Introduction
Diabetes mellitus is a dangerous disease affecting people worldwide irrespective of gender and place. It is a state of the body when it does not produce sufficient insulin and shows high level of glucose in the body. This paper presents various facts on diabetes mellitus. The clinical manifestations, subjective and objective data required to be collected, specific laboratory tests, role of multidisciplinary team and two of the nursing diagnoses of diabetic mellitus are also briefly summed up.
Diabetes mellitus is a disease that results in the increase of sugar level in the blood due to the inability of the body to produce sufficient insulin. There are three types of diabetes mellitus and they are Type 1, Type 2 and gestational diabetes. The patho-physiology of diabetes mellitus is hyperglycemia, macromasia, preeclampsia or intrauterine growth restriction and hyperinsulinemia. (The pathophysiology of Diabetes Mellitus n.d.).
Therefore, the data regarding the patho-physiology of the patient should be assessed. Diabetes mellitus leads the patient to other health problems. There is a possibility of developing cardiovascular disease in a diabetes mellitus patient due to elevated sugar in the blood. Silent heart attacks, pain while walking, hyper tension, sudden fainting, eye problems diabetic neuropathy, paralysis of cranial nerves and skin disorders are some of the complications related to the diabetes mellitus. The diabetes patient has a problem of increased urine pass every day. They feel more thirsty and hungry due to the effect of osmotic in the blood glucose and it can be diagnosed through routine examination.
Clinical manifestations, assessment, tests, and special diet
Some of the clinical manifestations of diabetes mellitus are “excessive urination which may be troublesome at night, excessive thirst due to dehydration, loss of weight and weakness due to loss of glucose in the urine and breakdown of tissue protein, itching around the external genitalia due to local infection by sugar-loving organisms, pain in the legs, increased appetite, failing vision, loss of sexual vigor, cardiovascular insufficiency and delayed healing of wounds.” (Mangala 2009).
The nurse should collect subjective and objective data from the patient for accurate assessment of the disease. The objective data that are required in the assessment are level of glucose, electrolytes, enzymes, lipids, creatinine and protein values, count of red blood cells and white blood cells and hemoglobin. The subjective data that are to be collected in the assessment are number of urination, level of thirst, measuring weight and weakness, feeling pain in the legs, levels of appetite and incidence of delayed healing of wounds. There are laboratory tests and diagnostic studies to confirm the assessment findings. Some of them are given below:
A type and Cross match: It is a laboratory test that assesses the compatibility of the blood of the client comparing it with the blood of a healthy person and this test recognizes the existence and non existence of A or B antigens.
Blood Chemistry Test: This test determines the presence of “glucose, electrolytes, enzymes, lipids, creatinine and protein.” (White and Duncan 2002, p.239). Diabetes mellitus patients are required to follow a special diet. The special diet should be of low fat, low protein and cholesterol containing food, fresh fruits, vegetables and grain that are rich for fiber, nuts, seeds and starch free bread.
They are required to reduce the use of salt. “American Diabetes and Dietetic Association recommend a balanced meal plan for diabetes the uses the following ratios: protein providing 10% to 20% total calories, fat providing no more than 30%, and carbohydrates supplying up to 60%.” (Diabetes diets: What is diabetes: What are the general guidelines for a diabetes diet: General dietary goals for people with diabetes 2001, para.3). Fiber is a composite of carbohydrates and it can be received from plants, vegetables, different varieties of fruit, grains, different kinds of nuts, and pea species.
Multidisciplinary team, care and two nursing diagnosis of Diabetes mellitus “Sumner (1998) believes that nurses are a vital element in the multidisciplinary teams that are essential for the care and treatment of diabetes because of the large number of illnesses that can result from the disease.” (Nursing care for young adults with type I diabetes 2009, para.4). Nurses have a pertinent role in assessing symptoms and case histories of the patient and they help the physician to treat and assess the patient according to their clinical manifestations. Along with nurses, physicians, therapists and counselors also have a vital role in the treatment of the diabetes mellitus patient.
After the discharge, the patient has to take care of himself first. Self care is an important fact that would lead the treatment to success. Keeping a balanced diet, integrity of the damaged skin, avoiding the risks of getting injured and infected and damaged urinary elimination have to be taken into consideration after the discharge. The patient must know about oral or insulin medication because it should be organized with the intake of calorie.
The treatment is to regain the normal state of glucose in the blood. Along with this medication, the patient should know about exercise that would control the level of glucose. There is a significant relation between the food intake and the medication especially in the case of a diabetes mellitus patient. There are many kinds of nursing diagnoses for diabetes mellitus and two relevant nursing diagnoses are unbalanced diet and damaged skin integrity.
- Unbalanced diet: It is one of the pertinent nursing diagnoses with regard to diabetes mellitus patient. The patient’s intake of food should not be more than what is required. So also, the patient has to refrain from excessive fat, protein and cholesterol containing food and preference should be given to vegetables, fresh fruits containing less sugar, seeds and nuts. So, diagnosis in relation to food intake is necessary in the case of diabetes mellitus patient.
- Damaged skin integrity: Wounds in the body of diabetes mellitus patient may take long time to get cured. Therefore, the nursing diagnosis should be vigilant to state the damaged skin integrity in the body of the patient. The patient has to avoid risks of getting wounded.
Conclusion
Diabetes mellitus is a state of the body when sufficient insulin for the body is not produced and having higher level of glucose in the body. This paper presents what is diabetes mellitus, its pathophysiology, clinical manifestations, nursing assessment, various tests, special diet and two significant nursing diagnoses with regard to diabetes mellitus.
References
Diabetes diets: What is diabetes: What are the general guidelines for a diabetes diet: General dietary goals for people with diabetes. (2001). Web.
Diabetes diets: What is diabetes: Fiber. (2001). Web.
Mangala, E. (2009). Clinical manifestations of diabetes mellitus: Clinical features of diabetes mellitus. India Study Channel. Web.
Metabolic diseases: Diabetes mellitus: Long term complications of diabetes. (2009). Web Health Center. Web.
Metabolic Diseases: Diabetes mellitus: Symptoms. (2009). Web Health Centre. Web.
Nursing care for young adults with type I diabetes. (2009). Lots of Essays. Web.
The pathophysiology of Diabetes Mellitus. (n.d.). Diabetes Research. Web.
White, L., and Duncan, H. (2002). Blood chemistry. Medical surgical nursing: an integrated approach (2nd edition). Cengage Learning. 239.