Question

Question

Nurse is working as a nurse in an outpatient clinic as the diabetic educator. The patient has recently been diagnosed with type 2 diabetes, and the nurse will be developing a teaching plan. Your patient is a 50-year-old man with a history of hypertension. His vital signs are stable, hemoglobin A1C is 7.5%, and the patient has a body mass index (BMI) of 28.

1. What are the main goals of therapy for all patients with diabetes in terms of both symptom control and quantitative targets for fasting blood glucose levels and for the hemoglobin A1c?
2. The nurse is preparing a teaching plan to include glargine (Lantus) for your patient. What information will the nurse include in the teaching plan?

Answer 1

To prepare a teaching plan nurse should consider  the patient BMI, A1C value and exsisting health conditions,treatment modality used.

Teaching plan should include the following components

• Lifestyle modification and exercise.
• Dietary modifications.
• Insulin (lantus) dosage and sites for injection.
• Regularly checking the blood glucose levels.

1. Lifestyle modification and exercise .

For the above information we come to know that patient is 50 yrs old and hypertensive, his BMI indicates that he is over weight.

We should explain patient that how important is weight  reduction for him to maintain his blood pressure and blood glucose levels .We should also explain him about how to make changes in lifestyle by quitting any habits like consumption of alcohol,smoking and any other kind of abuse .

How he should maintain active lifestyle by following an excercise routine.Atleast walking for 150 mins per week.

2.Diteary modifications

We should explain patient regarding the dietary modifications he should make in his day to day life ,like reducing the intake of refined foods ,alcohol,junk food,etc.

Explaining him about Glycemic Index of the foods,and encouraging him to include more of fresh food in his diet than canned or tinned food.

Encouraging patient to have protien rich diet and reduce carbohydrate intake.

3.Insulin (lantus) dosage and injection sites.

As the patient is newly diagnosed and he does not have any knowledge about how take insulin injection ,we should clearly explain him about how he should take the injection and where are the sites he can take the injection and how dosage of medication is to be adjusted according to the glucose levels.

4.Regulary checking the blood glucose levels.

Initially we advice the patient to check his glucose levels daily using a glucometer to adjust the dose of insulin .once it is done .we advice for periodic glucose level testing at laboratory by different methods like fasting blood glucose,A1C,post prandial glucose,random glucose levels ect.