources to identify life experiences such as medical records, statements from significant others and notes from consultants.In times of extreme physical and/or mental stress, the patient may be unable to accurately analyze the events that led to the current situation.    
Provide the patient with a comfortable environment that encourages open communication.The patient will be able to verbalize feelings about diminished function that can be expressed in a true and transparent manner.
Provide therapeutic communication techniques such as active-listening, acknowledgment, and silence.  This will help in developing a plan of action with the client to address immediate needs and assist with the plan’s implementation. Provides a starting point for dealing with the current circumstance in order to go on with the plan and assess progress.  
  

With proper use of the nursing process, a patient can benefit from various nursing interventions to assess, monitor, and manage diabetes and promote client safety and wellbeing.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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