SN instructed patient on diabetes and kidney problem, that diabetes mellitus ( DM ) is one of the leading cause of kidney failure in the United States. Approximately one-half of people who need dialysis have kidney disease from diabetes.With that, tight control of blood sugar must be done by avoiding concentrated sweets and high-carbohydrate content foods.Diabetic patients with hypertension have a special lower blood pressure target of less than 130 / 80 mmHg to reduce cardiovascular risk and delay progression of kidney disease.
Instructed in possible cause of hyperglycemia such as too little insulin, too much or wrong kind of food, infection, injury, illness, decreased activity.
SN instructed patient on diabetic diet:it is commonly thought that people with diabetes should avoid all forms of sugar. Most people with diabetes can eat foods containing sugar as long as the total amount of carbohydrates (carbs) for that meal or snack is consistent.Many research studies have shown that meals which contain sugar do not make the blood sugar rise higher than meals of equal carbohydrate levels which do not contain sugar. However, if the sugar-containing meal contains more carbs, the blood sugar levels will go up.
SN assessment done on all body systems. Checked blood sugar daily monitoring on patient's log book, hydration, dietary, and medication compliance. Instructed patient on keeping blood glucose within normal range and preventing the development of long-term complication. Careful monitoring of diet, exercise and blood sugar levels are as important as the use of oral medications in preventing complications of diabetes. Also taught infection control, safety/fall precautions and preventions, and to contact MD for any emergency and/or medical concerns and changes.
SN complete assessment done on all body systems, checked vital signs, blood sugar monitoring, hydration, nutrition intake, and medication compliance. SN refilled patient’s medication box for daily routine. Taught patient to carefully manage her blood sugar with diet, physical activity, and medication to prevent diabetes complication and avoid hypo/hyperglycemia.
SN advised to patient / caregiver that blood glucose monitoring is the main tool you have to keep your diabetes under control. This check tells you your blood glucose level at any one time. Keeping a log of your results is vital. When you bring this record to your health care provider, he /she will have a good picture of your body's response to your diabetes care plan.
The patient was instructed in diabetes insipidus in how to measure and record intake and output, stressing that intake should equal output. The patient was taught to check the urine’s specific gravity. The patient was advised to avoid fluids that may have diuretic effects, coffee, tea, alcohol.
The patient was instructed in diabetes mellitus ketoacidosis discussing blood sugar monitoring, when the test will take place, the technique, the necessary blood sugar range, how to read test results, what to do for abnormal results, the cleaning of equipment. The patient was taught when she or he is sick monitoring is increased to every 4 hours because illness or injury increases glucose demand. The patient was advised to maintain meticulous dental hygiene to prevent infection, wear shoes all the time to prevent foot injury. The patient was advised to monitor for vaginal infections. The patient was instructed the need to carry fast-acting sugar livesavers, sugar packets for treatment of hypoglycemia. The patient was advised to obtain appropriate items, equipment, and assistive devices for various diabetic needs, glucose monitor, medialert bracelet.
SN instructed patient about Glimepiride is an oral blood sugar-lowering drug in a class of medicines for controlling diabetes. Glimepiride lowers the sugar level in the blood by stimulating insulin to be secreted from the pancreas into the blood. Nausea and upset stomach may occur.
SN instructed that Janumet is used with a proper diet and exercise program and possibly with other medications to control high blood sugar. It is used in patients with type 2 diabetes. Instructed that common side effects include, nausea, vomiting, stomach upset, diarrhea, headache, weakness, or a metallic taste in the mouth may occur.