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Presented to the faculty of

St. Augustine College


Quezon City

In partial fulfillment of the requirement in


Maternal & Child Health Nursing

Submitted by:
Darnalet Ong
Jill Hazel Jocson
Carissa Joy Salado

TABLE OF CONTENTS:
I.
II.
III.

INTRODUCTION
THEORETICAL FRAMEWORK
NURSING HEALTH HISTORY
A. CHIEF COMPLAINT
B. BRIEF SUMMARY OF THE PATIENT CONDITION
C. GENERAL APPEARANCE
D. HISTORY OF PRESENT ILLNESS
E. PAST MEDICAL HISTORY
F. FAMILY HISTORY
G. DEVELOPMENTAL HISTORY
H. ENVIROMENTAL HISTORY
I. OB/GYNE HISTORY

IV.
V.
VI.
VII.
VIII.
IX.
X.
XI.

GORDONS TYPOLOGY OF 11 FUNCTIONAL HEALTH PATTERN


REVIEW OF SYSTEM
PHYSICAL ASSESSMENT(CEPHALOCAUDAL REGIONS)
PATHOPHYSIOLOGY
LABORATORY/DIAGNOSTIC RESULTS
NURSING CARE PLAN
HEALTH TEACHING PLAN
DISCHARGE PLANNING

ACKNOWLEDGEMENT

First of all, we would like to extend our deepest gratitude for all the people who had been
part of this study. We are giving thanks to Ms. Ernestina Claudia C. Que our School Directress
for her support and encouragement. To our school Dean Ms. Maria Liane D. Luna for sharing her
knowledge and expertise. To our adviser Ms. Emmy Macaraeg for her patience and limitless
guidance made possible the presentation of this study.
To our clinical instructors, Ms. Jessica Amba and Presentacion Q. Romero for guiding us
and motivating us to do our best, and also our classmates and friends for their support and
participation in this case study, especially to our family and relatives for their patience, for going
home late this past few weeks and also their guidance.
Finally, we are giving thanks to the Almighty God for giving us the strength, knowledge
and graces to be able to finish this study. We are thankful for his proper guidance throughout the
course of doing this case study.

I. INTRODUCTION
Gestational Diabetes is a type of diabetes mellitus or increase sugar in the blood that only
occurs in pregnant women. The prevalence of gestational diabetes is approximately 2% to 3% of
all women who do not begin a pregnancy with diabetes become diabetic. Usually at the midpoint
of pregnancy when insulin resistance becomes most noticeable, termed Gestational Diabetes
Mellitus (GDM). The symptoms will fade again at the completion of pregnancy, but the risk of
developing insulin dependent response to carbohydrate or from excessive resistance to insulin.
Before insulin was produce synthetically in 1921, women with Diabetes either failed to survive
pregnancy. Risk factors for Gestational Diabetes include obesity, Age over 35 years old, history
of large babies 10lb or more, history of unexplained fetal loss, history of congenital anomalies in
previous pregnancies, history of unexplained prenatal loss, family of diabetes.
Our patient is 35 years old, her name is Mrs. D.C. residing at Tondo Manila, Shes living
with her husband and its her first pregnancy. She works before as sales lady in one of the malls
in Manila which is Tutuban. During the 2nd week of September. The patient decided to seek for
medical consultation.
Interventions and care plan for the client, monitor vital signs, blood sugar and schedule and
cluster nursing time and interventions. Keep patients routine as consistent as possible, encourage
participation in activities of daily living.

OBJECTIVES
A. General
This case study was conducted to enhance our knowledge and develop our skills on how to
provide best possible care to a patient with condition like gestational diabetes.
B. Specific

To be able to know our responsibilities such as promoting health, prevent further harm or
illness, as well as restoration of health according to the extent of our knowledge and

skills.
To gain knowledge about Gestational Diabetes
To discuss the pathophysiology, anatomy and physiology, signs and symptoms.
To familiarize ourselves the different treatment modalities of Gestational Diabetes.

II. THEORETICAL FRAMEWORK:

Sister Callista Roy (Adaptation model)


ENVIRONMENT
Roy viewed environment as conditions, circumstances and influences that surround and effect
the development and behavior of the person. She described stressors as stimuli and uses the term
residual stimuli to describes those stressors whose influences on the person are not clear. Three
kinds of stimuli are the focal, contextual, and residual. Significant stimuli in all human
adaptation include stages of development, family, and culture.

HEALTH
Originally, Roy wrote the health and illness are on a continuum with many different states or
degrees possible. More recently, she states that health is the process of being and becoming an
integrated and whole person. Adaptation is defined as the process and outcome whereby thinking
and feeling, as individuals and in groups, use conscious awareness and choice to create human
and environmental integration.

III. NURSING HEALTH HISTORY


Patients Initial: Mrs. D.C
6

Address: Tondo, Manila


Age:35 years old
Sex: Female
Civil Status: Married
Religion: Roman Catholic
Occupation: Sales lady
Educational attainment: High School Graduate
Hospital: Ospital ng Tondo
Prenatal Visit: September 10, 2015
Examiner: Dr. Y
Informant: Patient
LMP: February 27, 2015
AOG: 29 weeks 2 days

A Chief Complaint
Bi pedal edema
B Brief Summary of patients condition
This is a case of 35 years old. Gravida 1 Para 0. With 28 weeks age of
gestation
C General Appearance
52 in height 75 kg weight, ambulatory, conscious and coherent
D History of present illness
During the 2nd week of September. The patient decided to seek for
medical consultation
E Past medical history
During her childhood year she experience chickenpox, and measles.
During his adolescent years, she experienced common illness like
cough, colds and fever.
1 Obstetrics
- Uterus is regularly enlarged containing single alive fetus in CEPHALIC
presentation. Fetal heart rate is 157 b/min. absence of gross fetal
abnormality. Fetal sex is MALE. Amniotic fluid is anterior, high-lying.
Adnexal are clear.
2 Immunization: patient received during the course of her pregnancy the
following immunizations.
TT1
7

TT2
TT3

Hospitalization
No history of hospitalization.

Injuries
The patient never had serious injuries
Transfusions
The patient never received any blood transfusion.
Medication taken
The patient took (ferrous sulfate) as her vitamin during pregnancy
Allergies
No allergies noted

5
6
7

F. Family History (3 Generations)


PATERNAL
Grandmother 85
years old

MATERNAL

Grandfathe
r
87
years old

Grandmother 85
years old

Grandfathe
r
80 years
8
old

Mother
55 years old

Father
60 years old

Patient
35 years old

LEGEND:
Deceased
Diabetes
Asthma
Hypertension
Gestational Diabetes
INTERPRETATION
On the paternal side of our patient, was noted to have diabetes mellitus. Whereas on the
maternal side of our patient, her grandmother was noted to have asthma. But, both of her parents
did not inherit any of the above conditions as well as on patient.
G. DEVELOPMENTAL HISTORY

THEORY

AGE

Psychosoci Middle
al
(Erick Adult(35
Erickson)
y/o)

DEVELOPMENTAL
TASK
Intimacy vs Isolation

CLIENT
DESCRIPTION

INTERPRETATION

Patient verbalized
that her husband
was
her
first
sexual partner.

The patient at this


stage she shared her
intimacy with her
husband.

Moral
(Lawrence
Kohlberg)

Middle
Adult(35
y/o)

Post
Conventional The patient gives
Morality
respect to the
opinions of other
people.

Our patient respecting


opinions of other
people surround her.

H. ENVIRONMENTAL HISTORY
Our patient D.C is a Saleslady; she lived with her husband in apartment in Tondo,
Manila. The apartment type is built in light materials. Her workplace is surrounded by fast food
chains were she ate mostly.

I.

OB/GYNE HISTORY
LMP- Feb 27, 2015
EDC- Nov 27, 2015
AOG-28 weeks
1. MENARCHE AGE:
12 Years old
2. DURATION OF MENSTRUATION:
Three-five days
3. CHARACTERISTICS:
Bright red
4. ASSOCIATED SYMPTOMS:
Dysmenorrhea
5. GRAVIDA-PARITY:
G1P0
6. COMPLICATIONS:
Gestational Diabetes

IV. GORDONS
PATTERN
1.Health
Perception
and Health
management

BEFORE PRE-NATAL
VISIT
-prior to patient condition she
said that ang isang taong
malusog ay yung walang sakit
at nagagawa niya ang mga
gawain sa pang araw- araw.
And also, she has always been

DURING PRE-NATAL
VISIT
- During her prenatal visit
the patient saidkailangan
ko na maging aware sa
condition ko at iwasan ang
pagkain na makakasama sa
akin. .she thinks that the

ANALYSIS
The patient needs
additional information
regarding her health
condition because she
perceived that her
unhealthy
eating
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2.Nutrition
and
Metabolism

healthy these past few months.


cause of her illnesses due to
She seldom gets cough or colds. too much eating sweets
foods and drink a lot of
juices.
-prior to patient condition the
During her prenatal visit the
patient said hindi naman ako
patient said kailangan ko
mapili sa pagkain, mahilig ako
na ma maintain ang pagkain
kumain ng matatamis at
ko, iiwas narin ako sa
uminom ng juice she eats 3-4
matatamis na pagkain
times a day.she drinks a lot of
water approximately 2L per
day.

habits
was
the
common culprit to her
condition
Another
misconception
because her condition
supported
and
accompanied with her
pregnancy although
she need to modify
her eating habits it is
not
the
common
reason of condition
The
patient
has
misconception again.
Because it is not
normal that frequent
in
urination
is
observed
during
pregnancy due to the
compression of the
bladder by the gravid
uterus
Shes developing
normal patterns of
behavior during
pregnancy

3.Elimination

Prior to the patient condition


the patient defecates once a day.
She observes brown clay
formed stool. The client
urinates 8-10 times a day
approximately 2000cc a day
with a yellow orange urine
color.

-The
urination
was
increased because of her
condition. (Have diabetes
during pregnancy.)

4.Activity
and Exercise

Prior to pt. condition she cannot


perform daily activity like
cleaning her house. During her
spend time, she sleeps. She stay
at home
Prior to patient condition the
client take afternoon naps. And
sleeps 7-9hrs in the night
She is able to understand and
follow instructions well. And
she is not aware what is
happening in her pregnancy

goes to a clinic for her


monthly prenatal check up
by simply walking 20
minutes and this serves as
her exercise
During prenatal visits the
No deviation in sleep
patient naps before check up pattern.

5.Sleep and
Rest
6.Cognitive
Perceptual

7.SelfPerception
and SelfConcept

the client also mentioned that as


much as possible she does not
want to get sick. naiirita ako
kapag may nararamdaman ako.
She also said that she does not
lose hope because of his

She is able to understand


and follow instructions well.
And she is not aware what is
happening in her pregnancy.
She has difficulty in
understanding doctors order
-She always feels weak and
irritable, because of her
condition.

Needs
additional
health teaching

Needs health teaching


of lifestyle change that
fits with her condition

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husband.
8.Sexuality
Reproduction

She and her husband do not


have problem regarding to
intimacy

9.Roles and
Relationship

She said she helps with her


husband for financial needs

10.Coping
and Stress
Tolerance

Stress in the sense that they are


not yet financially stable yet
happy for the incoming family
member
Prior the patient conditions said
that they go to the church
sometimes with his husband.
The client is a roman catholic
the client shares good moral
values to his family.

11.Values and
Belief

With her present condition Misconception again,


client said she have sexual sexual intimacy
activity
normal as noted
intimacy can have
many forms like
hugging etc.
During prenatal visit the The client has a good
patient said that she is relationship with her
supported by his husband husband and his
both
emotionally
and family
financially
Shes worried about her During prenatal visit
present condition especially the client will be
the baby
careful of its self.
During prenatal visits the
patient said hindi na kami
madalas na kakasimba, pero
hindi parin kami
nakakalimut mag dasal as
verbalize by the pt.

Before and during the


faith values of the
patient is still remain.

V. REVIEW OF SYSTEMS:
A. CONSTITUTIONAL SYMPTOMS

Weakness
Nurse: Sa inyong pagbubuntis ano ano po baa ng inyong nararamdaman sa inyong katawan?
Patient: Ako ay nanghihina

Sleeping Problem
Nurse: Ilang oras po ang inyong tulog sa magdamag?
Patient: Siguro umaabot sa anim hanggang walong oras
B. EYES
Nurse: May panlalabo bas a inyong mga mata ngayong buntis kayo?
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Patient: Meron, pero hindi madalas

C. NOSE
Nurse: May problema po ba kayo regarding sa inyong pang amoy?
Patient: wala naman po akong problema sa pang amoy

D. INTEGUMENTARY
Nurse: Sa inyo po bang balat, may napapansin po ba kayong pagbabago dito?
Patient: Meron
Nurse: Kagaya po ng ano?
Patient: Pansin ko kasi na nag-dry na yung balat ko

G. CARDIOVASCULAR
Nurse: May pagkakataon bang nahahapo kayo o sumusikip ang dib-dib niyo?
Patient:Tuwing malayo nilalakad ko hinahapo ako pero di sumisikip dib-dib ko

H. RESPIRATORY
Nurse: Sa paghinga niyo po ba ay may problema kayong napapansin?
Patient: Wala naman akong problema sa paghinga

I.GASTROINTESTINAL
Nurse: Ilang beses po kayong kumakain sa isang araw?
Patient: Nakakatatlo hanggang apat na beses
Nurse: Ano po yung mga karaniwang pagkain ang kinakain ninyo?
Patient: Sa ngayon, nagbabawas ako sa kanin at sa mga matatamis na pagkain. Madalas mga
prutas at gulay ang kinakain ko.

J.GENITOURINARY
Nurse: Sa isang araw po ba, ilang beses po kayo umiihi?
Patient: Umaabot ito sa walo hanggang sampu

K.MUSCULOSKELETAL
13

Nurse: Sa inyong kasu-kasuhan, may nararamdaman po kayo dito?


Patient: Wala naman akong nararamdaman

L.PSYCHIATRIC
Nurse: Ano po ang inyong balak para sa inyong unang magiging anak?
Patient: Syempre, bibigyan ko siya ng magandang buhay. At magsusumikap ako sa pagtatrabaho
para sa kinabukasan ng aking anak.

14

VI. PHYSICAL ASSESSMENT (CEPHALOCAUDAL BY REGIONS)

Date: September 17, 2015


MEASUREMENT

FINDINGS

NORMAL

INTERPRETATION

-Vital Signs (Axillary


temp.)
-Respiratory Rate

37.0C

36.4C-37.4C

Normal

25 c/min.

12-20 c/min.

-Pulse Rate

90 b/min.

60-100 b/min.

Has difficulty of
breathing
Normal

-Blood Pressure

130/100 mmHg

120/80 mmHg

The patient has an


abnormal blood
pressure due to her
gestational diabetes.

-Fundic Height

29 cm

29 cm

Normal

Weight

75kg

35kg

overweight

BMI

0.32

18.9-24.9

Overweight

15

BODY
PARTS

ASSESSMEN
T
TOOL

A.SKIN
1.Skin color, -Inspection
odor
and -Palpation
lesions

2.
Texture, -Palpation
temperature,
moisture,
turgor,
and
edema.

3. hair
B.EYES
1.External Eye

-Inspection

2.
Eyelid -Inspection
placement,
swelling,
discharge and

NORMAL
FINDINGS

-Skin color;
Pale, white
with pink,
yellow,
brown
or
olive tones
to dark or
black.
-The skin is
lesion free
Common
Skin
Variations:
-Birthmarks
-Milia
-Erythema
-Skin
is
warm and
slightly
moist.

-Inner
canthus
distance
approximate
ly
2.5cm,
horizontal
slant, and
no
epicanthus
folds.
-Transient
edema
absence of
tears.

ACTUAL
FINDINGS

ANALYSIS

INTERPRETATION

-Skin color is -Pale due to The patient has a mild


pale.
mild edema. edema.

-Dryness
skin

of

-Skin is dry -Dry


and warm to warm
touch.
touch
-Skin turgor
not quick to
response.

and -Due to her edema.


to

-Inner canthus Normal


distance
approximately
2.5cm,
horizontal
slant, and no
epicanthus
folds.

-Tear is
evident.

Normal

-Teary eyes
are evident.

16

lesions.
3. Sclera and -Inspection
conjunctiva for
color,
discharge,
lesions,
redness, and
lacerations.
4. Iris and the -Inspection
pupils.

5.Eyebrows

-Inspection

Eyelashes

C.BREASTS
1.
Shape, -Inspection
symmetry,
color,
tenderness,
discharge,
lesions
and
masses.
D.ABDOME
N
1.Shape
of -Inspection
abdomen
-Auscultation

2.Umbilicus

-Inspection
-Palpation

-Clear and
free
of
discharge,
lesions,
redness, or
lacerations.

-Clear
and Normal
free
of
discharge,
lesions,
redness,
or
lacerations.

Normal

-Brown iris,
brusfields
spots white
flecks
on
the
periphery of
the iris.
-Symmetric
in shape and
movement,
not
meet
midline.
-Evenly
distributed
and curried
outward.

-Pupils
are Normal
equal, round
and reactive
to light and
accommodati
on.
(PERRLA)
-Symmetric in Normal
shape
and
movement,
not
meet
midline.
-Evenly
distributed
and
curried
outward.

Normal

-Enlarged
and
engorged
breasts

-Enlarged and Normal


engorged
breasts

Normal

-Prominent -Prominent in
in
supine supine
position.
position.
-fetal
heart
tone
-Pink,
no -Pink,
has
discharge,
Linea Nigra,
no
odor, no discharge,
redness.

Normal

Normal

Normal

-Has tinea Normal


nigra.
-hard
to
palpate
beacause of
17

3.Bowel
Sounds

Fetal
tone

-Auscultation
-Palpation

heart -Doppler

the fetus
-theres
quickening
start
in
20weeks of
gestation
-Occur
-Occur every Normal
Normal
every
10- 10-30sec.
30sec.
-It sounds like
-It sounds clicks, gurgles
like clicks, or growls.
gurgles or
growls.
It sounds
like clicks,
gurgles or
growls.

157 b/min

120-160
b/min

Normal

4.Masses and
Tenderness

-Palpation

-Soft to
palpate and
without
masses or
tenderness

-Hard to
palpate and
with masses
or tenderness

-Hard to
palpate
because of
the fetus
inside.

Due to pregnancy

18

PATHOPHYSIOLOGY
Predisposing factors

precipitating factors

Sedentary lifestyle

35 years old
Female

Carbohydrate intake

Obesity

Sodium Glucose
intake

Family History
Diabetes Type II

Exercise

Pregnancy

Placenta
Hormones
(HPL)
Blood Glucose Level

Fat & Protein Metabolism

Insufficie
nt insulin
Inability of glucose to enter
cells for energy

Insulin
Production

19

Polydipsia

Polyuria

Polyphagia

Weight gain

Gestational Diabetes Mellitus

LABORATORY/DIAGNOSTIC RESULTS

BLOOD CHEMISTRY
Glucose
Blood Glucose
1st hr
2nd hr
3rd hr

WBC count
RBC count

Result
5.01 mmol/l
4.32mmol
77.76
7.01
100.10
8.97
110.46
4.58
130.44
CBC
Result
10-60

Hemoglobin

133

Hematocrit

0.40

Normal Values
4.8-10
M: 4.5-5.5 x 10
F: 4.0-5.5 x 10
M: 120- 183
F:110- 148
M: 0.38-0.54
F:0.36-0.48
150-400 X 10
1-3 mins

Platelet
Bleeding time

STAB:
SEG:
LYMPH:
MONO:
EOS:
BASO:

Normal Values
420-6.40 mmol/l

0.72
0.28

Analysis

Normal
Normal
Normal

0.00-0.05
0.55-0.75
0.20-0.38
0.03-0.07
0.01-0.05
0.00-0.01
20

BLOOD TYPING B (+)

Color:
Transparency:
Sugar:
Albumin:
PH:
Specific Gravity:
Ketone:

URINALYSIS
microscopic
Yellow
Pus cells:
S1 turbid
RBC:
positive
Ephitelial cells:
Trace
Bacteria:
5.0
Amorphonsurdler:
1.010
Mucous threads:
Crystals:

microscopic
3-7/hpf
1-2/hpf
++
+
+++
+++
calcium oxalatet

21

NURSING CARE PLAN

ASSESSMENT
Subjective:
Nagmamanas ang
aking paa As
verbalized by the
patient
Objective:
-Bipedal edema
V/S
T: 37.3
PR: 95
RR: 25
Bp: 150/90

NURSING
DIAGNOSIS
Excess fluid volume
r/t excess sodium
intake as manifested
by bipedal edema

PLANNING

INTERVENTION

After 8hrs of nursing


Monitor and
interventions the
record vital signs;
patient will have a
comparing current
stabilized fluid
weight gain with
volume as evidenced
previous stated
by a VS within
weight
patients normal limits
and be free of signs of Advise patient to
edema
elevate feet when
sitting down or in
supine
Instruct patient
regarding
controlled fluid
intake and hidden
sources (foods
high in water
content)
Promote early
mobility to patient

RATIONALE

EVALUATION

To obtain baseline
data

Goal partially met

To promote venus
return

Intake of fluid up to
500mL is equivalent
to 0.5 kg increase in
weight due to fluid
retention

To prevent stasis of
edema and reduce
risk of further injury

22

ASSESSMENT
Subjective:
Nababahala ako sa
aking kalagayan
As verbalized by
the patient

NURSING
DIAGNOSIS
Anxiety r/t changes
in health status as
manifested by
restlessness, foot
shuffling, and

PLANNING

INTERVENTION

RATIONALE

EVALUATION

After 8hrs of
nursing
interventions the
patient will describe
a reduction in the

Assess level of
anxiety

To be able to give
appropriate nursing
intervention

Goal met.
The patient level of
anxiety decreased

The presence of a
23

fidgeting
Objective:
-restlessness
-foot shuffling
-fidgeting

level of anxiety
experienced

Reassure patient
that she is safe. Stay
with the patient

Maintain a calm
manner while
interacting with
patient

ASSESSMENT
Subjective:
lalo akong
tumataba as
verbalized by the
patient
Objective:
-The patient is 78kg
now, compared
before 45kg.
-Increased food
intake 3-4 cups of
rice, compared

NURSING
DIAGNOSIS
Imbalanced
nutrition more than
body requirements
r/t inability to
absorb nutrients

trusted person may


be helpful during an
anxiety attack
Feeling of stability
increases in a calm
and non-threatening
atmosphere

PLANNING

INTERVENTION

RATIONALE

EVALUATION

After 8hrs if nursing


intervention the
patient will
demonstrate
appropriate changes
in lifestyle and
behaviors including
eating patterns, food
quatity/quality

Document patients
nutritional status on
admission, noting
skin turgor, current
weight, food intake,
body built

Useful in defining
degree or extent of
problem and
appropriate choice
of interventions

Goals partially met

Encourage small,
frequent meals, low
in calorie and
sodium

Maximizes nutrient
intake without
undue
fatigue/energy
expenditure from
eating large meals
24

before 1-2 cups of


rice
-Increased muscle
mass

ASSESSMENT
Subjective:
Gusto kong
malaman kung ano
yung sakit ko as
verbalized by the
patient
Objective:
- Request for
information
- Inaccurate followthrough instructions

Encourage
mobilization

NURSING
DIAGNOSIS
Knowledge deficit
r/t cognitive
limitation as
evidenced by
request for
information

To promote healthy
lifestyle

Refer to dietitian for


adjustments in
dietary composition

Provides assistance
in planning a diet
with nutrients
adequate to meet
metabolic need

PLANNING

INTERVENTION

RATIONALE

EVALUATION

After 4-6hrs of
nursing
interventions the
patient will1. Participate in
learning process
2. Verbalize
understanding of
disease process and
treatment
3. Demonstrate
awareness in
preventing the
reoccurrence of the
disease

Assess readiness to
learn

This allows the


patient to learn
efficiently

Goals met.
The patient gained
information about
her condition

Promote an
environment
conducive to
learning

This allows the


patient to
concentrate on what
is being discussed
and demonstrated

Establish objectives
and goals for
learning at the
beginning of the
session

This allows the


learner to know
what will be
discussed and
expected during the
session
25

Assist the learner in


integrating
information into
daily life

Provide instruction
and specific written
information for
patient to refer to
schedule for
medications and
follow-up for
documenting
response to therapy

This helps learner


make adjustment in
daily life that will
result in desired
change in behavior
Written information
relieves patient of
the burden of
having to remember
large amounts of
information.
Repetition
strengthens learning

26

HEALTH TEACHING PLAN


Health Teaching plan
Topic: Monitoring Blood Sugar (glucose)
Goals: The patient should perform self blood sugar testing
Time Allotment: 3 hours
Learning
Learning
Methodology
Resources
Method of
Objectives
Content
Evaluation
Perform self- -To explain -Short video -YouTube
Demonstratio
blood glucose the difference about how to -Health
n
monitoring
between type perform
nursing book -Discussion
1 and type 2 blood sugar Internet
diabetes.
testing.
-health care
-To identify
provider
the possible -Lecture
risk of having
a high blood
sugar level.
-To maintain
a stable blood
glucose level.
-Knowing the
blood glucose
levels
for
proper
diabetes
management
plan.

Evaluation
-Goal met
- The patient
will
know
how to do
blood sugar
testing.

28

Health Teaching plan


Topic: Diet
Goals: The patient should know the proper diet suited for her.
Time Allotment: 1-2 weeks
Learning
Learning
Methodology
Resources
Method of
Objectives
Content
Evaluation
The patient Implement
-Lecture
Health
Interview
should
be proper diet.
-Group
Nursing Book Monitoring
able
to
Know the discussion
-dietician
weight
perform
risk of eating With
proper
diet unhealthy
Dietician
for a healthy foods.
living.
Understand
the
importance of
having
a
proper diet in
the body and
in the self as
well.

Health Teaching plan


Topic: Exercise
Goals: The patient should be able to perform proper exercise.
Time Allotment: Everyday 15-30 minutes
Learning
Learning
Methodology
Resources

Method of

Evaluation
Goal met
The patient
will
know
how
to
maintain
healthy diet.

Evaluation
30

Objectives
Perform
proper
exercises.

Content
Learn
the
proper
exercise
techniques
and practices
to
avoid
injuries and
helps improve
body
condition.
getting
regular,
moderate
physical
activity.
- Simple walk
for
15-30
mins
every
day.

Evaluation
-Lecture
-YouTube
-Actual
-Goal met
-Video
-Healthy
performance
presentation
Lifestyle
-Interview
of the proper Book
with
the
exercise for -health care patient
pregnant
provider
-Observation
woman.
for
the
possible
improvement
in the body

Health Teaching plan


Topic: Monitoring diet, physical activity and glucose level.
Goals: The patient should keep daily records of her diet, physical activity and glucose level.
Time Allotment: 1-2weeks
Learning
Learning
Methodology
Resource
Method of
Evaluation
Objectives
Content
Evaluation
Patient should Be able to
-lecture by
-Health
Interview
Goal met
keep daily
monitor her
health care
Nursing Book Check up
records by
health diet
provider
- Internet
writing down physical
-health care
32

her blood
sugar
numbers,
physical
activities,
everything
she eat and
drink in a
daily record
book.

activities and
sugar level.

provider

XI.DISCHARGE PLANNING

MEDICATION:
1. Doctors order.
ENVIROMENT
1. Discuss patient on how to handle things around her such as emotion about her condition
having Gestational Diabetes.
TREATMENT:
1. Instruct patient to keep glucose level under control by managing her healthy diet.
2. Instruct patient maintain a healthy weight gain by keeping daily records of her diet,
physical activity and glucose level number.
HEALTH EDUCATION:
1. Eating a healthy diet meal plan.
2. Moderate physical activity to help control patient.

34

3. Blood sugar levels by allowing insulin to work better.


OPD FOLLOW-UP:
1. Explain to patient the importance of having follow-up check-ups and need to comply on
scheduled check-ups.
DIET:
1. Instruct the patient to eat healthy foods that fit in her meal plan, such as salads with lowfat dressing.
2. Use less butter and margarine on food.
3. Instruct patient to lessen the carbohydrates foods to her blood glucose level into normal.

36