Diabetes Nursing Care Plan

Nurse tests her senior adult patient's high blood sugar with a glucometer

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  1. Pathophysiology of Diabetes
  2. Diabetes Nursing Assessment
  3. Nursing Interventions for Diabetes

Pathophysiology of Diabetes

Diabetes Mellitus is a chronic metabolic disorder that affects how the body utilizes glucose. As a result, the body either does not produce enough insulin or is unable to use it effectively, leading to high blood sugar levels.

Causes of Diabetes

Type 1 diabetes is caused by an autoimmune response that destroys the insulin-producing cells in the pancreas. 

Type 2 diabetes is caused by a combination of genetic and lifestyle factors, such as obesity, physical inactivity, and poor dietary habits.

Diabetes Symptoms

  • Frequent urination
  • Excessive thirst
  • Hunger
  • Fatigue
  • Blurred vision
  • Slow healing of wounds

Subjective Data (Client Reports)

  • Feeling tired and thirsty all the time
  • Frequent urination 
  • Their wounds are slow to heal

Objective Data

  • Blood glucose levels are consistently high
  • BMI of 30 or above (overweight)
  • Blood pressure is within normal limits
  • No history of cardiovascular disease

Diabetes Risk Factors

  • Obesity
  • Sedentary lifestyle
  • Poor dietary habits
  • Family history of diabetes

Diabetes Nursing Assessment

Diabetes can cause long-term damage to the body resulting in multiple complications such as kidney failure, heart disease, blindness, and decreased sensation in the extremities. Careful assessment can evaluate potential secondary conditions with hyper or hypoglycemia.

Cardiac Function

Damage over time to the kidney leads to salt and water retention. This will raise the blood pressure. Diabetes also damages the small blood vessels, causing the vessels’ walls to stiffen. This leads to high blood pressure and cardiac issues. Therefore, the client’s blood pressure, heart rate, and cardiac rhythm should be assessed for abnormalities.

Respiratory Function

Often the client’s blood sugar will be too high (hyperglycemia) or too low (hypoglycemia) and can cause respiratory distress. The nurse should assess the client’s respiratory rate, depth, and effort. They should also monitor for signs of hypoxia or respiratory distress.

Neurologic Function

The body has a large amount of blood vessels and nerves. One particular area of concern is the feet. Neurovascular assessments are key to maintaining intact and healthy feet in the diabetic client.  

The nurse should assess the client’s mental status, cranial nerves, motor and sensory function, and reflexes, as diabetes (hyperglycemia and hypoglycemia) affects each area.

Sensory Function

The nurse should assess the client’s vision, hearing, and tactile sensations.

Labs for Diabetes (Evaluate and Report)

The nurse should monitor the client’s blood glucose levels and HbA1C levels. They should also monitor the client’s lipid levels, liver function, kidney function, and electrolyte levels.

Nursing Interventions for Diabetes

  • Encourage a healthy lifestyle by promoting physical activity and a balanced diet.
  • Educate the client on proper medication management, foot care, and blood glucose monitoring.
  • Monitor the client’s progress and adjust the care plan accordingly.

Diabetes Goals and Outcomes

  • Maintain blood glucose levels within a normal range
  • Prevent complications
  • Promote a healthy lifestyle
  • Improved glycemic control
  • Reduced risk of complications
  • Improved quality of life