What is Diabetes Mellitus?
Diabetes mellitus (DM) is a chronic disease characterized by insufficient production of insulin in the pancreas or when the body cannot efficiently use the insulin it produces. This leads to an increased concentration of glucose in the bloodstream (hyperglycemia). It is characterized by disturbances in carbohydrate, protein, and fat metabolism. Sustained hyperglycemia has been shown to affect almost all tissues in the body and is associated with significant complications of multiple organ systems, including the eyes, nerves, kidneys, and blood vessels.
Diabetes mellitus has a few types:
- Type 1 diabetes is characterized by destruction of the pancreatic beta cells.
- Types 2 diabetes involves insulin resistance and impaired insulin secretion.
- Gestational diabetes mellitus is when a pregnant woman experiences any degree of glucose intolerance with the onset of pregnancy.
Nursing Care Plans for Diabetes Mellitus
Nursing care planning goals for patients with diabetes include effective treatment to normalize blood glucose and decrease complications using insulin replacement, balanced diet, and exercise. The nurse should stress the importance of complying with the prescribed treatment program. Tailor your teaching to the patient’s needs, abilities, and developmental stage. Stress the effect of blood glucose control on long-term health.
Here are 13 nursing care plans (NCP) and nursing diagnoses for diabetes mellitus (DM):
- Risk for Unstable Blood Glucose
- Deficient Knowledge
- Risk for Infection
- Risk for Disturbed Sensory Perception
- Risk for Ineffective Therapeutic Regimen Management
- Risk for Injury
- Imbalanced Nutrition: Less Than Body Requirements
- Risk for Deficient Fluid Volume
- Risk for Impaired Skin Integrity
- Other Possible Nursing Care Plans
May be related to
- Decreased metabolic energy production
- Altered body chemistry: insufficient insulin
- Increased energy demands: hypermetabolic state/infection
Possibly evidenced by
- Overwhelming lack of energy, inability to maintain usual routines, decreased performance, accident-prone
- Impaired ability to concentrate, listlessness, disinterest in surroundings
- Verbalize increase in energy level.
- Display improved ability to participate in desired activities.
|Discuss with patient the need for activity. Plan schedule with patient and identify activities that lead to fatigue.||Education may provide motivation to increase activity level even though patient may feel too weak initially.|
|Alternate activity with periods of rest and uninterrupted sleep.||To prevent excessive fatigue.|
|Monitor pulse, respiratory rate, and BP before and after activity.||Indicates physiological levels of tolerance.|
|Discuss ways of conserving energy while bathing, transferring, and so on.||Patient will be able to accomplish more with a decreased expenditure of energy.|
|Increase patient participation in ADLs as tolerated.||Increases confidence level, self-esteem and tolerance level.|
|Assess response to activity.||Response to an activity can be evaluated to achieve desired level of tolerance.|
|Assess muscle strength of patient and functional level of activity.||To determine the level of activity.|
|Discuss with patient the need for activity.||Education may provide motivation to increase activity level even though patient may feel too weak initially.|
|Alternate activity with periods of rest or uninterrupted sleep.||Prevents excessive fatigue. Indicates physiological levels of tolerance.|
|Monitor pulse, respiration rate and blood pressure before and after activity.||Tolerance develops by adjusting frequency, duration and intensity until desired level is achieved.|
|Perform activities slowly with frequent rest periods.||Interventions should be directed at delaying the onset of fatigue and optimizing muscle efficiency.|
|Promote energy conservation techniques by discussing ways of conserving energy while bathing, transferring and performing ADLs.||Symptoms of fatigue are alleviated with rest. Also, patient will be able to accomplish more with a decreased expenditure of energy.|
|Provide adequate ventilation.||For proper oxygenation.|
|Instruct patient to perform deep breathing exercises.||Helps promote relaxation.|
|Provide comfort and safety measures.||To be free from injury during activity.|
|Administer oxygen as ordered.||To provide proper ventilation.|
References and Sources
References and recommended sources for this care plan guide for Diabetes Mellitus:
- Ackley, B. J. (2008). Evidence-based nursing care guidelines: Medical-surgical interventions. Elsevier Health Sciences.
- Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
- Brunner, L. S., & Suddarth, D. S. (2004). Medical surgical nursing (Vol. 2123). Philadelphia: Lippincott Williams & Wilkins. [Link]
- Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
- Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
- Rosenberg, C. S. (1990). Wound healing in the patient with diabetes mellitus. The Nursing clinics of North America, 25(1), 247-261. [Link]
- White, P. (1974). Diabetes mellitus in pregnancy. Clinics in perinatology, 1(2), 331-348.
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Endocrine and Metabolic Care Plans
Nursing care plans related to the endocrine system and metabolism:
- Acid-Base Balance
- - Respiratory Acidosis Nursing Care Plan
- - Respiratory Alkalosis Nursing Care Plan
- - Metabolic Acidosis Nursing Care Plan
- - Metabolic Alkalosis Nursing Care Plan
- Addison's Disease | 3 Care Plans
- Cushing’s Disease | 6 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Diabetes Mellitus Type 2 | 13+ Care Plans
- Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) | 4 Care Plans
- Eating Disorders: Anorexia & Bulimia Nervosa | 7 Care Plans
- Fluid and Electrolyte Imbalances | 10 Care Plans
- - Fluid Balance: Hypervolemia & Hypovolemia
- - Potassium (K) Imbalances: Hyperkalemia and Hypokalemia
- - Sodium (Na) Imbalances: Hypernatremia and Hyponatremia
- - Magnesium (Mg) Imbalances: Hypermagnesemia and Hypomagnesemia
- - Calcium (Ca) Imbalances: Hypercalcemia and Hypocalcemia
- Gestational Diabetes Mellitus | 4 Care Plans
- Hyperthyroidism | 7 Care Plans
- Hypothyroidism | 3 Care Plans
- Obesity | 4 Care Plans
- Thyroidectomy | 5 Care Plans