Risk for Unstable Glucose

[JSTECKI]

Hi Everyone!

I have a patient who has been having somogyi effect. I want to use the diagnosis of Risk for unstable glucose.

This is what i have so far...

Risk for unstable glucose r/t Ineffective medication management and blood glucose monitoring a/e/b frequent events of nocturnal hypoglycemia.

does this sound correct?

[Daytonite, BSN, RN]

risk for unstable glucose r/t ineffective medication management and blood glucose monitoring a/e/b frequent events of nocturnal hypoglycemia.

this diagnostic statement was ok until you got to

a/e/b frequent events of nocturnal hypoglycemia

. "risk for" diagnoses, which are anticipated problems (problems that do not exist--yet), cannot have any signs and symptoms because they have not occurred. the somogyi phenomenon is rebound hyperglycemia that happens in the morning.

• http://www.dlife.com/dlife/do/showcontent/inspiration_expert_advice/expert_columns/garnero_0106.html
  - somogyi effect vs. dawn phenomenon
  
  

so, if this patient is a diabetic on insulin and having a somogyi effect with hyperglycemia in the morning that is a real problem and i would diagnose it as

ineffective self health management r/t knowledge deficit aeb frequent nocturnal hypoglycemia

[this was previously called

ineffective therapeutic regimen management

].

ineffective health maintenance

could also be used if the patient is not following the physician's directions in performing blood glucose monitoring as directed or taking the right dose of insulin at the right time. the interventions would be teaching the patient about the somogyi phenomenon and what to do about it. include the importance of blood sugar measurements.