Defining Characteristics: (Specify: hyperglycemia—fatigue, irritability, headache, abdominal discomfort, weight loss, polyuria, polydipsia, polyphagia, dehydration, blurred vision; hypoglycemia—nervousness, sweating, hunger, palpitations, weakness, dizziness, pallor, behavior changes, uncoordinated gait.)
Goal: Client will not experience injury from hyperglycemia or hypoglycemia. Outcome Criteria
V Blood glucose levels remain between 60 mg/dL and 120 mg/dL.
V Urine is free of ketones and glucose. NOC: Risk Detection
Assess for signs and symptoms of hyperglycemia, blood glucose level, urinary glucose and ketones, pH and electrolyte levels.
Administer insulin SC as ordered (specify), rotate sites, increase dosage as indicated by glucose levels; decrease food intake during an infection or illness and adjust insulin dosage during an illness.
Provide diet with calories that balance expenditure for energy (specify) and correspond to type and action of insulin, and snacks between meals and at bedtime as appropriate.
Provides information about complication caused by increased glucose levels resulting from improper diet, an illness, or omission of insulin administration; glucose is unable to enter the cells, and protein is broken down and converted to glucose by the liver, causing the hyperglycemia; fat and protein stores are depleted to provide energy for the body when carbohydrates are not able to be used for energy.
Provides insulin replacement to maintain normal blood glucose levels without causing hypoglycemia; two or more injections may be given daily SC with a portable syringe pump or by intermittent bolus injections with a syringe and needle.
Provides child's nutritional needs for proper growth and development using the exchange system developed and approved by the American Diabetic Association (ADA), or by carbohydrate counting—monitoring carbohydrate intake
Promote exercise program consistent with dietary and insulin regimen; teach to increase carbohydrate intake before vigorous activities. hypoglycemia.
Assess for signs and symptoms of hypoglycemia, blood-glucose level.
Provide rest and immediate source of a simple carbohydrate such as honey, milk, or fruit juice followed by a complex carbohydrate such as bread in amounts of 15 gm; repeat intake in 10 minutes for expected response of a reduced pulse rate; administer IV 50 percent glucose or glucagon IM if hypoglycemia is severe.
Teach parents and child signs and symptoms to note, reasons why they occur, and interventions to correct the complication.
Teach parents and child to regulate insulin, manage dietary intake, and exercise to accommodate needs of individual child.
Teach parents and child to adjust insulin administration based on blood-glucose testing and glycosuria, during an illness or after changes in food intake or activities.
Teach parents and child to administer a quick-acting carbohydrate followed by a longer-acting carbohydrate and to have Lifesavers, sugar cubes, Insta-glucose on hand at all times; instruct parents that, in the case of severe hypoglycemia, if the child is unconscious or unable to take oral fluids, to rub honey or syrup on the child's buccal surface until alert enough to take fluids/foods by mouth.
Inform parents and child to report erratic blood and urine test results, only, maintaining consistent level at meals and snacks, and adjusting insulin as needed (requires close collaboration with physician).
Aids in the utilization of dietary intake, regular activity may reduce amount of insulin required; a decrease in insulin and increased carbohydrate intake before vigorous exercise or activity may prevent
Provides information about episodes of hypoglycemia resulting from increased activity without additional food intake or omission or incomplete ingestion of meals, incorrect insulin administration, illness.
Alleviates the symptoms of hypoglycemia as soon as symptoms are noted; glucagon releases the glycogen stored in the liver to assist in restoring glucose levels; IV glucose is administered when condition is severe and child is unable to take glucose source PO. Glucagon, a hormone, releases stored glycogen from the liver and raises blood glucose in 5 to 15 minutes.
Provides information about abnormal blood glucose levels causing complications of hyperglycemia, hypoglycemia, and the consequences.
Maintains child's growth and development needs while preventing complications.
Prevents and/or treats hyperglycemia; avoids serious complication of ketoacidosis.
Prevents and/or treats hypoglycemia.
Prevents more serious complications and long-term effects of the disease; poor difficulty in controlling blood glucose levels, presence of an infection or illness.
control leads to serious and severe consequences in a few hours.
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