Teaching Plan for Diabetes Mellitus Essay Example

Teaching Plan for Diabetes Mellitus Paper The Identified Learning Need Patients with diabetes have very comprhensive learning needs. The learning needs are focused on managing their glucose levels and preventing complications of diabetes. Learning needs for the patient with diabetes are complex and include: monitoring blood glucose levels, menu planning, exercise, medications, skin care, management of co-existing disease processes, knowledge of medications, knowledge of the disease process and how to manage hypo/pyperglycemia. Many of these patients are unaware that diabete mellitus requires lifestyle changes, especially in the areas of nutrition and physical activity. The main goal of the teaching plan is to provide the patient with the knowledge to be able to make self-directed behavioral changes to improve their overall health and manage their diabetes (Franz, 2001). Behavioral Objectives for the teaching plan The patient will be able to describe the diabetic medications that they are on and how to properly take the medication. The patient will be able to perform self-monitoring of blood glucose using a blood glucose meter as evidenced by demonstration of the technique to the nurse. The patient will be able to demonstrate proper skin and foot care. The patient will be able to describe the benefits of regular exercise and how regular exercise can improve blood glucose control. Teaching Plan Teaching Plan for Diabetes Mellitus 2 The diabetes teaching plan is aimed at helping the patient make educated lifestyle changes that will promote health and a stable blood glucose level. Each patient needs a comprehensive treatment approach. This includes: (a) an individualized food/meal plan, (b) education related to diabetes mellitus and nutrition, and  © mutually agreed-upon short term and long term goals for lifestyle changes. The teaching plan should stress the importance of complying with the prescribed treatment program. This plan should be tailored to the individuals needs, abilities, and developmental stage. We will write a custom essay sample on Teaching Plan for Diabetes Mellitus specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Teaching Plan for Diabetes Mellitus specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Teaching Plan for Diabetes Mellitus specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The plan should include: diet, medication administration, possible adverse effects of medication, exercise, blood glucose monitoring, hygiene, and the prevention and recognition of hypo/hyperglycenia (McGovern, 2002). Teaching Sessions Day 1 General overview of diabetes (2 hours) Day 2 Blood glucose monitoring and goals od blood glucose monitoring (3 hours) Day 3 Medications and Insulin (2-3 hours) Day 4 Complications from diabetes (1 hour) Skin and foot care (0. 5 hour) Teaching Plan for Diabetes Mellitus 4 Exercise and Diabetes (1. 5 hours) Day 5 Diet and Diabetes (2 hours) Coping with Diabetes (1 hour) Day 6 Questions and Answers (1 hour) Review of any concepts requested by patients (1 hour) General Overview of Diabetes Patients need to understand what diabetes is. Patients who understand what diabetes is and the complicated process associated with the disease are more likely to comply with the prescribed treatment regimen. Explain to the patient that diabetes is a syndrome with disordered metabolism and inappropriate hyperglycemia due to either a deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate (Davis, 2001). Understanding will increase the patients willingness to make the necessary lifestyle changes. Provide the patient with written material that they can refer to at a later time. Testing Blood Glucose Levels Testing blood glucose levels pre-meal and post-meal can help the patient with diabetes make better food choices, based on how their bodies are responding to specific foods. Patients should be taught specific directions for obtaining an adequate blood sample and what to do with the numbers they receive. Patients who have had education on the use of   their meters and how to interpret the data are more likely to preform self-glucose monitoring on a regular basis Franz, 2001). There are many different glucose monitors available for patients. The patient needs to have a device that is easy to use and convenient. A patients visual aquity and dexterity skills should be assessed prior to selecting a blood glucose monitor. Remind the patient to record the blood glucose values on a log sheet with the date and time and any associated signs and symptoms that he/she is experiencing at the time. This log should be shared with the primary care practitioner. A discussion of why the test is done, how it is performed, and how the health care provider will use the information should be included. Visual aids depicting the correct procedure can be helpful in allowing the patient to see the step by step instructions for using the glucose meter. Allow the patient to use the selected glucose meter to show that they understand the process and allow for feedback. Medications and Insulin The patient with diabetes needs to be reminded that the addition of medications to help manage his/her diabetes is not because they are failing at diet management. Many patients with diabetes become depressed or despondent when they have to begin taking oral medications and/or insulin. The teaching session should include a review of the different types of oral diabetic agents as well as the different types of insulins and how to mix insulins. Teach the patient about self -administration of insulin or oral agents prescribed, and the importance of taking medications exactly as prescribed (Davis, 2001). Provide the Teaching Plan for Diabetes Mellitus 6 patient with a list of signs and symptoms of hypo/hyperglycemia and actions to take in each situation. Have the patient relate to you the correct way to take the prescribed medication and if insulin is ordered to demonstrate self-administration. Complications from Diabetes Teaching regarding the complications encountered from diabetes should stress the effect of blood glucose control on long-term health (McGovern, 2002). The patient should be taught how to watch for diabetic effects on the cardiovascular system, such as CVA, CADaught to be alert for signs of urinary tract infection, respiratory tract infections and signs of renal disease. Assessment for signs of diabetic neuropathy should also be included in the teaching plan. Diabetes is also the leading cause of new blindness (McGovern, 2002). Patients should also be taught the importance of cessastion of smoking, cholesterol and lipid management, blood pressure monitoring, the effects of alcohol consumption on diabetes, and management of other disease processes. Skin and Footcare Skin and foot care should be stressed. Teach the patient to care for his/her feet by washing them daily, drying them carefully particularly between the toes, and inspecting for corns, calluses, redness, swelling, bruises, blisters, and breaks in the skin. Encourage the patient to report any changes to their health care provider as soon as possible. Advise the patient to wear non-constricting shoes and to avoid walking barefoot. The patient needs to be reminded that they should treat all injuries, cuts and blisters particularly on Teaching Plan for Diabetes Mellitus 7 he legs or feet carefully. Patients should be aware that foot problems are a common problem for diabetics. Inform them of what to look for is an important teaching concern. The signs and symptoms of foot problems to emphasize are: feet that are cold, blue or black in color, feet that sre warm and red in color, foot swelling, foot pain when resting or with activity, weak pulses in the feet, not feeling pain although there is a cut or sore on the foot, shiny smooth skin on the foot and lower legs. (American Diabetes Association, 2010). Exercise and Diabetes A moderate weight loss of ten to twenty pounds has been known to improve hyperglycemia, dyslipidemia, and hypertension. More emphasis is now placed on waist circumference greater than 40 inches in men and greater than 35 inches in women which indicates a risk for metabolic disease. This now part of what is referred to as metabolic syndrome. Reducing abdominal fat increase insulin sensitivity as well as lipid profiles. The benefits from exercise result from regular, long term, and aerobic exercise (Franz, 2001). The following points should be considered in educating patients regarding an exercise program: the program must be individualized and built up slowly, insulin is more rapidly absorbed when injected into a limb that is exercised and can result in hypoglycemia, the program should include a five to ten minute warm-up and cool-down session, research shows that similar benefits occur when activity is done in shorter sessions(approx. 10 minutes) accumulated throughout the day than in activity sessions of Teaching Plan for Diabetes Mellitus 8 rolonged sessions greater than 30 minutes (Ferri, 1999). Diet and Diabetes The food/meal plan is based on the individuals appetite, preferred foods, and usual schedule of food intake and activities, and cultural preferences. Determination of caloric needs varies considerably among individuals, and is based on present weight and current level of energy. Required calories is about 40kcal/kg or 20kcal/lb per day for adults with normal activity patterns (Davis, 2001). Emphasis should be placed on maintaining a consistent day-to-day carbohydrate intake at meals and snacks. It is the carbohydrates that have the greatest impact on glycerin. Maintaining a food diary can help identify areas of weakness and how to prepare better menus (Franz, 2001,p13). Coping with Diabetes The patient needs to understand that diabetes is a lifelong disease process that requires a lifetime commitment and lifestyle changes. It is a chronic illness that can be unexpected and potentially devastating. Grief is the most common reaction of an individual diagnoses with diabetes. Resolution of the grief is dependent on variables such as education, economics, geography, and religious and cultural factorrs. Depression is common with chronic diseases such as diabetes and should be treated promptly since depression can affect glycemic control and complicate the management of the diabetes (Buttaro, 1999). The patient should be educated about empowerment -having the Teaching Plan for Diabetes Mellitus 9 resources and knowing how and when to use them. The skills of empowerment help the patient reflect on life satisfaction in the following areas: physical, mental, spiritual, family related, social, work related, financial, personal. Encourage the patient to establish goals which emphasize at least two of these areas in which he/she has control. Assist the patient in developing better problem solving skills, and include stress management concepts. Evaluation: the client will Be able to describe what diabetes is. Demonstrate the correct procedure for self-glucose monitoring Show understanding in taking the prescribed medication and/or demonstrate elf-insulin administration. Be able to describe the complications of diabetes, skin and foot care, and explain their dily exercise routine. Be able to plan a daily meal/menu appropriate for their individual needs. Will be able to relate ways of coping with their disease effectively, and name some of the support groups/agencies available for assistance. References: American Diabetes Association (ADA) http://www. diabetes. org Buttaro, T. M. ,Trybulski,J. ,Baily,P. P. ,Sandberg-Cook,J. (1999). Primary Care: A Collaborative Practice. Philadelphia, PA: Mosby, Inc. Davis, A. (2001), Adult Nurse Practitoner: Certification Review. Philadelphia, PA; Mosby, Inc. Ferri, F. (1999). Clinical Advisor: Instant Diagnosis and Treatment. Philadelphia, PA: Mosby, Inc. Franz, M. (Ed. ) (2001). Diabetes Management Therapies: A Core Curriculum for Diabetes Education. 4th Edition. Chicago, Il: American Association of Diabetes Educators. McGovern, K. , Delvin, M. , Lange, E. , and Mann, N. (Eds. ) (202). Disease Management for Nurse Practitioners. Springhouse, PA: Springhouse Corporation.