Friday, June 1, 2012

Nursing Care Plan - Diabetes

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Bellow you will find a copy of one of the nursing care plans for type 2 diabetes authored by myself (a registered nurse manager). An detailed commentary by myself can be found below the nursing care plan. Please read through the care plan to better understand standards of type 2 diabetes care.
Please refer to the link at the end of this article for more in-depth Diabetes information for both patients and medical professionals!
Nursing Care Plan NANDA Nursing Diagnosis (problem statement)
Imbalanced nutrition r/t excessive intake of nutrients as evidenced by Type II Diabetes:
Nursing Care Plan Goal Statements:
  1. Patient will acknowledge his or her behaviors / feelings that exacerbate imbalanced nutrition (excessive) within 8 hours. (this is a great example of a short term goal statement).
  2. Patient will design a realistic dietary plan which will assist him / her with decreasing caloric intake, within 24 hours. (the key word in this statement is REALISTIC, to increase compliance).
  3. Patient will incorporate at least 30 minutes of well tolerated exercise into daily schedule by the end of 48 hours. (another short term goal statement, a lifestyle change in the longterm).
Nursing Interventions for Imbalanced Nutrition (Excessive):The Nurse shall explain and have patient verbalize the relationship of diabetes and diet, and the patient shall give a return explanation is his / her own words. (this nursing intervention will help clear up and misconseptions and reinforce the medical value of a healthy diabetic diet).
Patient will consult with a dietician to find out what an optimal caloric intake for her size, activity level and goal of weight loss is, so that she knows where to start in planning her dietary needs. (initial education and working knowledge).
Patient will keep a journal of total intake every time food is consumed and mark where improvement can be made. (accountability, ongoing education experience)
Patient will display (you choose how) a working knowledge of how to read a food label after nurse demonstrates (you choose method according to patient's best way of learning)
Promote family member or caregiver participating in the above mentioned 30 minute exercise program. (increases compliance through a support system, motivation).
The nurse shall have patient record an exercise log. (accountability)
The patient should have a list of goals and reward for those goals related to reducing overall caloric intake. (will increase compliance).
Comments: The most important fact to remember in dealing with type 2 diabetes is well thought out diet can completely negate the diabetic disease process. The Diabetic diet can be strict, but some "cheating" in moderate, planned ways are actually a GOOD idea. Human behavior dictates, and research has shown, a strict diet is rarely followed. With type 2 diabetes the diet is a lifetime diet and overall adherence to the diet is the overall goal. Lack of a regulated diet can easily lead to type 1 diabetes and more severe medical problems such as neuropathy, vision loss, and premature death related to diabetic complications.

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