Diabetes Nursing Diagnoses

Diabetes is an extremely common condition and one of the leading causes of death in the United States. While some cases of diabetes are caused by factors like weight gain or diet, other types of diabetes are caused by genetics. Diabetes mellitus is essentially a condition where the pancreas stops producing as much insulin. It may also happen when cells stop responding to the insulin that exists in the body. When the cells stop responding, it is called insulin resistance. Basically, the body becomes unable to absorb dietary glucose within the cells. Left untreated, diabetes can become fatal.

The Types of Diabetes

There are essentially three types of diabetes. The first type is known as Type 1 diabetes. It is also called Insulin Dependent Diabetes Mellitus. This type of diabetes happens when the body is not producing insulin. Because of this, the individual needs to have insulin injections to stay alive. They have to carefully track their blood sugar to make sure that it does not get too low or too high.

With Type 2 diabetes, the insulin in the body is not being used properly. It is known as insulin resistance and is more common among overweight people. The last type of diabetes is called gestational diabetes. This is when a pregnant woman develops diabetes, but did not have it before she was pregnant.

There are also a few other types of diabetes as well. These include congenital diabetes, monogenic diabetes, diabetes induced by high doses of glucocorticoids and cystic fibrosis related diabetes.

Diabetes Nursing Diagnoses

1. Imbalanced Nutritional Risks

There is a risk with diabetes that the body’s nutritional needs will not be met. The symptoms of this include insulin deficiency, reduced intake of food or fluids, increased stress hormones, diarrhea, weight loss, fatigue, diluted urine, weakness and frequent urination. Reduced food or fluid intake may be caused by stomach pain, altered consciousness, nausea, gastric fullness or anorexia.

Nursing interventions for this include:

– Administering insulin and glucose if needed
– Weighing the patient each day
– Checking for signs of hypoglycemia
– Perform glucose testing
– Creating a diet of 60 percent carbs and 20 percent proteins or fats
– Comparing weight with dietary intake
– Checking bowel signs
– Reporting symptoms like vomiting, stomach discomfort or diarrhea

2. Risk of Impaired Skin

If the patient is immobilized, it can lead to skin conditions like rashes and sores. Patients with diabetic neuropathy can also develop skin issues. Symptoms of this include changes to the wound or wounds that take a long time to heal.

Nursing interventions for this problem may include:

– Checking wound secretions
– Removing any pressure on the wound
– Looking at the type of wound
– Keeping the would clean and dressed with a sterile gauze

3. Deficient Fluid Risks

Because of diabetes, urine output can increase. This can lead to other problems. Symptoms of this problem include vomiting, confusion, poor skin turgor, diarrhea, nausea, dry skin, sudden weight loss, weakness, hypotension, excessive thirst and tachycardia.

Nursing interventions for this problem include:

– Maintaining and monitoring fluid intake
– Monitoring vital stats
– Maintaining a comfortable environment
– Nursing interventions:

4. Infection Risks

Circulation problems, high glucose levels or leukocyte issues can lead to infections.

Nursing interventions for this problem may include:

– Ensuring good hygiene
– Keeping the skin dry
– Looking for signs of inflammation and infection
– Rotating IV sites
– Maintaining apepsis
– Administering antibiotics when needed
– Providing proper skin care

5. Activity Intolerance Risk

Muscle weakness, fatigue and ill health can lead patients to stop being as active. Signs of this risk include high pulse rate, tiredness, high blood pressure, inability to do daily activities and decreased muscle strength.

Possible nursing interventions include:

– Seeing which muscles are affected by weakened strength
– Providing intermittent breaks and a quiet environment
– Encouraging patients to take part in treatment
– Checking muscle strength before and after giving medications

6. Disturbed Sensory Perception Risks

The patient’s mental state, tactile perception and visual perception may be altered. This may be noticeable through the patient losing their orientation. It can happen because of an imbalance of glucose, electrolytes or insulin.

Possible nursing interventions for this problem may include:

– Reorienting the patient to the place and time
– Ensuring a fixed schedule
– Monitoring their vital signs and mental status
– Making them take part in daily activities
– Carefully monitoring blood parameters like Hb/Hct, BUN/Cr and glucose levels

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