This will allow the healthcare provider to identify issues that bother the patient and significant others. Fractures and nerve damage may occur from birth trauma if the infant is LGA. This will avoid applying pressure to pressure-sensitive areas. Ensure client is knowledgeable about using his own blood glucose monitoring device. To assist the patient in identifying and managing modifiable risk factors related to diabetes. Uncontrolled levels of blood glucose may lead to serious complications such as neuropathy and retinopathy. The infants of diabetic mothers are large for their gestational age and may develop hypoglycemic episodes soon after birth. Dietary changes. Size differences and variations are more common in IDMs who are LGA than in other LGA newborns. Rates of 22%'' and 30%' have been reported. The multimedia enhanced edition of Wong''s Nursing Care of Infants and Children, 9th Edition has new resources on the Evolve website for students including case studies, journals articles from Mosby''s Nursing Consult, updated skills content plus interactive checklists, and the new Mobile Quick Reference - a web app with even more resources that can be accessed on any device. St. Louis, MO: Elsevier. Would you like email updates of new search results? diabetes mellitus, disorder of carbohydrate metabolism characterized by impaired ability of the body to produce or respond to insulin and thereby maintain proper levels of sugar (glucose) in the blood. To determine the appropriate treatment in maintaining target blood glucose levels. The blood glucose monitoring device is a handy and accurate way of assessing blood glucose levels. Administer oral care by moistening lips, as well as skin care by bathing on a regular basis. The patient will be able to assist in the planning of own care, and assume ownership for self-care tasks. She found a passion in the ER and has stayed in this department for 30 years. The emergence of psychological issues that influence ones self-concept might add to the stress. Risk for Ineffective Therapeutic Regimen Management. Explain the need to reduce sedentary activities such as watching television and using social media in long periods. The lanugo, or fine, downy hair that covers the newborns shoulders, arms, and back, would be rubbed away typically by the friction of the bedding and garments. The site is secure. Antenatally, intervention is aimed at identifying and preventing macrosomia and sudden fetal demise. Knowing the patients personality might aid in determining therapeutic goals. The problems facing the infant of a diabetic mother antenatally, intrapartally, and neonatally relate directly to the sequence of maternal hyperglycemia, fetal hyperglycemia, and . To personalize the teaching plan and facilitate learning or recall of information provided. Possible signs and symptoms of hypocalcemia include jitteriness, twitching, and a high-pitched cry. To bring the body temperature down quickly as possible. Nursing care plans: Diagnoses, interventions, & outcomes. Desired Outcome: The patient will be able to retain fluid volume at a functional level as evidenced by individually acceptable urine output with normal specific gravity, normal levels of electrolytes, stable vital signs, moist mucous membranes, good skin turgor, quick capillary refill, and firm and flat fontanelles. Write CSS OR LESS and hit save. Milia is a white, tiny papule that appears on the cheek or bridge of the nose in certain newborns and disappears between 2 and 4 weeks of age. Wherever newborns go, they continue to bring delight and excitement to everybody. This may make vaginal birth harder and may increase the risk for nerve injuries and other trauma during birth. Gray color an indication of an infection process, Jaundice (yellowish discoloration) If it emerges on the second or third day of life as a result of the disintegration of fetal red blood cells, it is deemed normal. The height and weight of a newborn are part of the physical examination. Risk for Infection. To give the patient enough information on the risks of blood sugar control (e.g. Fat and glycogen are deposited in fetal tissue, and the fetus grows large (macrosomia), especially if maternal blood glucose levels are not well controlled in the third trimester. Encourage the patient to make decisions about the treatment plan, such as ambulation, activity schedules, and so on. The patient is usually referred to a dietitian to ensure that a meal plan that suits the patients health goals and preferences is created. A pregnancy may end in a live birth, a miscarriage, an induced abortion, or a stillbirth. To allow the patient to relax while at rest. Nursing Care Plan for Diabetes 1. Polycythemia (ie, hematocrit exceeding 65%) may result from placental insufficiency causing chronic fetal hypoxia and increased fetal erythropoietin production. The spread of germs to the newborn is prevented by utilizing sterile equipment and not using the same equipment for every infant. The patient will show problem-solving abilities and engage in society at a normal level. Type 2 - This type of diabetes develops over time. Type 2 diabetes can be managed with lifestyle and diet changes as well as the intake of oral hypoglycemic agents (OHAs). Davis. These factors may need to be addressed in creating a clients healthcare plan. Allows the patient to have a feeling of control over the situation. Discuss with the patient the importance of identifying how the patient handled the problems in the past and determine how the patient became in control of the situation. Hyperglycemia in the mother without vascular changes causes large amounts of amino acids, free fatty acids, and glucose to be transferred to the fetus, but maternal insulin does not cross the placenta. The following are the two major types of diabetes: a. Assess vital signs and perform an initial head-to-toe assessment, particularly checking visual acuity, presence of tingling or numbness in the extremities, and response to pain stimuli. Description. cardiac disease, or diabetes in the mother. Type 1 Diabetes. Ask for any form of exercise that he/she used to do or wants to try. Advertisement. We and our partners use cookies to Store and/or access information on a device. Diabetes in pregnancy is associated with an increased risk of fetal, neonatal, and long-term complications in the offspring. the past 30-40 years because of improvements in the care Infants of Diabetic Mothers Lori Baas Rubarth, PhD, APRN-NP, NNP-BC AbstrAct Infants of diabetic mothers (Idms) can present with various symptoms and disorders. Heinemann, L. (2010). As directed by the attending physician, administer intravenous fluid replacement. Federal government websites often end in .gov or .mil. Blood glucose monitoring. Clinical specialists of nursing, con-suiting and working together, can develop a plan of nursing care for the pregnant woman with diabetes. Buy on Amazon, Gulanick, M., & Myers, J. L. (2017). 3. If diabetes in pregnancy is uncontrolled, the diversity of resulting health problems can have a profound effect on the embryo, the fetus, and the neonate. This deprives the nerves the nourishment they need. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. Nursing care plans: Diagnoses, interventions, & outcomes. Adherence to prescribed diabetic treatment ensures good blood flow and reduced risk for delayed wound healing. Assess the patients previous problem-solving abilities. To ensure that the blood glucose level is within target range. Start intravenous therapy as prescribed. Assess vital signs and signs of dehydration. Possibly evidenced by. In severe cases, amputation may be needed. As directed by the attending physician, administer antipyretics. The consent submitted will only be used for data processing originating from this website. Desired Outcome: The patient will be able to achieve a weight within his/her normal BMI range, demonstrating healthy eating patterns and choices. For concerns and clarifications post-discharge. Shallow respirations, but normal pulse rate, Paresthesia of fingers and around the mouth. They are used to measure the newborns maturity and provide baseline data. According to the National Center for Chronic Disease Prevention and Health PromotionDivision of Diabetes Translation, up to 34.2 million people in the United States have diabetes. Following is the nursing care plan for diabetes insipidus: Monitor the daily weights and determine the weight loss/gain. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. If the patient has a fever, give antipyretics as ordered by the physician. HHS Vulnerability Disclosure, Help Monitor patients serum electrolytes and recommend electrolyte replacement therapy (oral or IV) to the physician as needed. Keywords: maternal diabetes; Idm To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Avoid jumping into different topics. Poor blood flow and/or nerve damage in the feet increase the risk for blisters and cuts. To reduce the risk of skin breakdown that may lead to infection. Plastic surgical nursing: official journal of the American Society of Plastic and Reconstructive Surgical Nurses, 11(1), 20-25. Congenital anomalies are more likely in IDMs who are SGA than in other SGA newborns. In this post, we will formulate a scenario-based sample nursing care plan for hypoglycemia for an elderly patient with type-2 Diabetes Mellitus.. Hypoglycemia is a condition where the blood glucose level is lower than its normal level. Monitor polydipsia. The Apgar score serves as the starting point for all subsequent observations of a newborn. IDM is caused by chronic hyperglycemia in the mother (e.g., gestational diabetes mellitus or long-term diabetes mellitus with or without vascular changes). Determine clients preferred method of accessing information like visual, auditory and kinesthetic means. Insulin absorption from lipodystrophic areas: a (neglected) source of trouble for insulin therapy?. It is recommended to have at least 30 minutes of aerobic exercise. The high glucose levels in the blood may damage the blood vessel walls, including the arteries of the heart. Here are some of the most important NCPs for diabetes: May be related to unfamiliarity with information misinterpretation lack of recall, Possibly evidenced by verbal statements of concerns or misconceptions expressions of request for information improper or inadequate follow-through of instructions development of preventable complications, Desired Outcome participates in the learning process exhibits signs of taking responsibility for own learning by asking questions verbalizes understanding of condition and treatment correlates signs and symptoms of the disease process and identify corresponding management perform demonstrated procedures correctly and explain reasons for actions, May be related to lack of adherence to diabetes management inadequate blood glucose monitoring practices fluctuating physical activity level stress, As evidenced by blood glucose levels below or above normal levels, Desired Outcome identifies factors that may lead to unstable blood glucose levels verbalizes understanding of balancing body and energy needs verbalizes plan in modifying identified risk factors to prevent shifts in glucose level maintains blood glucose levels within the normal range, May be related to decreased leukocyte function circulatory changes due to high blood glucose levels, Desired Outcome verbalizes understanding of identified risk factors identifies important interventions in reducing risks for infection ensures timely wound healing free from purulent discharges and necrosis, See Also:Nursing Care Plan for Risk for Infection. In most cases, skin color variations in newborns do not usually signify an underlying condition. Patients who have an external way of control want to be looked after by others and may place blame for their situation on other forces. The detection of the signs of hypovolemia prevents worse conditions.
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