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symptoms of diabetes
12 year old previously healthy female presented to doctor with frequent urination, excessive thirst and weight loss of 8 pounds -
Nursing diagnosis given
Given the nursing diagnosis of knowledge defecit -
Emergency Room Visit
Primary care provider sent patient to ED to be admitted and get official diagnosis -
knowledge assessment
Assess parents and child understanding
of disease and ability to perform
procedures and care, for educational
level and learning capacity, and for
developmental level. -
Begin teaching
Provide a quiet, comfortable
environment; allow time for teaching small amounts at a time and for reinforcement, demonstrations and return demonstration; start educating one day following diagnosis and limit sessions to 30 to 60 minutes. -
Who will be included
Include as many family members in teaching sessions as possible. -
Basics
Teach about the cause of disease, disease
process and pathology; use pamphlets
and other aids appropriate for the age of child and level of comprehension of parents. -
Injection teaching
Instruct parents and child in insulin
administration including drawing up insulin into the syringe, rotating vial instead of shaking, drawing clear insulin first if mixing 2 types in the same syringe, injecting SC, storing insulin, rotating sites,
adjusting dosages, reusing a syringe, and needle, and disposing of them. -
Emergency Identification
Instruct the child to wear or carry identification and information about the disease, treatment, and physician name. -
Blood glucose monitoring
Instruct parents and child to monitor blood glucose levels 4 times a day (before meals and before bed), with a lancet and blood-testing meter or a reagent strip compared to a color chart; collection and testing of urine with ketostix or Clinitest. -
nutrition education
Teach parents and child about dietary
planning with an importance on proper meal times and adequate caloric intake
according to age as ordered. Teach that food intake depends on activity, and describe methods to judge amounts of foods; provide a list of acceptable food items from “fast food” restaurants. -
Common complications
Teach parents and child about skin
problems associated with diabetes, need for regular dental examinations, foot care, protection of and proper care of nails, prevention of infections and exposure to infections, eye examinations, immunizations. -
exercise
Teach parents and child about the role of
exercise and changes needed in food and insulin intake with increased or decreased activity. -
monitoring
Instruct parents and child to keep a record of insulin administration, glucose monitoring, responses to diet and exercise, noncompliance in medical regimen and effects. -
Review and Answer Questions
Prior to discharge be sure patient and family know how to draw up insulin, how to give an injection, review diet and exercise information -
discharge
Safe discharge to home knowing how to care for diabetes