I don't get where the assessment data is coming from to support a nursing diagnosis of Altered LOC (NANDA: Acute or Chronic Confusion?) because none of the symptoms that are listed supports this nursing diagnosis.
People with diabetes often have one or more of the following symptoms: polyuria, polydipsia, nausea, anorexia, polyphagia, headaches, fatigue, lethargy, reduced energy levels, muscle cramps, irritability, vision changes, numbness and tingling in extremities, or abdominal discomfort.
What is the etiology of the slurred speech? Does this patient have any cerebrovascular problems and this is just one manifestation of it? It is not uncommon to see long term diabetics having problems related to atherosclerosis. With cool, clammy, pale skin I would wonder if there were peripheral vascular problems going on. Any peripheral edema? Any foot problems? Also, with a B/P as low as you've listed, what is going on with this person's heart? What medications is this patient on? They may provide clues as to other problems they may be having in addition to the diabetes.
For the nausea and vomiting you can use the nursing diagnosis: Nausea
Without any other information, you could also use the nursing diagnosis of Impaired Verbal Communication
. However, I suspect that there is much more going on with this patient than you've actually gotten data on. With blood sugars of 40, there is a much bigger problem occurring--an infection or the patient isn't taking their medication properly. If infection is the problem, where is it and what is being done about it. If not taking their insulin properly is the problem, then Knowledge Deficit
is another nursing diagnosis you can use.
Any nursing care plan ALWAYS starts by looking at the abnormal data you have collected. In my experience when having problems finding nursing diagnoses for a patient, it is usually because abnormal data has been missed during the assessment process. The only abnormal data that you've listed was:
- BS of 40
- BP of 88/50
- heart rate of 120 bpm
- respirations of 28
- cool, clammy, pale skin
- nausea and vomiting
- slurred speech