Binlingan

Assessment Diagnosis Scientific Planning Intervention Rationale Evaluation

Explanation
Subjective: Ineffective Pattern of Short term: 1.) Assess the patient’s 1.) The patient’s point of view Short term:
“Nakalive po kasi Health regulating and 1.) After 2 hours perception of his or her reveals if he or she is open 1.) After 2 hours
ako kanina at manageme integrating into the patient will health status to change. The patient has the patient
hindi ko kop o nt r/t daily living a verbalize the to recognize that increased verbalized the
napansin yung impaired therapeutic reason why he health issues are caused by reason why he
oras. Hindi ko po decision regimen needs to follow 2.) Assess the patient’s their inability to manage needs to follow
na take yung making his therapeutic family dynamic their health. his therapeutic
gamut ko akala ko regimen; 3.) Assess the patient’s regimen;
po kasi okay lang for the a) The body can’t knowledge about his or 2.) Family and friends can a) The body can’t
na hindi kasi hindi treatment of make insulin her behavior influence behavior and make insulin
naman po ako illness and its anymore 4.) Help the patient social activities that might anymore
kumain” as sequelae b) The body needs identify daily habits contribute to the patient’s b) The body needs
verbalized by the the right amount of that prevent him or her lifestyle. the right amount of
patient insulin to keep the from implementing 3.) To change, the patient has insulin to keep the
that it is blood sugar levels in healthy habits to know about the blood sugar levels in
Objective: unsatisfactory a healthy range. 5.) Help the patient with inadequacy of skills to a healthy range.
-Impaired decision for meeting c) Without insulin, managing medication maintain a healthy lifestyle. c) Without insulin,
making specific health the body will break schedules The nurse needs to know if the body will break
goals down its own fat 6.) Reeducate about the patient wants to down its own fat
and muscle, indication and schedule change but does not have and muscle,
resulting in weight times of medications as the means or is unwilling to resulting in weight
(e.g. impaired loss and lead to well reasons why he change. loss and lead to
decision further needs to be comply 4.) Unhealthy lifestyle habits further
making) complications with the treatment can be slowly replaced by complications
regimen. healthy activities that
2.) After 3 hours the improve the patient’s 2.) After 3 hours the
patient will identify health patient identified
ways for him to 5.) The patient might be ways for him to
follow his willing to do it but finds it follow his
therapeutic to be complicated to therapeutic
regimen; accomplish. Use regimen;
a) Place the medication organizer, a) Place the
 medication were it alarm clock in the phone medication were it
is visible calendars to help keep is visible
things organized. b) Set an alarm clock
6.) It might make it easier to in the phone to
remind when it’s
time to take his
medication.

Assessment Diagnosis Scientific Planning Intervention Rationale Evaluation

Explanation
Subjective: Risk for Beta cells Short term: Independent: 1.) This is to monitor Short term:
‘Hindi ko po na unstable produce little or 1.) After 2 hours the 1.) Assess feet for peripheral perfusion and 1.) After 2
take yung blood no insulin patient’s blood temperature, pulses, neuropathy. hours the patient’s
insulin ko” Glucose glucose will be in color, and sensation. blood glucose is in
level the normal range 2.) Non-adherence to dietary the normal range 70
Objective: glucose builds up 70 -105 mg/dL 2.) Assess eating guidelines for a specific -105 mg/dL
 Blood in the patterns. clinical condition can result
glucose bloodstream 2.) After 4 hours the in fluctuations in blood 2.) After 4
level: instead of going patient will glucose. hours the patient
 Polyuria: 60 into the cells identify ways to 3.) Assist the patient 3.) This information provides identified ways to
mL/2 hrs keep his blood in identifying the basis for individualized keep his blood
 Nausea glucose level in eating patterns dietary instruction related glucose level in the
 Fruity This buildup of the normal range; that need to be to the clinical condition normal range;
breath glucose in the a) Monitor blood that contributes to a) Monitor
 Oral cavity blood is called sugar levels to see modified. fluctuation in blood glucose blood sugar levels to
is dry hyperglycemia what makes them levels. see what makes
go up or down. 4.) Hypertension is commonly them go up or
Too much insulin b) Eat at regular associated with diabetes. down.
hypoglycemia. times, and don't 4.) Monitor blood Control of BP prevents b) Eat at
skip meals. pressure and coronary artery disease, regular times, and
c) Consume foods report BP of more stroke, retinopathy, and don't skip meals.
and beverages than 160 mm Hg nephropathy. c) Choose
with lower in (systolic). 5.) Capillary blood glucose foods and beverages
calories, saturated monitoring provides the with lower in
fat, trans fat, patient with immediate calories, saturated
sugar, and salt. 5.) Teach the patient information about blood fat, trans fat, sugar,
d) Regular exercise on measuring glucose and salt.
as tolerated capillary blood 6.) Maintaining adequate d) Regular
glucose blood glucose supply is exercise as tolerated
critical during exercise
6.) Encourage the because it constitutes an
patient to exercise appreciable fraction of the
Long Term fuel for the working muscle
1.) After 1 month the 7.) Encourage the and, as is the case at rest, Long Term
patient would patient to have a supplies virtually all the 1.) After 1
improve his health balanced fuel for the central nervous month the patient
and has limited to carbohydrate- system. improved his health
no signs of controlled diet. 7.) Eating a balanced and has limited to
hyperglycemia or Dependent carbohydrate-controlled no signs of
hypoglycemia. Doctors’ orders: diet especially for insulin hyperglycemia or
1.) Insulin IV bolus dependent patient you may hypoglycemia.
STAT- 9.75 units need more or less
(0.15 units/kg) carbohydrate at a meal or
snack to ensure a healthy
blood glucose range.
Doctors order
1.) Insulin is required to lower
blood glucose levels in type
1 diabetes.
 Assessment Diagnosis Scientific Planning Intervention Rationale Evaluation
Explanation
Subjective: Activity Little to no Short term: Independent: Independent: Short term:
“Nanghihina po intolerance insulin 1.) After 5 hours the 1.) Assess the patients 1.) To plan the appropriate 1.) After 5 hours th
ako” r/t inability to production patient will perceived activities that fits to the patient verbalized
verbalize and capability for patient’s capabilities
Objective: take up and showed
show willingness increased activity 2.) To avoid the occurance
 Generalized glucose willingness to
to participate in 2.) Assist the patient of bone sores and help
fatigue secondary to to assume in a in the comfort of the participate in the
the plan of
 Pulse type 1 dm Cells can’t absorb plan of activities to
activities to comfortable patient.
oximeter: positions for rest 3.) To reduce stress and
the glucose in increase activity increase activity
93%
the blood tolerance. and sleep. excess stimulation, tolerance.
 RR: 23 cpm 3.) Provide a promoting rest.
 PR: 102bpm 2.)After 3 days of
2.) After 3 days of comfortable and 4.) Patient education
 BP: 35.5 C effective nursing
effective nursing quiet and promotes patient-
environment. centered care. interventions, the
interventions, the
Cells will starve patient report an 4.) Educate to the 5.) To prevent a sudden patient reported a
and will not increase in activity patient the workload increase in activity
function properly tolerance and will importance of rest tolerance and will
be able to do and energy be able to do ADL’
ADL’s and conservation. and participate in
participate in self- 5.) Increase the
self-care activities
 Insufficient care activities activity gradually
physologic Long Term
energy to Long Term 1.)After 1 week th
1.) After 1 week the patient will be able
complete
patient will be to increase activity
required desired able to increase tolerance evidence
daily activities activity tolerance by absence of
evidenced by weakness
absence of
weakness