4 Diabetes Mellitus Type 1 (Juvenile Diabetes) Nursing Care Plans

By
Paul Martin, BSN, R.N.
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Insulin-dependent diabetes mellitus (IDDM) also known as type 1 diabetes or juvenile diabetes, is a metabolic disorder caused by a lack of insulin. The deficiency is believed to happen in people who are genetically prone to the disease and who have experienced a precipitating event, commonly a viral infection or environmental change, that causes an autoimmune response affecting the insulin-producing cells (beta cells) of the pancreas.

It is treated by injection of insulin and regulation of diet and activity that maintain body functions. Complications that occur from improper coordination of these include hypoglycemia and hyperglycemia which, if untreated, lead to insulin shock or ketoacidosis. Long-term effects of the disease include neuropathy, nephropathy, retinopathy, atherosclerosis, and microangiopathy.

Nursing Care Plans

Nurses have an essential role and responsibilities when caring for a client with diabetes such as providing child and family with education about the management of hyperglycemia and hypoglycemia including insulin administration, dietary regimen, and exercise needs for the child, helping the family to adjust to having a chronic disease, and preventing short-term and long-term complications of diabetes.

Here are four (4) nursing care plans (NCP) and nursing diagnosis (NDx) for diabetes mellitus type 1:

  1. Deficient Knowledge
  2. Compromised Family Coping
  3. Risk for Injury
  4. Risk for Unstable Blood Glucose
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Compromised Family Coping

Compromised Family Coping: A usually supportive primary person (family member, significant other, or close friend) insufficient, ineffective, or compromised support, comfort, assistance or encouragement that may be needed by the individual to manage or master adaptive tasks related to his or her health challenge.

May be related to

  • Inadequate or inaccurate information
  • Prolonged disease or disability progression that depletes the physical and emotional supportive capacity of caretakers

Possibly evidenced by

  • Expression and/or confirmation of concern and inadequate knowledge about long-term care needs, problems and complications
  • Anxiety and guilt
  • Overprotection of child

Desired Outcomes

  • Family will explore feelings regarding the child’s long-term needs.
  • Family will determine appropriate support systems and coping skills.
Nursing InterventionsRationale
Assess family coping mechanisms and its
effectiveness, family dynamics and expectations related to longterm care, developmental level of family, response of siblings, knowledge, and use of support systems and resources, presence of guilt and anxiety, overprotection and
overeating behaviors.		Recognizes coping methods that work and the need to develop new coping skills and behaviors, family attitudes; child with special long-term needs may tighten or strain family relationships, and that over-protection may be deleterious to child’s growth and development.
Allow family members and child to express difficult areas, anxiety and explore solutions responsibly.Lessens anxiety and improves understanding; provides the family with an opportunity to recognize problems and generate problem-solving methods.
Assist family to establish short- and
long-term goals for the child and to
involve the child in the activities of the family; include the participation of
all family members in care routines.		Promotes engagement in and control over situations and keeps the role of family members and parents.
Encourage family members to verbalize feelings, to tell how they handle the chronic needs of the family member, and to define coping patterns that support or inhibit adjustment to the problems.Encourages expression of feelings to identify the need for information and support and to dismiss guilt and anxiety.
Provide support social worker,
counselor, clergy, or other as needed.		Provides assistance to the family dealing with the long-term care of a child with chronic illness.
Teach family about long-term care and treatments.Improves family’s understanding of treatment regimen and responsibilities of family.
Teach family that overprotective behavior may inhibit growth and development so they should treat the child as normally as possible.Facilitates understanding of the significance of making the child a part of the family and illustrates the unfavorable effects of being overprotective.
Explain the importance of attending follow-up appointments for physical examinations, laboratory tests.Promotes positive outcome when family collaborates with the physician and health team to monitor disease.
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See Also

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