Type II Diabetes Mellitus

SHGR, MSN, RN, CNS · Dec 4, 2011

What is a concept map? When we did nursing diagnoses in nursing school (in the 90's) we called it a care plan- is that what you are talking about?

Jolie, BSN · Dec 4, 2011

What is her level of understanding of her condition and management? Is there a caregiver whose understanding and actions also needs to be assessed?

Please consider using a larger font and a darker color of lettering. Your post is really hard for over-40 eyes to read :)

Cuddleswithpuddles · Dec 4, 2011

What is a concept map? When we did nursing diagnoses in nursing school (in the 90's) we called it a care plan- is that what you are talking about?

Concept maps are care plans with fancy graphics. Seriously.

It has the same aspects but is presented in a map-like fashion.

:uhoh3:

Cuddleswithpuddles · Dec 4, 2011

here we go again...
i'm working on a concept map for a case scenario. no real patient to asses...just the information given by the instructor.
"patient" is an 82 year old female diagnosed with type ii diabetes mellitus and dementia. she is experiencing hyperglycemia with blood sugars running consistently over 285. she is hungry all the time and forgets that she has eaten.
i do not, however, know if the "patient" is overweight.
i want to use the diagnosis imbalanced nutrition: more than body requirements based on the fact that she is eating all the time. were this a real patient, i would assess her dietary habits, weight, glucose levels, and activity level. i feel like there is more i could look at, but at the moment i'm drawing a blank.
any help would be greatly appreciated!
thank you!

i do not think the information you have fully supports the nursing diagnosis you have chosen.

you do not have a baseline, objective parameters to determine what is balanced nutrition for this hypothetical patient and enough details like her weight and daily calorie intake to support the claim that what she is eating is excessive. i get what you are saying and if this was a real patient you will most likely find lots of supporting evidence, but you do not have much to work with for that diagnosis.

another thing you can consider is that if she forgets what she has eaten, maybe she has forgotten what medications she has taken. maybe there is a hidden safety issue involved here.

xtxrn, ASN, RN · Dec 4, 2011

here we go again...
i'm working on a concept map for a case scenario. no real patient to asses...just the information given by the instructor.
"patient" is an 82 year old female diagnosed with type ii diabetes mellitus and dementia. she is experiencing hyperglycemia with blood sugars running consistently over 285. she is hungry all the time and forgets that she has eaten.
i do not, however, know if the "patient" is overweight.
i want to use the diagnosis imbalanced nutrition: more than body requirements based on the fact that she is eating all the time. were this a real patient, i would assess her dietary habits, weight, glucose levels, and activity level. i feel like there is more i could look at, but at the moment i'm drawing a blank.
any help would be greatly appreciated!
thank you!

knowledge deficit.

self-care deficit.

cognitive impairment (aeb- whatever they used to decide she was demented)

potential for - the go through the list of diabetic complications that seem applicable.

not sure you can use "more than body requirements" without weight- i 'get' that she's overeating- but you also don't know how much the hyperglycemia is causing possible weight loss. :) think about the "polys" that go with dm- phagia, dipsia, uria, etc... they usually go with weight loss ....it's sorta not fair to you to not have her weight. imo :)

go from there :up:

Ted's Wife · Dec 4, 2011

what is a concept map? when we did nursing diagnoses in nursing school (in the 90's) we called it a care plan- is that what you are talking about?

kind of the same thing...it's like a diagram.

for each diagnosis you have to list a. assessment b. dx/tests and c. treatments/medications.

Ted's Wife · Dec 4, 2011

i do not think the information you have fully supports the nursing diagnosis you have chosen.
you do not have a baseline, objective parameters to determine what is balanced nutrition for this hypothetical patient and enough details like her weight and daily calorie intake to support the claim that what she is eating is excessive. i get what you are saying and if this was a real patient you will most likely find lots of supporting evidence, but you do not have much to work with for that diagnosis.
another thing you can consider is that if she forgets what she has eaten, maybe she has forgotten what medications she has taken. maybe there is a hidden safety issue involved here.

i would definitely love to have more info to work with. but since this is all i've got, i have to make it work. i did list medications as one of the first things i would assess.

SHGR, MSN, RN, CNS · Dec 4, 2011

Knowledge deficit.
Self-care deficit.
Cognitive impairment (aeb- whatever they used to decide she was demented)
POTENTIAL for - the go through the list of diabetic complications that seem applicable.
Not sure you can use "more than body requirements" without weight- I 'get' that she's overeating- but you also don't know how much the hyperglycemia is causing possible weight loss. :) Think about the "polys" that go with DM- phagia, dipsia, uria, etc... they usually go with weight loss ....it's sorta not fair to you to not have her weight. IMO :)
Go from there

I was thinking along exactly the same lines- potential for safety issues (what else might she be forgetting?) seems the most important thing here, not necessarily the "specifics" of eating a lot.

Fancy graphics? We did ours in pen on actual lined paper. Pages and pages of paper filled with every NANDA diagnosis possible!

Ted's Wife · Dec 4, 2011

knowledge deficit.
self-care deficit.
cognitive impairment (aeb- whatever they used to decide she was demented)
potential for - the go through the list of diabetic complications that seem applicable.
not sure you can use "more than body requirements" without weight- i 'get' that she's overeating- but you also don't know how much the hyperglycemia is causing possible weight loss. :) think about the "polys" that go with dm- phagia, dipsia, uria, etc... they usually go with weight loss ....it's sorta not fair to you to not have her weight. imo :)
go from there

thanks for the diagnosis suggestions. one of my other ones is impaired memory.

allnurses Guide · Dec 4, 2011

i want to use the diagnosis imbalanced nutrition: more than body requirements based on the fact that she is eating all the time. were this a real patient i would assess her dietary habits, weight, glucose levels, and activity level. i feel like there is more i could look at, but at the moment i'm drawing a blank.[/b']

don't use that. she's hungry and eating all the time because insulin isn't working to move the sugar from the blood to her cells. her blood sugar is high. her cells are screaming for food. she may be losing weight (this would be good info to know) because she is burning fat to use for energy. and ketones are building up.

is she on any meds for diabetes? is it newly diagnosed?

SHGR, MSN, RN, CNS · Dec 4, 2011

Don't use that. She's hungry and eating all the time because insulin isn't working to move the sugar from the blood to her cells. Her blood sugar is high. Her cells are screaming for food. She may be losing weight (this would be good info to know) because she is burning fat to use for energy. And ketones are building up.

..which would be an alteration in nutrition, no?