Diabetes Concept Map - Lecture notes 1 PDF

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Diabetes: Type 1 and Type 2 Pathophysiology Type 1     Type 2  

The destruction of the beta cells of the islets of Langerhans in the pancreas, only cells that produce insulin When beta cells are destroyed, insulin is no longer produced Autoimmune or Idiopathic, 90 % of cases are immune mediated Begins with insulitis, a chronic inflammatory process that occurs in response to the autoimmune destruction of islet cells A condition of fasting hyperglycemia that occurs despite the availability of endogenous insulin Insulin resistance exceeds the ability of the pancreas to compensate, and over time the pancreas fails to produce enough insulin to meet the body’s needs.

Nursing: A concept-based approach to learning (3rd ed., vol 1). (2019). Pearson. (pg. 808, 836))

Signs and symptoms Type 1         Type 2     

Hyperglycemia Ketosis Polyuria Glucosuria Polyphagia Weight loss Malaise Fatigue Fatigue Extreme thirst Frequent urination Extreme hunger Weight loss

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Infection Delayed wound healing Blurry vision

Nursing: A concept-based approach to learning (3rd ed., vol 1). (2019). Pearson. (pg.809, 837)

Diagnostic Tests Type 1     Type 2   

Hemoglobin A1C Symptoms of diabetes plus casual plasma glucose concentration Fasting plasma glucose Two-hour PG FPG measurement A Glycated hemoglobin (A1C) 2-hour PG during an OGTT (OGTT not commonly used for screening, only in pregnant women)

Nursing: A concept-based approach to learning (3rd ed., vol 1). (2019). Pearson. (pg.817,838)

Nursing Diagnosis # 1- Risk for impaired Skin Integrity Intervention # 1  Assessment for lesions, fissures between toes, corns, calluses, plantar warts, ingrown or overgrown toenails, redness over pressure points, blisters, cellulitis, or gangrene.  Assessment of hydration status, including dryness or excessive perspiration.  Teach the patient proper toe hygiene because proper toe hygiene decreases the risk for infection  Discuss the importance of maintaining blood glucose levels through prescribe diet, medication, and exercise  Neurologic assessment  Report any changes, cuts or injuries to your lower extremities to your provider. Nursing: A concept-based approach to learning (3rd ed., vol 1). (2019). Pearson. (pg.831-833))

Walker, R. (2005). Diabetes and peripheral neuropathy: keeping people on their own two feet. British Journal of Community of Nursing, 10(1), 33-36. https://doi.org/10.12968/bjcn.2005.10.1.17333

Nursing Diagnosis # 2- Risk for injury Intervention # 2  Reduce environmental hazards in the healthcare setting and teach the patient about safety in the home and in the community.  Assess the presence of contributing or causative factors that increase the risk of injury: blurred vision, cataracts, decreased adaptation to dark, decreased tactile sensitivity.  Monitor for and teach patient and family to recognize and seek care for the manifestations of DKA in the patients with Type 1 diabetes  Recommend that the patient wear a medical alert bracelet or necklace that identifies the patient as an individual with diabetes Nursing: A concept-based approach to learning (3rd ed., vol 1). (2019). Pearson. (pg.831-833))

Nursing Diagnosis # 3 – Risk for Infection Intervention # 3  Teach the patient about the importance of hand hygiene. Hand hygiene is the most effective way of preventing the spread of an infection.  Discuss the importance of skin care. When washing hands, use lukewarm water and mild soap, keep the skin clean and dry. Clean, intact skin are the first line of defense against infection.  Teach dental measure, patient should use a soft toothbrush when brushing their teeth.  Educate women with diabetes on the symptoms and prevention measures for vaginitis

Patient/ Family Education

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Educate patients on how to take care in regulating their blood sugar levels to lower the chance of developing other conditions and complications. Educate patients on what it means to have diabetes Teach patient about self-management and having a goal and being motivated Teach patient that Lifestyle choices have to be made by each individual to improve and maintain an optimal level of selfmanagement. Assist in motivating and empowering persons living with DM2 by enabling them to make better choices for their own condition and lifestyle Proving resources such as support groups and other community resources. Ensure the patient has access to medication, testing strips and lancets for checking their glucose levels, and to regular checks for damage caused by the condition

O’Brien, C., van Rooyen, D., & Ricks, E. (2020). Self-management of persons living with diabetes mellitus type 2: Experiences of diabetes nurse educators. Health SA = SA Gesondheid, 25, 1381. https://doi.org/10.4102/hsag.v25io.1381

Medications Type 1    Type 2    

Insulin lispro (rapid-acting or ultra -short-acting insulin) Regular insulin (short acting insulin) Insulin glargine (24-hour, long-acting rDNA human insulin analog) Oral hypoglycemia Incretin hormones Metformin Insulin therapy

Nursing: A concept-based approach to learning (3rd ed., vol 1). (2019). Pearson. (pg.819-821, 839-841)...