need help with NRSDX for pt with chronic diabetes type 2

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I am writing a nursing process paper on a 63yo Caucasian male who was admitted to the hospital for an abscess on the mid section of his forehead. He also has cellulitis on the surrounding tissue of the abscess. He is non compliant with his diet, over weight, does not exercise and he smokes a pack and a half of cigarettes a day. He was diagnosed with diabetes 6 years ago.

On the trajectory continuum I placed him at the acute phase due to complications from the chronic illness that required him to be hospitalized..

Also, when he was hospitalized, his blood glucose was 176. His blood glucose was 384 the next day. He stated that his sugar goes up and down like that all the time.

I am looking for some good interventions for this patient. Can anyone give me some idea's?

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I am writing a nursing process paper on a 63yo Caucasian male who was admitted to the hospital for an abscess on the mid section of his forehead. He also has cellulitis on the surrounding tissue of the abscess. He is non compliant with his diet, over weight, does not exercise and he smokes a pack and a half of cigarettes a day. He was diagnosed with diabetes 6 years ago.

On the trajectory continuum I placed him at the acute phase due to complications from the chronic illness that required him to be hospitalized..

Also, when he was hospitalized, his blood glucose was 176. His blood glucose was 384 the next day. He stated that his sugar goes up and down like that all the time.

I am looking for some good interventions for this patient. Can anyone give me some idea's?

I guess it would help if I told you what the nursing dx. was: Impaired Tissue Integrity r/t bacterial invasion.

We only need one priority dx. Is this what you would use?

I do have a couple of interventions, but I'm not sure about them:

1.monitor blood glucose levels

2. assess for pain and keep pain at a reasonable # of 4, being 1 the least and 10 the greatest

3. smoking cessation education

4. pt. will remain a febrile during my shift

HELP!!!

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I would recommend using this website http://www1.us.elsevierhealth.com/MERLIN/Gulanick/Constructor/#New. When we do careplans we determine priority by doing any ABC issues first. I think impaired tissue integrity would be good, but I'm not really sure that would be a priority. Some interventions you could use

Provide patient with rationale for importance of behaviors such as the following:

  • Balanced diet low in cholesterol This prevents vascular disease.
  • Smoking cessation Smoking has been directly linked to cancer and heart disease.
  • Cessation of alcohol and drug abuse In addition to physical addictions and the social consequences, the physical consequences of substance abuse mitigate against it.
  • Regular exercise This promotes weight loss and increases agility and stamina.
  • Proper hygiene This decreases risk of infection and promotes maintenance and integrity of skin and teeth.
  • Regular physical and dental checkups Checkups identify and treat problems early.
  • Reporting of unusual symptoms to a health professional This initiates early treatment.

Consult dietitian for further assessment and recommendations regarding a weight loss program. Changes in eating patterns are required for weight loss. The type of program may vary (e.g., three balanced meals a day, avoidance of certain high-fat foods). Dietitians have a greater understanding of the nutritional value of foods and may be helpful in assessing or substituting specific high-fat cultural or ethnic foods.

Encourage diabetic patients to attend diabetic classes. Review and reinforce principles of dietary management of diabetes. Obesity and diabetes are risk factors for coronary artery disease.

Just some ideas hope it helps. I would suggest buying a careplan book thats what I always use.

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