nursing care plan for infant of diabetic mother

In addition, limited joint mobility or a prior handicap may make it difficult for the patient to evaluate the bottom of the feet. Introduction. Educate about adjusting home glucose monitoring frequency depending on the clients risk factors like stress and poor diet. This will keep moisture from causing further complications. Desired Outcome: The patient will maintain a blood glucose level of less than 180 mg/dL and an A1C level below 5.7. Proper diabetic diet balanced with nutritional needs is important in maintaining normal blood glucose levels. Alright, let's take a look at the physiology of glucose metabolism during pregnancy. Determine the clients most urgent learning need both from the clients and nurses point of view. An understanding of the metabolic alterations seen in normal and diabetic pregnancies can lead to an optimal plan of care for the diabetic patient and her infant. Create a daily weight chart and a food and fluid chart. Hypoglycemia refers to low blood glucose in the baby immediately after delivery. To quickly identify fluctuating blood glucose levels for immediate correction. Gestational diabetes mellitus (GDM) from all causes of diabetes is the most common medical complication of pregnancy and is increasing in incidence, particularly as type 2 diabetes continues to increase worldwide. The problems facing the infant of a diabetic mother antenatally, intrapartally, and neonatally relate directly to the sequence of maternal hyperglycemia, fetal hyperglycemia, and . Insulin facilitates the entry of blood glucose into the cells of the body, which results to the lowering of its amount in the bloodstream. Possible signs and symptoms of hypoglycemia include jitteriness, irritability, diaphoresis, and blood glucose level less than 45 mg/dL. The patient will be able to declare the ability to cope and when necessary, seeks assistance. Length and head size are usually within normal range for gestational age. Risk for Injury. Maternal diabetes may be pregestational (ie, type 1 or type 2 diabetes diagnosed before pregnancy with a prevalence rate of approximately 1.8 percent) or gestational (ie, diabetes diagnosed during pregnancy with a . To address the patients cognition and mental status towards the new diagnosis of diabetes and to help the patient overcome blocks to learning. Hyperglycemia may cause Kussmauls respirations and/or acetone breath. . Deficient Knowledge. Davis. Nursing Diagnosis: Fatigue related to decreased metabolic energy production as evidenced by overwhelming lack of energy, verbalization of tiredness, generalized weakness, blood sugar level of 210 mg/dL, and shortness of breath upon exertion. Diabetic control needs constant energy and thinking, which might cause a relationships focus to shift. Severe hemolytic disease of the newborn (incompatibility of blood types of mother and baby) Birth defects and congenital metabolic diseases. The respiratory evaluation is the most crucial assessment before anything else. Imbalanced Nutrition: Less than Body Requirements, Disturbed Sleep Pattern Nursing Diagnosis, Blood Transfusion Nursing Diagnosis and Nursing Care Plan, Hip Fracture Nursing Diagnosis and Nursing Care Plan, Pleurisy Nursing Diagnosis Care Plan - NurseStudy.Net, Gestational Diabetes Nursing Diagnosis Interventions and Care Plans - NurseStudy.Net, Colon Cancer - Pathophysiology, Podcast, and Nursing Care Plan. She found a passion in the ER and has stayed in this department for 30 years. Here are 17 nursing care plans (NCP) and nursing diagnoses for diabetes mellitus (DM): Risk for Unstable Blood Glucose Level. Advertisement. Nurses pocket guide: Diagnoses, prioritized interventions, and rationales. A pregnancy may end in a live birth, a miscarriage, an induced abortion, or a stillbirth. Provide information about community resources, support groups and diabetic educators. To facilitate early detection and management of infection and to provide proper wound management as needed. Physical therapy, 88(11), 1254-1264. Do not share ones equipment with other infants. This condition can cause serious complications if left uncontrolled. This information is critical to creating an effective and accurate care plan. Inform the patient the details about the prescribed medications (e.g. Chest movement, intercostal retraction, xiphoid retraction, nares dilatation, and expiratory grunt are the five criteria used to assess the newborns respiratory health. Patients who are involved in decision-making are more likely to progress toward independence. Hypoglycaemia is the most common metabolic disorder of the neonate, and occurs in 5-15% of all neonates. In gestational diabetes, the placenta secretes hormones that are vital for pregnancy but may form insulin resistance in the mothers cells. The nurse's assessment of the . Buy on Amazon, Gulanick, M., & Myers, J. L. (2017). She has worked in Medical-Surgical, Telemetry, ICU and the ER. Problem-solving and good coping are aided by an open connection. Desired Outcome: The patient will demonstrate ways to properly care for the feet and the patient will maintain an intact skin on the legs and feet while still admitted to the hospital. Identify desired outcomes to be achieved. To bring the body temperature down quickly as possible. The white cloth makes it easy to see if there is any presence of blood or exudates. denial of diagnosis or poor lifestyle habits). Polycythemia (ie, hematocrit exceeding 65%) may result from placental insufficiency causing chronic fetal hypoxia and increased fetal erythropoietin production. Symptoms of high blood glucose levels include: In general, there are three types of diabetes and each one varies in terms of treatment and management. To ensure that the blood glucose level is within target range. It helps in cooling down the body temperature. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Hypocalcemia may result from decreased parathyroid hormone production. (Frequency of blood glucose checks depends on the treatment plan.). Encourage the patient to keep the feet warm by wearing white cotton socks. Antenatally, intervention is aimed at identifying and preventing macrosomia and sudden fetal demise. The patient may describe feelings of helplessness as a result of attempting to manage medications, food, exercise, blood glucose monitoring, and other preventative measures. peri pheral. Journal of diabetes science and technology, 4(3), 750-753. Essential in ensuring the clients understanding of his treatment regimen to ensure his compliance and adherence. Nursing Care Plan for Diabetes 1. Monitor for signs of hypocalcemia (see table 2). Transplant of Pancreas. Type 1 - This type of diabetes is believed to be due to an autoimmune reaction in the body that prevents the body from producing insulin. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. Bethesda, MD 20894, Web Policies Please follow your facilities guidelines, policies, and procedures. To allow the patient to relax while at rest. Type 1 diabetes is also called insulin-dependent and juvenile-onset diabetes. To ensure that the patient does not experience hyperglycemia (high blood glucose level) or hypoglycemia (low blood glucose level), patients are educated to check their blood sugar about 3 to 4 times a day, or more depending on their treatment plan. Low fat, low calories, and high fiber foods are ideal for diabetic patients. Poor blood flow and/or nerve damage in the feet increase the risk for blisters and cuts. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. smoking, excessive alcohol intake, high sodium and/or. Normal blood glucose levels ensure good circulation, especially around the affected wound area. Perform an initial head-to-toe assessment, particularly checking for the presence of any wounds and cuts. Diabetes is one of the common endocrine disorders affecting pregnancy. Refer the client to a dietitian to plan specific dietary needs based on complicated situations like pregnancy, growth spurt and change in activity level following an injury. An example of data being processed may be a unique identifier stored in a cookie. An IDM is more likely to have periods of low blood sugar (hypoglycemia) shortly . As they grow older, the color of the skin that they were born with may change. RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. Allows the patient to have a feeling of control over the situation. Stress can cause a wide range of behavioral and physiological responses, which can indicate how difficult it is to cope. First 24 hours-1 wet diaper/1 stool. Contributors: Infants of mothers with diabetes, or IDMs for short, have a higher risk of developing fetal and neonatal complications, including growth abnormalities, respiratory distress, and metabolic complications, in addition to preterm delivery. Prediabetes. Bookshelf Excess glucose may damage the blood vessels located in the eye. Risk for Infection. infants of a woman with diet controlled diabetes (pre-existing or gestational) early, frequent oral feeding (preferably breast milk) glucose infusion (4-6 mg/kg/min = 60-80 mL/kg/day 10 per cent glucose) judicious use of glucagon. Powerlessness. Obtain hematocrit value; report the findings to the physician. Careers. The acceptable vital signs measurements of a newborn are listed below. If signs and symptoms continue after feeding, observe for other complications. But physical examinations are also performed on babies to detect any visible illnesses or physical deformities. St. Louis, MO: Elsevier. People with prediabetes may eventually have type 2 diabetes if the condition is left untreated. Intravenous fluid is used to replenish fluid losses of the newborn. Desired Outcome: The patient will be able to avoid the development of an infection. The Apgar score serves as the starting point for all subsequent observations of a newborn. With proper use of the nursing process, a patient can benefit from various nursing interventions to assess, monitor, and manage diabetes and promote client safety and wellbeing. An Audit in a Tertiary Care Hospital. Administer diabetic medication (oral and/or insulin therapy) as prescribed. Wherever newborns go, they continue to bring delight and excitement to everybody. If the, Diabetes Screening blood sugar screening, Body mass index of greater than 23 (regardless of age), Women who has experienced gestational diabetes screening every 3 years, Prediabetes patients screening every year, Glycated hemoglobin (A1C) test to check the average blood glucose level in the last 2-3 months; non-fasting, Random blood sugar test blood sugar level of 200 mg/dL or 11.1 mmol/L suggests diabetes, Fasting blood sugar test fasting overnight; blood sugar level of greater than 7mmol/L in 2 different test days suggests diabetes, Oral glucose test fasting overnight; patient is asked to drink a sugary liquid, then the nurse tests the blood sugar level for the next 2 hours; a level of more than 200 mg/dL or 11.1 mmol/L suggests diabetes. Other various skin colors, appearances, and remarkable characteristics of newborns are listed below, along with their interpretations. Determine what circumstances may have affected the patients ability to stick to the medication routine. Gestational diabetes mellitus (GDM) from all causes of diabetes is the most common medical complication of pregnancy and is increasing in incidence, particularly as type 2 diabetes continues to increase worldwide. To effectively monitory the patients daily nutritional intake and progress in weight loss goals. In maternal long-term diabetes with vascular changes, the newborn may be SGA because of compromised placental blood flow, maternal hypertension, or pregnancy-induced hypertension, which restricts uteroplacental blood flow. Desired Outcome: The mother must still be able to identify and demonstrate ways for maintaining lactation as well as techniques for providing breast milk to the newborn. Hyperbilirubinemia may result from breakdown of excess RBCs after birth. Educate patient about the importance of adhering to prescribed diabetic treatment. It happens when the pancreas is unable to produce adequate insulin to meet the bodys needs or when the bodys cells become resistant to it. Educate the patient (or guardian) on how to fill out a fluid balance chart at bedside. Nursing care plans: Diagnoses, interventions, & outcomes. Abstract: In the United States, approximately 100,000 infants are born to diabetic mothers each year. To create a baseline of activity levels and mental status related to fatigue and activity intolerance. The patient will be able to begin making lifestyle modifications that will allow adaptation to current circumstances. To meet the clients needs and not the instructors needs. Monitor and record the characteristics and strength of peripheral pulses. To monitor for impending infection or progressing necrosis. 8600 Rockville Pike Buy on Amazon. To document significant changes in vital signs, such as a drop in blood pressure, an increase in pulse rate, and a rise in temperature. If these signs are present, it is indicative that the patient needs preventive care. The mother is also at high risk for pre-eclampsia, a fatal condition during pregnancy. Clipboard, Search History, and several other advanced features are temporarily unavailable. Greater size results from fat deposits and hypertrophic liver, adrenals, and heart. Risk for Disturbed Sensory Perception. and transmitted securely. To balance dietary intake with complicated body needs. Insulin therapy. Observation reveals the characteristics appearance of a round, red face and an obese body. Diabetes in pregnancy is associated with an increased risk of fetal, neonatal, and long-term complications in the offspring. St. Louis, MO: Elsevier. To change a patients health or lifestyle practices, avoid using fear or scare tactics. Assess the patients previous problem-solving abilities. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. Stabilized blood glucose levels ensure good blood flow, especially around the wound site. A low blood glucose level can be life-threatening if not treated quickly. To prevent the development of infections that may be associated with poor wound care and hygiene. These can affect the patients coping abilities. The average parameters that nurses use to examine the newborns vital statistics are listed below. Diabetic patients need complex nursing care. Necrotic tissues around a diabetic persons wound signify poor blood flow. Discuss with the patient about the previous management done to keep up with the diabetic treatment plan. Efforts in controlling blood glucose levels is essential in ensuring good blood flow around the wound. Advise the patient that it is not allowed to walk around barefoot. Ascertain that every equipment used to care for the newborn is sterile and immaculate. Heinemann, L. (2010). For healthcare management resources post-discharge. Clinical specialists of nursing, con-suiting and working together, can develop a plan of nursing care for the pregnant woman with diabetes. Massage the limbs and keep the skin dry. However, some skin colors may be due to certain health conditions. Provide the patient a thorough explanation of the desired information and avoid giving more than what the patient can manage. To allow the newborn to have enough rest so that the oxygen available for cellular uptake is maximized. Accessibility Ask the patient to repeat or demonstrate the self-administration details to you. Laboratory and diagnostic study findings. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Just recall all the patients you saw today and theres probably a handful of them who are diabetic. Identify clients support person that may also need information about the planned diabetes regimen. Here are some of the most important NCPs for diabetes: 1. sharing sensitive information, make sure youre on a federal If the patient has a fever, give antipyretics as ordered by the physician. Etiology . Circumcision-Main complication (hemorrhage & infection), glucose water on pacifier, use petroleum jelly on site) want to be sure that the newborn is in . PMC Retinopathy. Apply distraction methods during procedures that may cause fear to the patient. Desired Outcome: At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of Type 2 diabetes and its management. On the other hand, the cells of people with prediabetes and type 2 diabetes develop insulin resistance. The patient will be able to verbalize feelings about diminished function that can be expressed in a true and transparent manner. This increases the risk for, Diabetic coma. Nursing care plans: Diagnoses, interventions, & outcomes.