Question

Develop a nursing care plan with a priority diagnosis, outcomes, and interventions. Be sure to include patient teaching, growth and development, self-concept, and lifestyle issues both in the present and going forward.

Ashley is a 17-year-old Type 1 diabetic. She was diagnosed at the age of 14 and is managing her insulin needs "mostly" independently, but in the office because she is going to start using a lispro insulin pump for control, with a basal rate and boluses as needed based on FSBG and carbohydrate counting. She checks her FSBG upon awakening (fasting), before eating lunch and dinner, and at bedtime. She is currently applying to colleges which are mainly located out of state. Her parents are having a great deal of difficulty dealing with Ashley's choices of where to go to college because of the distance. She is academically motivated and has a high GPA. She has a partner, and is not yet sexually active although she admits that they have been "talking about it." Ashley is on the varsity swim team and practice is every weekday morning at 0630-0730. From there she goes to classes and lunch is at 1130. Ashley states she "sometimes gets up too late to have breakfast before swimming."

Answer 1

Type 1 diabetes also called as juvenile diabetes. It is a life time dependence on insulin disease.it is a chronic metabolic disorder caused by a absolute or deficiency of insulin. It is characterized by the body ’s inability to produce insulin due to the auto immune destruction of beta cells in the pancreas.

This is disease is considered as a adult disease but 5% begins in childhood. Usually at about 6years of age orvaroundvtge time of puberty. So these child's needs a special care and teaching to adapt this situation in their life.

Priority nursing diagnosis are....

• Nutritional imbalance .less than body requirements related to insufficient intake to meet growth and development needs and the inability of body to use nutrients.
• Risk for impaired skin integrity related to slow heeling process and decreased circulation.
• Risk for infection related to elevated glucose levels.
• Knowledge deficiency related to complicating of hypoglycemia and hyperglycemia,exercise and activities, management of diet.

Outcomes for type 1 diabetes is include

• Maintain adequate nutrition.
• Maintain skin integrity.
• Prevention of infection.
• Regulating blood glucose levels.
• Learning about adaptation with disease, hyperglycemia, hypoglycemia ,diet and exercise..

Nursing interventions......

1. Ensure adequate and proper nutrition.

Type 1 diabetes should need balanced diet plan to maintain their blood glucose levels and to promote adequate growth and development.advise don't miss any meals.it can leads to hypoglycemia.

2.Teach about the prevention of skin breakdown.

Teach to inspect her skin daily in properly to take care of even a small skin breakdown. Teach to importance of daily bath and drying the skin after bath.special care to feet ,and folded areas.

3. Prevention of infection.

These peoples are chance to get infection in urinary tract and respiratory tract.advice vto inform or to consult doctor if any signs of infection. They need to take more fluids and should not skip insulin at this time.

4 Regulate glucose levels .

Checking glucose levels according yo doctor order and taking insulin is important to them.help the chiild to perform it and relief fear.

5 Teach the child and family about ...

• Signs and symptoms of hypoglycemia and hyperglycemia.
• Importance of exercise in their daily life.
• Importance of engaging healthy eating habits to maintain blood glucose levels and their growth and development.
• Teach about or counsel about adaptation of longer disease duration, treatment challenges like blood glucose management, parental worry about disease.

6 Regular checkup and monitoring sugar levels,HbA1c.

It is important to maintain normal levels all their life time.

To manage ytpe1 diabetes is always a challenging one in both parent and patient. A deep understanding of disease and impact of that in patients is very important to obtain their intervention targets.