DAVAO DOCTORS COLLEGE

General Malvar St., Davao City

Nursing Program

Name of Patient: Mascubado Diabetiko Date of Admission: Room: ____

Age: 50 Sex: M Civil Status: ___Single____ Chief Complaint:

Religion: ____________________ Attending Physician:

NURSING CARE PLAN

DATE/TIME CUES NURSING DIAGNOSIS GOAL AND OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

8/2/21
SUBJECTIVE: After 8 hours of nursing After 8 hours of my
Patient verbalize “daghan Risk for Ineffective Therapeutic intervention patient will  Investigate the  Can provide an intervention, patient is
jud ko mga samad samad Regimen Management be able to: patient’s prior important starting able to demonstrate
sa panit samot na sa tiil, efforts to manage point in
knowledge of diabetes
the diabetes care understanding
ambot nganu, dugay man Short term: self-care measures.
regimen. any complexities
mayo.”  demonstrate or difficulties the Able to slowly verbalize
REFERENCE:
knowledge of patient-perceived understanding of the
OBJECTIVE: in his diabetes diabetes diseases
Diabetes mellitus nursing care diabetes self-care
- anxious management
measures. process and potential
- showing signs of plans: 13 nursing diagnosis. Long term: regimen. The complications and
(2020, May 15). Nurseslabs. patient may
deppression
https://nurseslabs.com/diabetes  Patient will report
continously perform
- weak
-mellitus-nursing-care-plans/ verbalize experiences of necessary procedures
- poor skin turgor and explain reasons for
understanding of being
- presence of ulceration the actions.
the diabetes overwhelmed by
on the skin (foot) attempts to
diseases process
- warm to touch with manage Goal partially met.
and potential
temperature of 36.5°C medications, diet,
complications.
- sunken eyes exercise, blood
 Patient will glucose
- nasal flaring
correctly perform monitoring, and
- facial grimace
necessary other measures
procedures and to prevent
explain reasons for complications.
the actions.
 Self-management
skills determine
 Evaluate the the amount and
patient’s self- type of education
management skills, that needs to be
including the ability provided.
to perform
procedures for blood  Limited vision
glucose monitoring. may impair the
patient’s ability to
 Identify factors that prepare and
may negatively administer insulin
affect success with accurately.
following the Limited mobility
regimen. and the loss of
fine motor control
can interfere with
the skills needed
for insulin
administration
and blood glucose
monitoring.

 Information on
diabetes
management can
be overwhelming
and may be
difficult to follow
 Provide simple for some patients.
explanation of the
treatment regimen.

 Instead of
focusing on
health behaviors
that were
neglected,
providing positive
reinforcement
helps motivate
 Provide positive the patient to
 reinforcement of continue
changed self-care treatment
behaviors. regimen. Avoid
use of fear or
scare techniques
in an effort to
modify the
patient’s health
or lifestyle
behaviors.

 Elevated blood
glucose levels in
patients with
previously
diagnosed
diabetes indicate
the need to
evaluate diabetes
management.

 Determine and
ensure that patient’s
knowledge about
the symptoms,
causes, treatment,
and prevention of
hyperglycemia.
LASCANO

NAME OF STUDENT
 CRITERIA:
DAVAO DOCTORS COLLEGE Content and organization 40%
General Malvar St., Davao City Analysis 40%
Nursing Program Neatness and promptness 10%
Reference 10%
TOTAL 100%
Name of Patient: M. D Date of Admission: Room: ____
Age: 50 Sex: M Civil Status: _______ Attending Physician:

DRUG STUDY
MODE
DATE MEDICATION OF DOSAGE INDICATION CONTRAINDICATION SIDE NURSING
ORDERED ACTION EFFECTS RESPONSIBILITIES

Paracetamol Hematologic:  Assess patient’s fever or

GENERIC NAME: may cause 500 mg 1 tab To relieve mild to Hypersensitivity to hemolytic pain: type of pain,location,
Paracetamol analgesia by Route:Oral moderate pain due to acetaminophen intensity,duration,
anemia,
inhibiting CNS Frequency:q things such as orphenacetin; use with leukopenia, temperature,and
prostaglandins
4° headache,muscle and alcohol. neutropenia, diaphoresis.
BRAND NAME: ynthesis. The
mechanism of joint pain,backache and pancytopenia,th
Biogesic
morphine is period pains. It is also rombocytopeni  Assess allergicreactions:
believed to used to bring down a a. rash,urticaria; if these
involve high temperature. For Hepatic: occur,drug may have to
decreased this reason, paracetamol bediscontinued.
CLASSIFICATION: liver damage,
Analgesic(Non-opioid) permeability of
can be given to children jaundice
Antipyretic the cell
after vaccinations to
membrane to  Teach patient torecognize
prevent post-
sodium, which Metabolic: signs of chronic
results in Immunization pyrexia overdose:bleeding,
hypoglycemia
diminished (hightemperature). bruising,malaise, fever,
transmission of Paracetamol is often Skin:
sorethroat.
pain impulses included in cough, cold rash,urticuria
therefore
and flu remedies.
analgesia.  Tell patient to
notifyprescriber for
pain/fever lasting for
morethan 3 days.
LASCANO
NAME OF STUDENT
FDAR
FOCUS DATA ACTION REACTION

SUBJECTIVE:  Provide simple explanation of the  Information on diabetes

Risk for Ineffective Therapeutic Regimen Patient verbalize treatment regimen. management can be overwhelming
Management “daghan jud ko mga samad samad sa panit and may be difficult to follow for
some patients.
samot na sa tiil, ambot nganu, dugay man
mayo.”  Provide positive reinforcement of changed
self-care behaviors.  Helps motivate the patient to
OBJECTIVE: continue treatment regimen.
- anxious
- showing signs of deppression  Determine and ensure that patient’s
- weak knowledge about the symptoms, causes,  Elevated blood glucose levels in
treatment, and prevention of patients with previously diagnosed
- poor skin turgor
hyperglycemia. diabetes indicate the need to
- presence of ulceration on the skin (foot) evaluate diabetes management.
- warm to touch with temperature of 36.5°C
- sunken eyes
- nasal flaring
- facial grimace

IV Line
IV line hooked PNSS PNSS
IV level received 1L/1000mL 1L/1000mL
IV rate per hour 60cc/hr 120cc/hr
IV level to endorse 520mL 40mL

CUS
I am concerned with the patient's condition because the nurse did not check his blood glucose as she administers regular insulin and also, the nurse did not follow the sliding scale as
ordered.
C
 I am uncomfortable because when giving insulin to the patients with DM, we should monitor first the CBG of the patient. Monitoring of CBG is a strategy that allows caregivers and
people with diabetes to evaluate diabetes management regimens. The frequency of monitoring will vary by patients' glycemic control and diabetes regimens.
U
It is a safety issue because if patient is hypoglycemic, and then the nurse administers insulin without checking the blood glucose level, it may lead to serious
complications and it can be fatal.
S

Ethico-moral Concideration
As a Nurse, we cannot just randomly decide which order to follow and which not to follow. Unless there is a safety concern or an order that conflicts with personal or religious beliefs,
Nursing Action failing to carry out orders can be grounds for discipline by the employer as well as the board of nursing, as it could be deemed "neglect."

I believe that the principle Upheld in this situation is justice, we can observe the injustice that the doctor showed. The unfairness and undeserved outcomes that the patient will received.
Ethical Principles Simply we call it "fat shaming" that was the doctors interaction to the patient. Fat shaming is the act of criticizing and harassing overweight people about their weight or eating behavior.
Upheld It’s often justified as a means to motivate people, but research shows that it has the opposite effect, as we can see the patient just stay quiet with his head down and got nothing to do
with it.

Discharge Plan
Medication
Continue medications as prescribed home medication to ensure optimum recovery.

Exercise
Do exercises like walking, cycling, swimming, team sports, aerobic dance, weightlifting, yoga. Regular physical activity is important, not only for managing type 1 diabetes but also for promoting
your overall health.

Treatment
Take insulin for home medication, carrbohydrate, fat and protein counting every meal, frequent blood sugar monitoring if available at home, eating healthy foods, exercising regularly and
maintaining a healthy weight.
The goal is to keep your blood sugar level as close to normal as possible to delay or prevent complications. Generally, the goal is to keep your daytime blood sugar levels before meals between
80 and 130 mg/dL (4.44 to 7.2 mmol/L) and your after-meal numbers no higher than 180 mg/dL (10 mmol/L) two hours after eating.
Health Education
Take your medicine as prescribed. If you have unpleasant side effects, contact your healthcare provider. Have a complete eye exam once a year. Controlling your blood sugar level can prevent
damage to your eyes. Take care of your teeth. People with diabetes have a higher risk of cavities and gum disease. Have regular checkups, brush after every meal, and floss daily. Protect your
skin. Inspect your skin daily for dryness, cuts, redness, or any changes. Drink plenty of water (unless your healthcare provider wants you to limit fluids). Check your feet. Because diabetes may
damage nerves in your feet, you may not feel small cuts and bruises. Check your feet every day for sores. If you feel any numbness, tingling, or burning in your feet, contact your healthcare
provider immediately. Wear comfortable shoes that fit properly and never go barefoot. Keep an eye on your blood pressure and weight. Your healthcare provider will check your blood pressure
at each visit; 130/80 or less is best. Watch your blood cholesterol level. Have it checked once a year. Your total cholesterol should be below 200 mg/dL. Find support. Your healthcare provider
can tell you about diabetes support groups in your area so you can get tips for living with diabetes.

Out pt dept.
Continue follow up check up to the doctor.

Diet
Healthy diabetic eating includes: Limiting foods that are high in sugar
Eating smaller portions, spread out over the day
Being careful about when and how many carbohydrates you eat
Eating a variety of whole-grain foods, fruits and vegetables every day
Eating less fat
Limiting your use of alcohol
Using less salt

Spirituality
Maintain good and safe environment.

Reference

Patient education: Diabetes. (n.d.). Lippincott NursingCenter | Professional Development for Nurses.
https://www.nursingcenter.com/journalarticle?Article_ID=843489&Journal_ID=522928&Issue_ID=843475

Diabetic diet. (n.d.). MedlinePlus - Health Information from the National Library of Medicine. https://medlineplus.gov/diabeticdiet

Type 1 diabetes - Diagnosis and treatment - Mayo Clinic. (2017, August 7). Mayo Clinic - Mayo Clinic. https://www.mayoclinic.org/diseases-conditionsitions/type-1-diabetes/diagnosis-
treatment/drc-20353017