Date Cues Nsg Dx Scientific basis Goal of care Nsg intervention Rationale Evaluation

03/3/2 ROS Risk for DEFINITION OF THE After 8 hours of INDEPENDENT After 8 hours of
1 Endocrine unstable NSG. DIAGNOSIS nurse-client >Monitor blood glucose >Normal fasting blood nurse-client
system: blood Vulnerable to variation interaction, the levels as fasting and glucose for an adult is 70 interaction, the
resistance to glucose level of blood glucose/ client will be able postprandial levels to 105 mg/ dL client was able to:
insulin related to sugar levels from the to:
insulin normal range, which >Monitor serum insulin >Obesity and insulin -Identify factors
ASSESSMENT resistance may compromise -Identify factors levels receptor dysfunction in that may alter
Subjective: health that may lead to peripheral tissues blood glucose
“mag lipong unstable blood stimulates insulin levels
lipong man ko PATHOPHYSIOLOG glucose levels secretion from the
gyud nya mao Y BASIS pancreas - verbalizes
to taas man Characterized by - verbalizes understanding
diay kog sugar peripheral insulin understanding >Assess eating >Nonadherence to of balancing
pag laboratory” resistance, impaired of balancing patterns and knowledge dietary guidelines for a body and
regulation of hepatic body and of the prescribed diet specific clinical condition energy needs
Objective: energy needs can result in fluctuations
glucose production,
-Fasting blood in blood glucose - verbalizes
and declining β-cell
sugar result is - verbalizes
function, eventually plan in
217 mg/dL >Assess the pattern of
leading toβ -cell plan in modifying
physical activity >It causes insulin-like
failure. modifying identified risk
-Patient effect and may lower
identified risk factors to
experiences blood glucose level.
dizziness RATIONALE factors to >Assess alcohol intake prevent shifts
This causes high prevent shifts >Excessive alcohol in glucose level
-Polyuria blood glucose levels, in glucose consumption, without
which can lead to a level food intake, blocks - keep their
DX STUDIES number of release of glycogen from blood glucose
Fasting Plasma complication if not - maintains the liver, causing levels close to
Glucose managed and remain blood glucose hypoglycemia the normal
untreated. levels within DEPENDENT range
the normal >Administer insulin
range medications as directed >To lower blook glucose
levels in type 1 diabetes
 mellitus, and for many
patients with type 2
>Administer food or diabetes mellitus
other sources of
glucose as directed for >A rapidly absorbed form
hypoglycemia of glucose is indicated to
manage hypoglycemia
COLLABORATIVE
>Refer the client to an
exercise physiologist or
physical therapist. >Specific exercises can
be prescribed for the
patient based on any
>Refer the client to a physical limitation
dietician to plan a
specific dietary need >To balance dietary
based on complicated intake with complicated
situations like body needs
pregnancy, growth
spurt, and change in
activity level

>Provide information
about community
resources, support >For client’s access to
groups, and diabetic additional resources for
educators diabetes management