NursingInterventions for Type 2 Diabetes Mellitus JenelyseMendolaNUR32612/03/2017 NursingInterventions for Type 2 Diabetes Mellitus Type 2 diabetes mellitus is a condition in which the bodydoes not use insulin properly.
At first, the pancreas makes extra insulin tocompensate for this but, over time the body cannot keep up and doesn’t makeenough insulin to keep blood glucose at normal levels. High levels of insulinin the body cause the body to store fat and prevent fat from being utilized bythe body. Diabetes Mellitus is a global problem affecting roughly 415 millionadults (Moloughney, 2017). Numbers are expected to increase significantly overthe next twenty years.
Type 2 diabetes is the form that is most common. Notonly do patients have to worry about the disease itself but all the othercomplications that go along with it if not controlled properly. Treatment islife-long which can create fluctuations in compliance in many people. Thepurpose of this paper is to explain nursing interventions that can be utilizedfor patients affected with type 2 diabetes mellitus. The interventions willinclude increased awareness of the role of uncontrolled diabetes, signs andsymptoms of hyperglycemia, strategies to improve nutrition, and the role of exercisein controlling diabetes.
The first intervention is to educate the patient on therole of uncontrolled diabetes in the development of complications. By knowingthe risks associated with uncontrolled diabetes, it can help the patient tostay motivated and on track with their care. Acute complications of type 2diabetes mellitus can cause hypoglycemia, hyperglycemia, and a hyperosmolarhyperglycemia state. Chronic complications can cause coronary artery disease,peripheral vascular disease, retinopathy, neuropathy, and nephropathy. Therationale behind this intervention is to stress the importance of personalself-management and the responsibility of the individual to control their care.These exacerbations of the condition can cause patients to lose their toes,feet, or legs, it can cause blindness, and it can lead to serious heartconditions such as congestive heart failure or a myocardial infarction.Explaining these serious complications to the patient can hopefully lead to aneye-opening experience for them and can help them to take control of theirhealth.
The second intervention includes teaching the patient thesigns and symptoms of hyperglycemia. Hyperglycemia can occur in a patient withtype 2 diabetes mellitus if they have increased food intake, if they omit theiroral medications, if they decrease their insulin dosing, decrease exercise, andif they have infection, illness, or dehydration. The signs and symptoms ofhyperglycemia are a blood glucose level greater than 200 mg/dL, polyuria,polydipsia, polyphagia, fatigue, blurred vision, and weight loss. Polyuria isincreased urination, polydipsia is excessive thirst, and polyphagia isexcessive hunger. The rationale behind this intervention is elevated bloodglucose causes dehydration from osmotic diuresis, potassium is elevated becauseof hemoconcentration, and because carbohydrates are not metabolized, the clientloses weight.
The patient should be aware of these symptoms so they know whento increase their insulin or seek medical attention. The third intervention is to discuss strategies with thepatient to improve nutrition. Provide information regarding food groups such ascarbohydrates which include starches, starchy vegetables, milk, fruits, aprotein group, and a vegetable group. Instruct on the use of the “plate method”as an easy way of meal planning and maintaining healthy nutrition. Thisincludes showing the client and family a paper plate that is divided intoquarter sections. Fill half of the plate with non-starchy vegetables (lettuce,tomatoes, and broccoli), fill a quarter with protein (meat, beans, fish, andeggs), and fill a quarter with starches (rice, potatoes, pasta, and bread).
Addone cup of skim milk, and one piece of fruit. Teach the client to lower fatintake by trimming fat off meat, avoiding fried foods, limiting saladdressings, and selecting low fat. Advise the client to drink water, limit dietsoda, coffee, and tea. Avoid all sugar drinks (juice, soda, and power drinks).Eat breakfast every day (high-fiber cereal, low-fat milk), do not skip meals, makean effort to eat the same amount at each meal, avoid seconds, and watch portionsizes. The rationale behind this intervention is that balanced nutrition helpsto maintain normal blood glucose levels. The American Diabetes Associationrecommends an individualized meal plan based on a client assessment. The “platemethod,” carbohydrate counting, and portion control are easy and acceptablemethods of meal planning.
Low-fat foods, water as a beverage, and portioncontrols of carbohydrates and protein can reduce weight and lower blood glucose.Poor glucose control and insulin resistance are two of the most pervasivebio-markers associated with chronic diseases affecting over 80% of Americans (Moloughney,2017). Carbohydrate counting and controlling their diet can help the patient tomanage their type 2 diabetes mellitus and can keep exacerbations fromoccurring. The fourth intervention is to explain the role ofexercise in controlling type 2 diabetes mellitus.
Exercise intervention isconsidered a cornerstone. It improves glycemic control significantly inpatients with type 2 diabetes. Consideringthe significant relationship between blood glucose content and the risk ofcardiovascular disease and premature death, such a decline in blood glucosecontent would lead to a reduction in the risk of microvascular and macrovasculardisease and premature death. Besides lowering blood glucose content in thesepatients, exercise interventions lead to improvements in exercise capacity,decreases in adipose tissue mass, increases in lean tissue mass, improvementsin blood lipid profile and quality of life, and reductions in bloodinflammatory markers and blood pressure. Exercise interventions substantiallyreduce cardiovascular disease risk. Explain to the patient that the goal is toengage in a total of thirty minutes of moderate-intensity physical activityevery day.
Wear a pedometer to monitor and motivate. Instruct the client toseek the advice of a health care provider before beginning an exercise program.Exercise may be contraindicated with certain complications (severe nephropathyand proliferative retinopathy). Teach the client to avoid injecting insulininto a body part that is about to be exercised. Encourage the client toexercise with others or where other informed persons are nearby, always weardiabetes identification, and always carry a fast-acting carbohydrate. Explainhow to reduce serious hypoglycemic episodes related to exercise, monitor bloodglucose before and after exercise, and exercise when blood glucose level tendsto be higher, such as shortly after a meal. Always carry a source offast-acting sugar for emergency. The rationale behind this intervention is insulinabsorption increases in a body part that is exercised, which alters theinsulin’s absorption.
Exercising with others ensures that assistance is availableshould hypoglycemia occur. Proper timing of exercise, monitoring blood glucose,and adjusting food or insulin decreases the risk of exercise induced hypoglycemia.In the event of a severe reaction, a semiconscious or unconscious client mayrequire glucagon. Exercise is one of the major factors in controlling type 2diabetes mellitus so encouraging the patient to avoid a sedentary lifestyle isvery important. Conclusion Diabetes is a worldwide epidemicthat can be easily controlled with diet and exercise. Consumers face manychallenges when it comes to managing this health condition, as it requireslife-long commitments that often lead to physical and mental struggles. Thereare several interventions that can be used for patients with type 2 diabetesmellitus.
These include increased awareness of the role of uncontrolleddiabetes, signs and symptoms of hyperglycemia, strategies to improve nutrition,and the role of exercise in controlling diabetes. All of these interventionsplay a role in keeping the client on track and focused on their health. Themany complications that diabetes can cause are severe and can lead to ashortened life. Explaining the importance of the improvement and maintenance ofhealth is imperative to the patient. Perhaps through these interventions, type2 diabetes mellitus patients can avoid exacerbations and can control or evenimprove their condition. ReferencesCarpenito, L. J.
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2522/ptj.20120400Moloughney, S. (2017,October). Blood Sugar Under Threat: Developing Effective Management Strategies:Along with diet and lifestyle changes, nutraceuticals can help consumersachieve better metabolic health. Nutraceuticals World, 20(8), 46+. Retrievedfrom http://libproxy.ecpi.edu:2374/apps/doc/A510183400/HWRC?u=lirn55593&sid=HWRC&xid=98326e65