What are some good ideas for Diabetic Teaching on a nursing care plan?

[Samian Q]

So I have to do some patient teaching and then write up a teaching journal for a patient I care for tomorrow.

Here's the instructions for the assignment:

"The evening before clinical, identify a client/family with a learning need in the clinical setting. In lieu of one reflective journal, use the steps of the nursing process to discuss client/family teaching done on a clinical day. (Include assessing/identifying client needs, setting client goals, implementing and the evaluating these learning goals.) Address the Health Belief Model. This is a prospective assignment, rather than retrospective. You should be familiar with the model and use it as a guide for planning your teaching. "

So anyway, when I was going to pick a patient today, I found that my prospective patient had an elevated blood glucose of 133, yet she wasn't on a diabetic diet nor was she on any insulin whatsoever. I found that weird. Weirder still, I looked through her chart and saw "diabetes mellitus" written on her medical history. I think she may have just been diagnosed.

Anyway, the nursing care plans on the computer system list "Diabetic teaching" as something that has yet to be done.

Hooray for me! What if I did just that for my teaching assignment? It would get me a grade AND would fulfill one of her to-do things in the hospital! Killing two birds c one stone!

So what goes on in a diabetic teaching in the hospital? What can I teach her? Any clues?

[Double-Helix, BSN, RN]

Now, I could easily list a multitude of topics that fall under "diabetic teaching", but I'd rather you think critically and come up with the list on your own (since this is your assignment) . Then feel free to post your teaching topics and ask for feedback. If you were just diagnosed with diabetes, or another disease that you weren't familiar with, what would you want to know?

Here's some questions to get you thinking:

1. What is the patient's current knowledge about diabetes? It's very important to find out what the patient already knows (or thinks they know) in order to know what they need to learn.

2. What lifestyle modifications does someone with diabetes have to make?

3. What medications might a diabetic need to take? How are those medications administered?

4. How/how often does a diabetic monitor (hint) their blood sugar?

In many hospitals, diabetic teaching is does by a diabetes educator. It's very in depth and there's usually a list of topics that need to be covered before the patient can be discharged. When you're at clinical, ask your primary nurse if there is such a list and where you might find it.

[Samian Q]

Hmmm. I haven't met the patient, and since it's a prospective assignment, I need to have all the details ready already when I'm there tomorrow.

How about I do something with diabetic diets? All I know from the patient record is that this patient doesn't take dairy products. Is there any way to integrate something about that into a lesson plan?

[Double-Helix, BSN, RN]

I found that my prospective patient had an elevated blood glucose of 133, yet she wasn't on a diabetic diet nor was she on any insulin whatsoever.

Let me also add that one "abnormal" lab result may not be weird at all. It's important when you're analyzing your patient's lab results to look at the whole picture. It's good that you recognize that the blood glucose is out of the normal range, but that's not enough. If you see an abnormal lab result you need to think about the patient's condition and the situation.

In the case of blood glucose: When was the last time the patient ate? What did they eat? If the labs were drawn right after the patient finished eating pancakes and orange juice for breakfast, would 133 be considered abnormal? Is the patient taking any medications that might increase the blood sugar (such as steroids)? Are there any other factors that might be increasing the blood sugar (such as physical or emotional stress or pain)? Without the diagnosis of Diabetes Mellitus written on the chart, the blood sugar alone is not indicative of anything.

[Double-Helix, BSN, RN]

Hmmm. I haven't met the patient, and since it's a prospective assignment, I need to have all the details ready already when I'm there tomorrow.

How about I do something with diabetic diets? All I know from the patient record is that this patient doesn't take dairy products. Is there any way to integrate something about that into a lesson plan?

This is where Google can be very helpful to you. I typed in "Diabetic diet plan" and found several websites that will be very helpful to you. You can also search "Diabetic teaching" for even more helpful links.

[nurseprnRN, BSN, RN]

This the same patient with the no-dairy thing you mentioned in another thread?

Honestly, OP (and all students, so you don't think I'm picking on the OP), do you have a med-surg textbook? Have you read the section on diabetes? Have you had any classes in diabetes? Have you any imagination about what you would need to know if you were a newly-diagnosed diabetic? Do you know whether every diabetic has to be on insulin? Apparently the answer to all of these is...no. But it shouldn't be, not at all, and you should know these before you come here for your answers to your homework.

I think we all appreciate your excitedness about being connected to people who know more than you do, and we do want to help, because nursing is one of the most collaborative professions around ... and you need to bring a lot more to the table. Your faculty will not appreciate it if when they ask you a question like these you whip out your smartphone to find the answer. You need to know these yourself using references you had better have on your desk already, and do more preparation than "Ask AN."

Tell us what you know already (and giving a list of foods are acceptably high in calcium and then asking whether they have dairy in them??? Salmon? Bok choy? Fail.), what you think and how you found out or tried to find out, and ask for clarification of confused points, not just the answers.

So...what do you think?