Nursing with diabetes: what is it for?

There are a huge number of different diseases, in the treatment of which not only the work of the doctor is of great importance, but also the nursing process. In diabetes mellitus, modern medical institutions assign the main work, as well as control over the implementation of various appointments by the doctor, to the shoulders of the junior medical staff. Therefore, one should not underestimate such work, because this category of employees in certain situations plays a far from secondary role.

Diabetes mellitus: is control necessary?

The nursing process for diabetes is carried out in accordance with applicable standards. According to the accepted classification, two main types of this disease are distinguished:

• insulin dependent;
• insulin independent.

Both can often be found in modern people, and the sister process with diabetes can be required at almost any age. The causes of the development of the disease can be very diverse, but all of them, one way or another, have a direct connection with the process of producing the hormone insulin. Not always it is a shortage or absence of this substance, since its volume may be normal or even exceed it, but at the same time, the cells of the human internal tissues do not perceive the hormone, which leads to an increase in the total blood sugar level.

The nursing process in diabetes is also complicated by the fact that the disease does not have any pronounced symptoms, so for a long time it can go completely unnoticed, causing significant harm to the body. This is precisely why it is dangerous, because when a person finds out about his diagnosis, some things may already be irreversible, and it is far from rare that the patient can hear this phrase for the first time after suffering a hyperglycemic coma. However, all this relates to an insulin-independent form of the disease, since the sister process in diabetes mellitus (DM-1) is somewhat easier due to the rapid development and rapid diagnosis.

Stages

There are three main stages in the development of this disease:

1. Prediabetes. In this case, the main risk groups are indicated, that is, those people who have relatives with a similar diagnosis, patients who are overweight, people over 45 years old, or women who gave birth to dead children or infants weighing more than 4.5 kg.
2. Latent form. At this stage, the disease proceeds completely imperceptibly and most often in the morning sugar remains within normal limits. You can determine it by conducting a specialized test of the sensitivity of the body to glucose.
3. Diabetes. The disease is in no way "hidden" and with due attention it can be easily diagnosed by various external signs. The nursing process in diabetes is often prescribed after the patient has a constant thirst, frequent urination, a sharp set or weight loss, sugar in the urine or skin itching.

After and in the process of determining the diagnosis, as well as further clarifying the specific cause of this ailment, a person may need not only the help of a qualified doctor, but also the support of nurses. However, not everyone understands what the nursing process card for diabetes includes and what it is.

Main goals

First of all, it is worth noting that the nursing process is a specific technology for patient care, which has rationale from a medical and scientific point of view. Its main goal is to maximize the quality of life of the patient, as well as providing assistance in finding a solution not only to existing problems, but also to those that may arise in the future. Based on this, a map of the sister process for diabetes is compiled.

How is the work done?

The package of measures itself includes the following:

• The first stage, from which the nursing process in diabetes begins, is an examination, when assistance is provided in drawing up a complete picture of the development of this disease. It must be correctly understood that each person should have their own medical history, into which all analyzes are made and observations and conclusions about the patient’s health are recorded. In this case, another important point for which the sister process for diabetes is carried out is the collection of information about the patient, as this also helps to get an accurate picture of the problem.
• At the second stage, a diagnosis is made that takes into account not only the obvious problems of the patient that are present at the moment, but also those that may appear during treatment. It is quite natural that, first of all, the reaction of specialists should be precisely on the most dangerous symptoms that threaten the life and health of the patient, and the sister process in diabetes is used to prevent this. The patient’s problems are determined by the nurse, and she compiles a list of ailments that can introduce some difficulties into the patient’s life. At the same time, checking the card and a simple survey is not all that is limited in this case to the nursing process in diabetes. Stages of this kind already require preventive and psychological measures, including working with close relatives.
• At the third stage, systematization of all the information received is carried out, after which the nurse is set certain goals that are not only short-term, but can also be designed for a longer period of time. All this is indicated in the action plan, and then is recorded in the individual history of the patient in whom diabetes was detected. The nursing process for this disease will already depend directly on what specific problems were identified.

Further, the nurse begins to act in accordance with the developed plan and takes on a number of comprehensive measures aimed at ensuring the improvement of the patient's condition.

Ultimately, based on the dynamics of the development of the disease, as well as various positive changes in the overall health of the patient, the doctor determines how effective the help of the nurse was.

It is worth noting that for each individual patient an individual nursing process for diabetes can be prescribed. The organizational stage here completely depends on how complicated the disease is and what measures the doctor must take to save the patient from this ailment. In the standard case, the nurse will work under the continuous supervision of a doctor, following all his instructions. Quite often, it also happens that the sister process in type 1 or even diabetes mellitus involves an interaction between a doctor and a nurse, that is, when they work, and at the same time any measures are agreed upon among themselves.

In addition, a completely independent nursing intervention may be prescribed. In this case, the features of the nursing process in diabetes mellitus provide for independent actions by the medical officer to provide the care that the patient needs at the moment, without the need for prior coordination with the attending physician.

Key Features

Regardless of what specific type the nurse’s actions are, she should control and predict the possible scenarios of events as much as possible, which provides for the organization of a nursing process (diabetes mellitus of any type). It does not matter whether there is direct observation by the doctor or if she performs all the work herself - the nurse will be responsible for the patient’s health and life, therefore, this issue must be taken very seriously.

As mentioned above, nurses have to solve a fairly large number of problems of patients, and they should help them adapt to the new realities of life. In particular, even the sister process for type 2 diabetes requires the introduction and compilation of a new menu, the provision of primary information on maintaining counts of XE, calories and carbohydrates, as well as consultations with relatives who must learn how to help the patient. If we are talking about insulin-dependent diabetics, then in this case an additional lecture is given regarding injections, the drugs used, as well as the correct administration of each of them. The daily rate in this case is selected solely by the doctor and is not included in the nursing process for diabetes. The collection of information during the initial examination and advice on where to put the injections and how to take the medicine are the main tasks of this specialist in this case.

You need to correctly understand that in diabetes mellitus, the influence of a nurse is extremely important, because this is exactly the person with whom you can communicate, find support or valuable advice if you wish. Each such specialist is a little psychologist who helps to accept the ailment that has arisen and helps to teach the patient how to fully live with him and what physical exercises will need to be done.

Survey

As mentioned above, this process begins after the appointment of treatment and the implementation of the transfer of the patient’s nurse. She is engaged in a thorough examination of the patient, studying the history of his illness and a detailed survey in order to find out the following facts:

• whether a person has any endocrine and other diseases;
• whether the patient was taking insulin before the examination, and if so, what was specifically taken and at what dosage, what other antidiabetic and other drugs were used;
• whether he is currently following a specific diet, is he using the table of bread units correctly;
• if there is a glucometer, then in this case the nurse checks whether the patient is able to use it;
• it is checked whether a person injects insulin with a standard syringe or a special syringe pen, how correctly this procedure is performed and whether a person knows about the possible occurrence of complications;
• how long the disease has been present, whether hypo- or hyperglycemic coma and other complications have arisen, and if this has occurred, what exactly has become the cause, and also whether the person is able to act in such situations.

The nurse asks a huge number of questions regarding the daily routine, basic habits and physical activity of her patient. If we are talking about a child or an elderly person, then in this case, a preliminary conversation with relatives or parents is mandatory. This examination technology is called subjective, since the completeness of information in this case directly depends on the experience of the nurse, as well as her ability to ask the right questions and find a common language with people.

The second part of

The second part is a physical examination, which includes the following activities:

• General external inspection. In this case, for example, “bags under the eyes” or similar swelling may indicate that a person has certain problems with the kidneys or heart.
• Extremely careful inspection of the skin. It is also worth noting that special attention is paid to the condition of the mucous membranes, and if they are pale, this indicates the presence of dehydration in a person.
• Measurement of temperature, respiratory movements and pulse rate, as well as conducting a standard pre-medical examination.

After this procedure, the nursing process continues, in particular, a nursing medical history is compiled , which, accordingly, differs from the medical one. It must be understood that the doctor, based on the results of tests and examinations, writes down what exactly is happening in the patient’s body at the moment, while the nurse, making her own observations, fixes what problems the patient has in connection with the violations that have occurred. A number of additional information is also written in the history of the disease, such as the occurrence of neurosis, the possibility of self-care, and so on.

Help in the hospital

Composing his own medical history, the nurse may notice some specific problems in the patient, that is, indicates those that are present at the moment, and takes into account those that may appear in the future. Some of them are quite dangerous, while others can be quite easily prevented, but any changes need to be prepared. It also identifies factors that can subsequently provoke various complications, neurosis, a tendency to violate the established diet, and other deviations, given all this in the process of caring for the patient.

A competent nursing process is simply not possible if a sufficiently clear plan is not drawn up. It is for this reason that in her own version of the medical history, the nurse writes specialized care manuals, which lists in detail all possible problems, and also plans a response.

Example

All this may look something like this:

• Certain prescriptions of the doctor are carried out, which are carried out under his direct supervision or control. In particular, we are talking about insulin therapy and the issuance of drugs, preparation for medical diagnostic procedures or their conduct and much more. In the process of outpatient treatment, tests and regular check-ups are taken.

Intervention options

It is worth noting that there are three main types of nursing intervention - this is the implementation of specific medical prescriptions, direct patient care, as well as various actions that are carried out together with the doctor or after a preliminary consultation.

Nursing care includes manipulations that the nurse performs solely at her discretion, based on the experience gained and the "sister" medical history. In particular, we are talking about training in self-control skills, the basic principles of nutrition and monitoring how the patient observes the established regimen of the day, diet and special doctor's prescriptions. If a nursing process is provided for diabetes in children, she will necessarily conduct a conversation not only with the child, but also with his parents. The child will not be afraid of anything in the hospital, while parents will be able to learn about the features of this disease, the correct menu design and basic skills that will be useful in life with such an ailment.

The interdependent nursing process for diabetes in children and adults is a set of measures in which the sister constantly shares various observations with the attending physician, and then the doctor alone makes decisions about changes or additions to the used treatment tactics. In this case, the nurse will by no means prescribe sleeping pills for the diabetic, but at the same time she will tell the doctor about the occurrence of sleep problems, after which he will make a decision on the use of some drug.

One of the most important features of diabetes is that the quality of life of the patient is absolutely equally dependent on treatment, medical care and self-discipline. The nurse will not come home every day to the patient in order to track how correctly they comply with medical prescriptions. For this reason, the nursing process in the event of diabetes is simply not possible if the patient does not get used to self-control in advance.