Care plan

Nursing Students Student Assist

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I have to develop a careplan for a patient and am not sure what to relate my diagnosis to or what to do for evaluation. I have put down a related to statement but I am not happy with it, what do you think? Thanks

Diagnosis

1) Risk for unstable blood glucose related to lack of motivation to monitor diabetic status

Goals

- Patient will understand the importance of monitoring blood glucose level

- Patient will monitor blood glucose before meals and before bed.

- Patient will exercise on a daily basis (walk at least 20 minutes a day)

Limit sugar intake and eat a well balanced diet

Interventions

Teach patient complications associated with diabetes (hypo/hypertension)

- Ensure patient understands the importance of monitoring blood glucose level

Teach the patient the importance of exercise

Specializes in LTC, Nursing Management, WCC.

I have never seen that nursing dx. Is this a new one?

Specializes in med/surg, telemetry, IV therapy, mgmt.

do you have a nursing diagnosis reference that has the taxonomy information? it would include the risk factors (related to information). with "risk for" diagnoses you are trying to prevent the problem from happening, so your interventions are designed to do just that. goals are also to prevent unstable blood glucose from happening if the interventions are followed as ordered.

risk for unstable blood glucose (page 95, nanda-i nursing diagnoses: definitions & classification 2007-2008)

definition: risk for variation of blood glucose/sugar levels from the normal range

risk factors:

  • deficient knowledge of diabetes management (e.g., action plan)
  • developmental level
  • dietary intake
  • inadequate blood glucose monitoring
  • lack of acceptance of diagnosis
  • lack of adherence to diabetes management (e.g., action plan)
  • lack of diabetes management (e.g., action plan)
  • medication management
  • mental health status
  • physical activity level
  • physical health status
  • pregnancy
  • rapid growth periods
  • stress
  • weight gain
  • weight loss

looking at the interventions you did post, it sounds like you have more of an ineffective health maintenance r/t lack of motivation and unwillingness to perform health-seeking behaviors aeb not performing blood glucose monitoring on a regular basis. that is because your interventions are teaching the complications of uncontrolled blood sugar and why it needs to be done. that is not in the spirit of risk for unstable blood glucose. with risk for unstable blood glucose you have fluctuating and uncontrolled blood sugars that are occurring because of the risk factors that are listed. "lack of adherence to diabetes management" is one of the risk factors, but your interventions make it sound like your patient lacks information and that is not part of risk for unstable blood glucose. with risk for unstable blood glucose a plan is in place but the patient continues to remain uncontrolled. with "risk for" diagnoses, follow these instructions for writing the interventions: https://allnurses.com/forums/2751313-post8.html

Thanks for posting this! I was just looking for information on this dx and this was just the info I needed (even if just to see that it does not apply to my pt).

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