Cues Nursing Diagnosis Planning Intervention Rationale Evaluation

Subjective: Imbalance Nutrition After a week of  Weigh daily or as  Weighing serves as After a week of
Objective: r/t increased nursing interventions, ordered. an assessment tool nursing interventions,
 Weight loss with protein/fat pt will demonstrate  Discuss eating to determine the pt demonstrated
adequate food metabolism AEB weight gain toward habits and adequacy of weight gain toward
intake weight loss with goal. encourage a nutritional intake. goal.
adequate food intake diabetic diet  To achieve health
(balanced diet) as needs of the patient
prescribed by the with the proper
doctor. food diet for his
 Ascertain condition.
understanding of  To determine what
individual information to be
nutritional needs. provided to client
 Review meal plan or SO.
with the client that  It is recommended
focuses on the that 60% of
recommended calories should be
distribution of derived from
calories from carbohydrates. It is
carbohydrates, fats, recommended that
proteins, and other 20-30% of calories
sources. should be derived
 Educate patient on from fats. Protein
the dangers of sources should be
consumption of composed 10-20%
alcohol with of the patient’s
diabetes mellitus. caloric intake.
 Provide liquids Fiber should be
containing increased in the
nutrients diet as it can
and electrolytes as improve blood
soon as the patient glucose levels,
can tolerate oral decrease the need
fluids then for insulin sources,
progress to a and lowers the total
 portion of more cholesterol and
solid food as low-density
tolerated. lipoprotein levels.
 Teach patient how  Note that
to perform home moderation is
glucose recommended in
monitoring. alcohol
 Observe for signs consumption,
of hypoglycemia: similar alcohol
changes in LOC, consumption
cold and clammy precautions by
skin, rapid pulse, people without
hunger, irritability, diabetes apply to
anxiety, headache, people with
lightheadedness, diabetes. When
shakiness. consumed, alcohol
 Administer regular is absorbed first
insulin by before other
intermittent or nutrients,
continuous IV consuming large
method: IV bolus amounts can be
followed by a converted to fats,
continuous drip via increasing the risk
pump of for DKA. 
approximately 5–  Oral route is
10 U/hr so that preferred when
glucose is reduced patient is alert and
by 50 mg/dL/hr. bowel function is
 Instruct pt to restored.
exercise regularly.  Blood glucose is
 Consult dietician monitored before
and/or physician meals and at
for further bedtime. Glucose
assessment and values are used to
recommendation adjust insulin
regarding food doses.
preferences and  Hypoglycemia can
nutritional support. occur once blood
glucose level is
reduced and
carbohydrate
metabolism
resumes and insulin
is being given.
 Regular insulin has
a rapid onset and
thus quickly helps
move glucose into
cells. The IV route
is the initial route
of choice because
absorption from
subcutaneous
tissues may be
erratic.
 To reveal changes
that should be
made in the client’s
dietary intake. For
greater
understanding and
further assessment
of specific foods.
 exercise lowers
blood glucose
levels by muscles
and by improving
insulin utilization.