Nursing Care Plan for Diabetes Mellitus
Assessment
- Family Health History
- Are there families who suffer from illnesses such as client ?
- Patient Health History and Previous Treatment
- How long suffered from DM client, how to handle, get what kind of insulin therapy, how to take the medicine whether regular or not, what is done to cope with illness clients.
- Activity / Rest:
- Tired, weak, hard Moves / walking, muscle cramps, decreased muscle tone.
- Circulation
- Is there a history of hypertension, AMI, claudication, numbness, tingling in the extremities, ulcers on the feet long healing time, tachycardia, changes in blood pressure
- Ego Integrity
- Stress, anxiety
- Elimination
- Changes in the pattern of urination (polyuria, nocturia, anuria), diarrhea
- Food / Fluids
- Anorexia, nausea, vomiting, do not follow the diet, weight loss, thirst, the use of diuretics.
- Neurosensori
- Dizziness, headache, numbness, muscle weakness numbness, paraesthesia, visual disturbances.
- Pain / Leisure
- Abdominal strain, pain (is / weight)
- Respiratory
- Cough with or without purulent sputum
- Security
- Dry skin, itching, skin ulcer.
Nursing Diagnosis and Nursing Intervention
Fluid volume deficient related to osmotic diuresis from hyperglycemia
Planning
After 8 hours of nursing interventions, the patient will demonstrate adequate hydration.
Intervention
- Monitor orthostatic blood pressure changes.
- Rational : Hypovolemia may be manifested by hypotension and tachycardia.
- Assess peripheral pulses, capillary refill, skin turgor, and mucous membrane.
- Rational : Indicators of level of dehydration, adequacy of circulating volume.
- Monitor respiratory pattern like Kussmaul’s respirations and acetone breath.
- Rational : Lungs remove carbonic acid through respirations, producing a compensatory respiratory alkalosis for ketoacidosis.
- Monitor input and output. Note urine specific gravity.
- Rational : Provides ongoing estimate of volume replacement needs, kidney function, and effectiveness of therapy.
- Promote comfortable environment. Cover patient with light sheets.
- Rational : Avoids overheating, which could promote further fluid loss.
- Monitor temperature, skin color and moisture.
- Rational : Fever, chills, and diaphoresis are common with infectious process; fever with flushed, dry skin may reflect dehydration.
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