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
- Long-term/progressive illness that is not curable
- Dependence on others
Possibly evidenced by
- Reluctance to express true feelings; expressions of having no control/influence over situation
- Apathy, withdrawal, anger
- Does not monitor progress, nonparticipation in care/decision making
- Depression over physical deterioration/complications despite patient cooperation with regimen
- Acknowledge feelings of helplessness.
- Identify healthy ways to deal with feelings.
- Assist in planning own care and independently take responsibility for self-care activities.
|Encourage patient and/or SO to express feelings about hospitalization and disease in general.||Identifies concerns and facilitates problem-solving.|
|Acknowledge normality of feelings.||Recognition that reactions are normal can help patients problem-solve and seek help as needed. Diabetic control is a full-time job that serves as a constant reminder of both presences of disease and threat to patient’s health.|
|Assess how patient has handled problems in the past. Identify locus of control.||Knowledge of an individual’s style helps determine the needs for treatment goals. A patient whose locus of control is internal usually looks at ways to gain control over their own treatment program. Patient who operates with an external locus of control wants to be cared for by others and may project blame for circumstances onto external factors.|
|Provide opportunity for SO to express concerns and discuss ways in which he or she can be helpful to patient.||Enhances sense of being involved and gives SO a chance to problem-solve solutions to help patient prevent recurrence.|
|Ascertain expectations and/or goals of patient and SO.||Unrealistic expectations or pressure from others or self may result in feelings of frustration and loss of control. These can impair coping abilities.|
|Determine whether a change in relationship with SO has occurred.||Constant energy and thought required for diabetic control often shifts the focus of a relationship. Development of psychological concerns affecting self-concept may add further stress.|
|Encourage patient to make decisions related to care: ambulation, schedule for activities, and so forth.||Communicates to patient that some control can be exercised over care.|
|Support participation in self-care and give positive feedback for efforts.||Promotes feeling of control over situation.|
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