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Patients with diabetes need to understand what diabetes is. Patients who understand what diabetes is and the complicated process associated with the disease are more likely to comply with the prescribed regimen. Diabetes Mellitus is a syndrome with disordered metabolism and inappropriate hyperglycemia due to either a deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate (Davis, 2001). Diabetes is a chronic progressive disease that requires lifestyle changes, especially in the areas of nutrition and physical activity. The overall goal of medical and nutritional therapy is to assist persons with diabetes in making self-directed behavioral changes that will improve their overall health (Franz, 2012). Blood glucose monitoring and goals of blood glucose monitoring

Testing blood glucose levels pre-meal and post-meal can help the patient with diabetes make better food choices, based on how their bodies are responding to specific foods. Patients should be taught specific directions for obtaining an adequate blood sample and what to do with the numbers that they receive. Research has found that patients who have had education on the use of their meters and how to interpret the data are more likely to perform self-blood glucose monitoring on a regular basis (Franz, 2012).

There are many different glucose monitors available for patients. The patient needs to have a device that is easy for them to use and convenient. A patient’s visual acuity and dexterity skills should be assessed prior to selecting a blood glucose monitoring device. A device is usually selected to meet the patient’s needs in collaboration with a diabetic educator at a health care facility.

The patient needs to be reminded to record the blood glucose values on a log sheet with the date and time and any associated signs and symptoms that he/she is experiencing at the time the specimen was obtained. This log should be shared with his/her primary care practitioner.

A discussion of glycosylated hemoglobin (HbA1c) should include the reasons for doing the test, how it is performed and how the health care practitioner will interpret the data. These laboratory tests are ordered on a routine basis along with other laboratory tests that are being monitored for the patient. A simple method to describe the HbA1c is to tell the patient that the test measures the amount of sugar that attaches to the protein in the red blood cell. The test shows the average blood sugar during the last three months. The higher the blood sugar the higher the HbA1c. The high blood sugar over a long period of time causes damage to the large and small blood vessels therefore increasing the risk of complications from diabetes.

Medications and Insulin

The patient with diabetes needs to be reminded that the addition of medications to help manage his/her diabetes is not because they are failing at diet management. Many patients with diabetes become depressed or despondent when they have to begin taking oral hyperglycemic medications and/or insulin. The teaching session should include a review of the different types of oral diabetic agents. A review of the different types of insulins and how to mix insulins should also be discussed.

Teach the patient about self-administration of insulin or oral agents as prescribed, and the importance of taking medications exactly as prescribed, in the appropriate dose (Davis, 2001). Patients should be provided with a list of signs and symptoms of hypoglycemia and hyperglycemia and actions to take in each situation.

Complications from Diabetes

The teaching regarding the complications encountered from diabetes should stress the effect of blood glucose control on long-term health (McGovern, 2002). The patient should be taught how to manage their diabetes when he/she has a minor illness, such as a cold, flu or gastrointestinal...
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