Priority Nsg Diagnosis # 1: Ineffective Priority Nsg Diagnosis # 2: Risk for
Self-Health Management Impaired skin Integrity
Subjective data: “I was alarmed at Subjective data: “My feet sometimes feel
the high reading I got on my friend’s like they are on fire. It’s worse at night”
meter. I had never used a meter Objective data: Decreased sensation to
before.” “Please tell me what to do.” stimulation with a pin in bilateral feet;
Objective data: Blood glucose- Unable to perceive touches of a light
195mg/dL, HgbA1C- 10.5, high wisp of cotton to bilateral feet; Could not
fat/high carb diet, BMI:28.6 Related to Insufficient Contributed to identify the position of her toes
Knowledge of alteration in sensation bilaterally
Therapeutic Regimen
Current information
Medical diagnosis: Type 2 Diabetes Current information
mellitus
Patient: L. J. Medical diagnosis: Type 2 Diabetes mellitus
Risk factors: Family Hx, Obesity, Race,
Experiencing nocturia, polyuria, and occasional Risk factors: Family Hx, Obesity, Race, Age,
Age, Previous impaired fasting glucose,
Hypertension, High Cholesterol blurred vision for past 2 months; burning sensation Previous impaired fasting glucose,
Diagnostic tests: Fasting Blood Sugar, in feet bilaterally; blood glucose of 275 Hypertension, High Cholesterol
HgbA1C Diagnostic tests: Fasting Blood Sugar,
Treatments: Glucose Monitoring, HgbA1C
Healthy Diet, Exercise Treatments: Glucose Monitoring, Healthy
Medications: Glyburide Diet, Exercise
Medications: Glyburide
Nsg interventions
Nsg interventions
Nursing interventions:
1. Educate client on use of blood sugar
Nursing interventions:
meter including time and frequency to test,
1. Educate client regarding the importance
target blood glucose ranges and how to
of and procedure for diabetic foot care
record results
2. Inspect client’s feet without shoes and
2. Educate client on importance of a daily
socks at each visit, observing skin for
exercise program such as walking for 30
redness, blistering, corns, calluses, cracks,
mins per day
edema, changes in temperature
Short-term goal: x 24 hours- Client will
Short-term goal: x 24 hours- Client will
demonstrate the proper technique of using
perform appropriate diabetic foot care
glucometer
Long-term goal: x 1 month- Client’s skin will
Long-term goal: x 1 month- Client will Submitted by: Angelene Thomson, N221
remain intact
report engaging in light exercise regimen,
Self-Health Management Impaired skin Integrity
Subjective data: “I was alarmed at Subjective data: “My feet sometimes feel
the high reading I got on my friend’s like they are on fire. It’s worse at night”
meter. I had never used a meter Objective data: Decreased sensation to
before.” “Please tell me what to do.” stimulation with a pin in bilateral feet;
Objective data: Blood glucose- Unable to perceive touches of a light
195mg/dL, HgbA1C- 10.5, high wisp of cotton to bilateral feet; Could not
fat/high carb diet, BMI:28.6 Related to Insufficient Contributed to identify the position of her toes
Knowledge of alteration in sensation bilaterally
Therapeutic Regimen
Current information
Medical diagnosis: Type 2 Diabetes Current information
mellitus
Patient: L. J. Medical diagnosis: Type 2 Diabetes mellitus
Risk factors: Family Hx, Obesity, Race,
Experiencing nocturia, polyuria, and occasional Risk factors: Family Hx, Obesity, Race, Age,
Age, Previous impaired fasting glucose,
Hypertension, High Cholesterol blurred vision for past 2 months; burning sensation Previous impaired fasting glucose,
Diagnostic tests: Fasting Blood Sugar, in feet bilaterally; blood glucose of 275 Hypertension, High Cholesterol
HgbA1C Diagnostic tests: Fasting Blood Sugar,
Treatments: Glucose Monitoring, HgbA1C
Healthy Diet, Exercise Treatments: Glucose Monitoring, Healthy
Medications: Glyburide Diet, Exercise
Medications: Glyburide
Nsg interventions
Nsg interventions
Nursing interventions:
1. Educate client on use of blood sugar
Nursing interventions:
meter including time and frequency to test,
1. Educate client regarding the importance
target blood glucose ranges and how to
of and procedure for diabetic foot care
record results
2. Inspect client’s feet without shoes and
2. Educate client on importance of a daily
socks at each visit, observing skin for
exercise program such as walking for 30
redness, blistering, corns, calluses, cracks,
mins per day
edema, changes in temperature
Short-term goal: x 24 hours- Client will
Short-term goal: x 24 hours- Client will
demonstrate the proper technique of using
perform appropriate diabetic foot care
glucometer
Long-term goal: x 1 month- Client’s skin will
Long-term goal: x 1 month- Client will Submitted by: Angelene Thomson, N221
remain intact
report engaging in light exercise regimen,
