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What is diabetes mellitus?

Diabetes mellitus is chronic syndrome characterized by distributed energy metabolism
Related to deficiency of insulin secretion or altered of insulin action at cellular level

Types:
There are two types of diabetes mellitus type 1 and type 2

Type 1:  is caused by insulin deficiency it known as child onset diabetes
Type 2: caused by deficiency of insulin action at the cellular level or body ineffective use of insulin
There are other types of diabetes like gestational diabetes which occurs during women pregnancy

Causes

·        Genetic
·        Exposure to stress
·        Infection in pancreas

Symptoms (Assessment criteria)

·        Change in urination – Increase urine production (polyuria)
·        Loss of weight- weakness –muscle cramps –decrease in muscle tones
·        Fatigue –nausea –abdominal pain
·        Ulcer on legs – long healing process ,numbness in extremes 
·        In extreme …………coma

Complication

1-   Infection: Glucose increase growth of infection  
2-   Arteriosclerosis with hypertension
3-   Retinopathy
4-   Neuropathy
5-   Increase stunted growth in children
6-   Increase liver size ( Hepatomegaly) 

Nursing care plane and nursing interventions for diabetes mellitus 

 nursing mangment for diabetes mellitus


(1) Nursing diagnosis

Increase risk for injury related to hypoglycemia
Nursing goal

Nursing Interventions 

1-   Assess patient every 2 hours  for signs of hypoglycemia and when you find it give patient glucose quickly
2-   If there is hyperglycemia check blood glucose and give insulin according to glucose level
3-   Give insulin before meals at least 30 minute before meal

Expected out come

Avoiding hypoglycemia occurs to patient

(2) Nursing diagnosis

Impaired skin integrity related to abnormal healing of injures

Nursing goals
Maintaining skin normal

Nursing interventions 

1-   Assess skin integrity
2-   Record any skin changes
3-   Administer antibiotics as order to treat infection
4-   Assess temperature every 2 hours, temperature is goad indicator for infection.

Expected outcome 

Patient skin is free from any abnormalities

(3) Nursing diagnosis

Imbalanced nutrition, less than body requirements related to insufficient of insulin , decrease oral intake and increase stress hormone 

Nursing goals 

Patient eats balanced diet and keep his weight normal .

Nursing interventions
 
·        Check patient weight every day regularly
·        Allow patient to eat preferred food
·        Give insulin as ordered
·        Give meal at same time every day
·        Encourage patient to eat balanced diet
·        Encourage patient to eat green vegetable

Expected outcome
Maintaining normal patient weight and blood glucose level

(4) Nursing diagnosis:

Body image disturbance related to abnormal health

Nursing goals
Patient develop self-esteem

Nursing interventions 

·        Ask patient to increase social interaction
·        Allow doing social activities and his previous hobbies
(5) Nursing diagnosis

Increase risk for infection related to increase blood glucose level and decrease immune functions

Nursing goals

Decrease risk for infection

Nursing interventions 

·        Check signs of infection and inflammations
·        Check temperature regularly , temperature is a good indicator for infection – infection increase body temperature
·        Instruct patient to keep good hygiene.
·        Change patient position every 2 hours


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