Nursing Diagnosis and Nursing Interventions for Diabetes Mellitus

Nursing Diagnosis for Diabetes Mellitus

1. Risk for Injury (hypoglycemia) related to insulin effects, inability to eat.
2. Activity Intolerance related to poor glucose control
3. Imbalanced Nutrition: More than Body Requirements related to intake in excess of activity expenditures

Nursing Interventions for Diabetes Mellitus

1. Risk for Injury (hypoglycemia) related to insulin effects, inability to eat.
   
   Goal :
   Injury is not appears
   
   Nursing Interventions :
   • Assess patient for the signs and symptoms of hypoglycemia :
     • Adrenergic (early symptoms) sweating, tremor, pallor, tachycardia, palpitations, nervousness from the release of adrenalin when blood glucose falls rapidly.
     • Neurologic (later symptoms) light-headedness, headache, confusion, irritability, slurred speech, lack of coordination, staggering gait from depression of central nervous system as glucose level progressively falls.
   • Closely monitor blood glucose levels to detect hypoglycemia.
   • Assess patient for cognitive or physical impairments that may interfere with ability to accurately administer insulin.
   • Treat hypoglycemia promptly with 15 to 20 g of fast-acting carbohydrates.
   
   
   
2. Activity Intolerance related to poor glucose control
   
   Goal :
   Normal Activity
   
   Nursing Interventions :
   • Instruct patient to avoid exercise whenever blood glucose levels exceed 250 mg/day and urine ketones are present. Patient should contact health care provider if levels remain elevated.
   • Advise patient to assess blood glucose level before and after strenuous exercise.
   • Encourage patient to eat a carbohydrate snack before exercising to avoid hypoglycemia.
   • Advise patient that prolonged strenuous exercise may require increased food at bedtime to avoid nocturnal hypoglycemia.
   
   
   
3. Imbalanced Nutrition: More than Body Requirements related to intake in excess of activity expenditures
   
   Goal :
   Nutritions banlance
   
   Nursing Interventions :
   • Assist patient to identify problems that may have an impact on dietary adherence and possible solutions to these problems. Emphasize that lifestyle changes should be maintainable for life.
   • Assist patient to establish goals for weekly weight loss and incentives to assist in achieving them.
   • Advise patient on the importance of an individualized meal plan in meeting weight-loss goals. Reducing intake of carbohydrates may benefit some patients; however, fad diets or diet plans that stress one food group and eliminate another are generally not recommended.