nursing plan for diabetes

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MABEL CASE STUDY
1. Six Nursing strategies to assist diabetes patient for each identified problem Risk for Impaired Swallowing
Maintain upright position for 45–60 min after eating.
Stimulate lips to close or manually open mouth by light pressure on lips/under chin, if needed; •Place food of appropriate consistency in unaffected side of mouth; •Have suction equipment available at bedside, especially during early feeding efforts. •Promote effective swallowing, e.g.:Schedule activities/medications to provide a minimum of 30 min rest before eating; •Provide pleasant environment free of distractions (e.g., TV); •Feed slowly, allowing 30–45 min for meals;

Self-Care Deficit
Assess abilities and level of deficit (0–4 scale) for performing ADLs. •Provide self-help devices, e.g., button/zipper hook, knife-fork combinations, long-handled brushes, extensions for picking things up from floor; toilet riser, leg bag for catheter; shower chair. •Assist and encourage good grooming and makeup habits.

Be aware of impulsive behavior/actions suggestive of impaired judgment. •Create plan for visual deficits that are present, e.g.: Place food and utensils on the tray related to patient’s unaffected side; Situate the bed so that patient’s unaffected side is facing the room with the affected side to the wall; Position furniture against wall/out of travel path. •Provide positive feedback for efforts and accomplishments. •Avoid doing things for patient that patient can do for self, but provide assistance as necessary.

Impaired Verbal Communication

Assess type/degree of dysfunction: e.g., patient does not seem to understand words nor has trouble speaking or making self understood. Differentiate aphasia from dysarthria •Listen for errors in conversation and provide feedback

Ask patient to follow simple commands (e.g., “Shut your eyes,” “Point to the door”); repeat simple words/ sentences; •Point to objects and ask patient to name them;
Have patient produce simple sounds, e.g., “Sh,” “Cat”. •Provide alternative methods of communication, e.g., writing or felt board, pictures. Provide visual clues gestures, pictures, “needs” list, demonstration

Constipation

Maintain fluid intake of at least 2500 mL/day within cardiac tolerance when oral intake is resumed. •Determine the pattern of defecation for clients and train clients to do so. •Set the time is right for clients such as defecation after meals. •Provide laxatives or enemas as indicated

Provide coverage of nutritional fiber according to the indication. •Assessment of usual and current bowel pattern, duration of the problem, and individual contributing factors. Depression/Aggressive behaviour

Make sure client is taking the drug correctly and precisely •Help to understand that the client can overcome despair. •Clients are protected from violent behaviour to self and others •Listen to the notice of the patient with empathy and patient attitude more use non-verbal language. For example: a touch, a nod. •Help identify sources of hope (eg, peer relationships, beliefs, things to be resolved) •Monitor carefully the risk of suicide / violence themselves.

1.DEFINITIONS

CVA STROKE A cerebral vascular accident is another name for a stroke. It is damage to the brain caused by a disruption of the blood supply to a part of the brain. This disruption of blood supply can be caused by a blood clot, or by a ruptured artery. The symptoms of a cerebral vascular accident depend on which part of the brain is affected. Common symptoms may include paralysis of a part of the body, loss of all or part of the vision, or loss of the ability to speak or to understand speech.

DIABETES Diabetes is a chronic condition in which the levels of glucose (sugar) in the blood are too high. Blood glucose levels are normally regulated by the hormone insulin, which is made by the pancreas. In people with diabetes, the pancreas doesn't produce enough...