COLLEGE OF NURSING SIMS

SERVICES HOSPITAL LAHORE

DISCIPLNE :
BSN GENERIC 2nd YEAR
SESSION:
2022-2026
PORTFOLIO:
ADULT HEALTH NURSING
SUBMITTED TO:
MAM SAMINA SARWAR
MAM SHAHEEN DILDAR

Submitted by:
Iqra shareef
Table of
Content
Sr.N0 CONTENT OUTLINE
Remarks
1. Acknowledgement
2. Introduction
3. Objectives
4. Nursing Health History
a. Demographic data
b. Chief complaint
c. History of resent illness
d. Past medical history
e. Past surgical history
f. Family history
g. Drug and allergic history
h. Socioeconomic history
5. Physical Examination
6. Gordon Functional Health Pattern
1. Health Perception & Management
11. Nutritional-Metabolic Status
111. Elimination Pattern
IV. Activity and Exercise Pattern
V. Cognitive Perceptual Pattern
VI. Self-Perception and Self Concept
VII Rest and Sleep Pattern
VI11. Roles and Relationship Pattern
IX. Sexuality and Reproductive
Pattern
9. References

X. Cognitive and Stress Pattern

XI. Value and Belief Pattern
7. Introduction of Disease
a. Definition
b. Causes
c. Risk Factors
d. Pathophysiology
e. Clinical Manifestation
f. Diagnostic Evaluation
g. Complications
 h. Prevention
i. Medical Management
j. Nursing Management
8. Nursing Process
ACKNOWLEDGEMENT
I bow my head before Allah Almighty for this
opportunity to work on this case and also provide his
limitless blessings for the completion of this project
and to sincere with my work.
I would like to express my gratitude towards my
teachers for this kind co-operation and
encouragement to complete my work.
I would like to express my gratitude and respesct
to my subject teachers MAM SAMINA
SARWAR and MAM SHAHEEN DILDAR
who has given their valuabe support and co-
operation from time to time in successfully
completing my work. I am thankful to
departments of Services Hospital Lahore for
guidance and constant supervision as well as
necessary information regarding my case.
Background
I choose Asthma as my case study to be studied out
of curiosity. It is my first time to encounter such
kind of case and because of that I was interested in
it.I was willing to do this case to challenge my mind
in analysis the problem and to enhance my
knowledge and also gain new experiences which
would bring new learning to me.
Significance of study
The case will help me in understanding the disease
process of the patient. This will also help the group
in identifying the primary needs of patient with
Asthma. The case study would also provide
knowledge attitude skills on how to manage the
patient with asthma.

Objectives

At the end of my presentation learners will be able

to:
 Define asthma
Define the types of asthma
Explain the pathophysiology of asthma
Identify the sign and symptoms ,causes and risk
factor of asthma

NURSING HEALTH HISTORY

1 Demographic data
 Patient Name: Asia Ali
 Age: 34 y
 Gender : Female
 Marital Status: Married
 Nationality: Pakistani
 Date of admission: 13_ 03_ 2023
 Occupation : House wife
 Admitting Impression: shortness of breath
 Diagnosis: Asthma
 Address: LHR
Case Scenario and chief complain
The case is about 27 y female received from OPD in
SERVICES HOSPITAL LAHORE who was
conscious with Chief complain.
 Dyspnea. Yes
 Cough. Yes
 Low grade fever. Yes
 Fatigue. Yes

History of present illness

Two month prior to admission the patient
suffered from dyspnea low grade fever and she
had a significant weight loss. Two weeks prior to
admission the patient experienced from coughing.
Respiratory pattern was very Disturbed.

d.Past medical history

No significant history
 e.Past surgical history
No significant surgical history
f.Family history

Mother is asthmatic

g.Drug allergies history

No allergies

h.socioeconomic history
She belongs to middle class family and she is
house wife

5.
PHYSICAL EXAMINATION
 6.
Gordans Functional Health Pattern

I.Health Percetion and Health Management

 Opinion about health. Health is a

great blessing
 Visit to doctor for check up. Monthly
 Last physical Examination. One week
ago
 Taking any medicine. No

 Any allergies. No
 II. Nutritional-Metabolic status

 Eat three meals a day: : yes

 Fruit twice a day. : Yes
 Drink 1 litres of water daily. ; Yes
 Any food restriction.: Soft drinks and oily
food
 Patient on soft diet. : No

III.Eliminatin pattern
 Urine frequency: 4 to 6 times a
day
 Urine output : Normal
 Catherized or self voiding: self
voiding
 Color of urine : Yellowish
 Urinary problem : No
 Constipation : No
 Difficulty passing stool: No
 Using any laxatives : No

IV.Activity and Exercise

 Lifestyle : Active
 Breathing problems: Dyspnea
 Active ROM: Yes
 Cough: Yes
 Charges in breathing during exercise: yes
 Expansion : yes
 Activities decrease: yes due to breathing
problems and cough

V. Cognitive and Perception

 Lack of consciousness : Normal
 Dark circles under eyes: yes
 Pain : yes
 Loss of memory: NO
 Orientation about time person place and time
Good

VI.Self Perception and Self Concept

 Manage Normal lifestyle practices:

yes
 Dressing:
good
 Eye contact.:
Normal
 Major concern:
towards recovery

 VII.Rest and Sleep

 Sleep hours: At5 to 6 hrs
 At hospital : 4 hrs
  At home: 5hr
 Problem to fall asleep. Yes due to
cough
 Naps: for
sometime
 Position: semi fowlers
 Any medicine to sleep : yes often
 Walking before sleeping : No

VIII.Roles and relationship

 Family. Joint family
 Children: one daughter
 Satisfaction with family.: Satisfied
 Decision maker: her husband
 Financial status: Normal
 Cooperative behaviour: yes
IX. Sexuality and Reproductive pattern
 Age of puberty : 14 y
 Marital Status : married
X.Coping and stress

 Mood: have mood swings

 Worried; Sometimes
 Shared with: husband
 Stress coping style : pray
 Drugs : No

XI.Value and belief

 Religion : Islam
 Family : Muslim
 Nationality : Pakistani
 Satisfaction with life: good
 Physical Examination

General appearance of client

1.The general appearance of client give clues to
the illness severity of disease and patient’s
values social status and personality

Physique
The physique of the patient is normal .
Skin
General colour Palor
Texture Smooth
Temperature Afebrile
Turgor Normal
Moisture Normal

Nails

Palor Positive
Cynosis Positive
Clubbing Negative

Eyes
Lids Symmetrical
Conjuctiva Normal
Sclera Normal
Reaction to light Normal
Eye sight Normal

Nose
Mucosa Pink
Smell Normal
Sinuses Non tender

Mouth
Teeth All present
Gums Normal

Experiment
Deformity Absent
Range of Active
motion
Muscular Fair
strength
Gait Coordinated
Respiratory status
Breathing rate 24 breath per
min
Breathing Irregular
pattern
Position of Middle
trachea
Lung expansion Asymmetrical
Percussion Hyper
sonund resonance

Adventious
sounds

Neurological Assessment
Communication Difficulty in
speech
Level pf Awake
consciousness
GBS Awake

Behaviour Anxious

Abdomen
Shape Normal
Sear Absent
Bowel sound Active

Cardiovascular system
Hear beat 15beats/mint

Heart sound Regular

Peripheral pulse Regular
Capillary refill Normal
Blood pressure 130/90mmHg

Vital signs
Temperature 98F
Pulse 105 beats/
 minutes
Respiration rate 15/minute
Bp 130/80 mmHg

Laboratory Investigations
Component Reference Unit Present
value value
White blood 4 _11.0 10⁹/L 12.5
cells
Red blood 4.00_ 5.00 10¹²/L 4.5
cells
Hemoglobin 12_ 16.5 g/dl 13.0
Mean cell 80_ 96 fl 82
volume
Mean cell 30_ 35 g/dl 31
hemoglobin
concentration
volume
Platelet 150_ 459 10⁹/L 350

Neutrophils 2.5 _7.5 10⁹/L 4.5

Eosinophil 0.04_0.44 10⁹/L 1.0
Basophils 0.015_0.1 10⁹/L 0.1
Monocytes 0. 2_0.8 10⁹/L 0.6
Lymphocytes 1.5_3.5 10⁹/L 2.5

Renal Function test

Component Reference Unit Patient

value value
Urea 7_8 mg/gl 9
Creatinine 0.6_1.3 Mg/gl 1.1

Liver function test

Component Reference Unit Patient
value value
Bilirubin 0. 0_ mg/dl 0.6
1.0
Albumin 3.5_5.0 g/ dl 3.3
SGPT More than 63 U/L 21
SGOT More than 37 U/L 33

Serum electrolyte
Component Reference Unit Patient
 value value
Sodium 135_ 145 mmol/L 139
Potassium _3.5_5.0 mmol/L 3.9
Chloride 96_ 108 mmol/L 98
Calcium 8_ 10 mg/gl 9

Arterial blood gases

Component Reference Unit Patient
value value
pH 7.35_ 7.45 7.31
PaCO2 35_ 45 mmHg 48
HCO2 22_26 mmol/L 27
PaO2 80_ 110 mmHg 73

Serological Test
Component Findings
Hepatitis A Negative
Hepatitis B Negative
Hepatitis c Negative
HIV Negative

INTRODUCTION OF
DISEASE

Asthma:
Definition:
Asthma is a condition in which your small airways
narrow and swell and may produce extra mucus.
This can make breathing difficult and trigger
coughing, a whistling sound (wheezing) when you
breathe out and shortness of breath. Asthma is a
heterogeneous disease usually characterized by
chronic airway inflammation.
Types of asthma:
It is of two types
1—Extrinsic (Allergic); commonly occur in children
2—Intrinsic (Non Allergic ):Commonly occur in
adults.

Causes:
Followings are the causes of Asthma:
 Allergy
 Respiratory infection
 Fever
 Weather changes
 Exposure to food additives
 Air pollutant and irritant such as smoke
 Chemical fumes
 Strong odors

Pathophysiology
Clinical Menifestation
Followings are the clinical menifestation of Asthma:
 Cough
 Dyspnea
 Wheezing
 Chest tightness
 Diaphoresis
 Tachycardia
 Hypoxemia
 Central cyanosis
 Night problems
 Hypoxemia
 Chocking sensation

Assessment and diagnostic test

o Blood and sputum test ( eosinophilia/elevated levels of
eosinophils)
o Serum test (elevated IgE levels in allergy )
o ABG analysis and pulse oximetry ( hypoxemia )
o FeNO test ( high levels of NO/ over 50 ppb in adults and
over 34 ppb in children )
o Spirometry
o Observe adventitious lung sounds
Medical managemet of asthma:
Medical management may be necessary
because continuing and progressive dyspnea
leads to increase anxiety aggravating
situation.
Pharmacologic Therapy:
It include two types of asthma medications:
o Quick relief medication
o Long acting control medication

Quick relief medication:

o Short acting medication SABAs (short-acting beta 2
agonists)
o Albuterol
o Levalbuterol
o Pirbuterol & Metaproterenol
o Anticholinergics
o Ipratropium
o Corticosteroids
o Methylprednisolone
 Long acting medication:
Long-acting medications
o Inhaled corticosteroids
o Beclomethasone
o Fluticasone
o Flunisolide
o LABAs ( long-acting beta 2 agonists )
o Salmeterol
o Formoterol
o Leukotriene inhibitors
o Zileuton ( LOX inhibitor )
o Zafirlukast & montelukast ( leukotriene receptor antagonists

Nursing management of
asthma:
 The immediate nursing care of patient with asthma
depend on severity of symptoms. The nurse
generally perform the following interventions:
 Obtain a history of allergic reaction to medications
before administering medication.
 Identify medication the patient is taking.
 Administer medication as prescribed and monitor
patient response to those medication.
 Administer fluid if patient is dehydrated
 A cam approach to patient and family because
they are anxious

Complication of Asthma:
Followings are the complications of asthma:
 Atelectasis
 Pneumonia
  Respiratory failure
 Airway obstruction
 hypoxemia

Discharge plan
Before discharging the patient following things are
done.
 Guide the patient about medication dose.
 Instruct the family members to provide the
patient with fresh environment
 Advice the patient to take medicine on time
 Intsruct the patient to take adequate diet
 To take diet as tolerated
 Nursing Care Plan:
Assessment Diagnosis Planning Intervention Evaluation
Subjective Shortness Relief Provide Fatigue is
data of from medication relieved.
Shortness breathing anxiety to relief from Anxiety is
of breath related to Relief shortness of relieved.
Fatigue infection from breath
anxiety shortness
of breath

Objective Provide Provide Shortness of

data face psychosocial breath is
Coughing mask for support to relieved
Fast heart oxygenat relief from
rate ion anxiety
Low
oxygenatio
n
COLLEGE OF NURSING SIMS

SERVICES HOSPITAL
LAHORE

DISCIPLNE :

BSN GENERIC 2nd YEAR

SESSION:

2022-2026
PORTFOLIO:

ADULT HEALTH NURSING

SUBMITTED TO:

MAM SAMINA SARWAR

MAM SHAHEEN DILDAR

SUBMITTED BY:

Iqra shareef
 Table of Content
Sr.N0 CONTENT OUTLINE
Remarks
1. Acknowledgement
2. Introduction
3. Objectives
4. Nursing Health History
a. Demographic data
b. Chief complaint
c. History of resent illness
d. Past medical history
e. Past surgical history
f. Family history
g. Drug and allergic history
h. Socioeconomic history
5. Physical Examination
6. Gordon Functional Health Pattern
1. Health Perception & Management
11. Nutritional-Metabolic Status
111. Elimination Pattern
IV. Activity and Exercise Pattern
V. Cognitive Perceptual Pattern
VI. Self-Perception and Self Concept
 VII Rest and Sleep Pattern
VI11. Roles and Relationship Pattern
IX. Sexuality and Reproductive
Pattern
X. Cognitive and Stress Pattern
XI. Value and Belief Pattern
7. Introduction of Disease
a. Definition
b. Causes
c. Risk Factors
d. Pathophysiology
e. Clinical Manifestation
f. Diagnostic Evaluation
g. Complications
h. Prevention
i. Medical Management
j. Nursing Management
8. Nursing Process
9. References
ACKNOWLEDGEMENT

I bow my head before Allah Almighty for this

opportunity to work on this case and also provide
his limitless blessings for the completion of this
project and to sincere with my work.
I would like to express my gratitude towards my
teachers for this kind co-operation and
encouragement to complete my work.

I would like to express my gratitude and respesct

to my subject teachers MAM SAMINA
SARWAR and MAM SHAHEEN DILDAR who
has given their valuabe support and co-operation
from time to time in successfully completing my
work. I am thankful to departments of Services
Hospital Lahore for guidance and constant
supervision as well as necessary information
regarding my case.
Background

I choose Asthma as my case study to be studied

out of curiosity. It is my first time to encounter
such kind of case and because of that I was
interested in it.I was willing to do this case to
challenge my mind in analysis the problem and to
enhance my knowledge and also gain new
experiences which would bring new learning to
me.

Significance of study

The case will help me in understanding the

disease process of the patient. This will also help
the group in identifying the primary needs of
patient with Asthma. The case study would also
provide knowledge attitude skills on how to
manage the patient with asthma.

Objectives
At the end of my presentation learners will be
able to:

 Define asthma

 Define the types of asthma

 Explain the pathophysiology of asthma

 Identify the sign and symptoms ,causes and

risk factor of asthma

NURSING HEALTH
HISTORY
1 Demographic data

 Age
 Gender
 Marital Status
 Nationality
 Date of admission
 Occupation
 Admitting Impression
 Diagnosis
 Address

Case Scenario and chief

complain
The case is about 27 y female received from OPD in
SERVICES HOSPITAL LAHORE who was
conscious with Chief complain.
 Dyspnea. Yes
 Cough. Yes
  Low grade fever. Yes
 Fatigue. Yes

History of present illness

Two month prior to admission the patient
suffered from dyspnea low grade fever and she
had a significant weight loss. Two weeks prior to
admission the patient experienced from coughing.
Respiratory pattern was very Disturbed.

d.Past medical history

No significant history

e.Past surgical history

No significant surgical history
 f.Family history

Mother is asthmatic

g.Drug allergies history

No allergies

h.socioeconomic history
She belongs to middle class family and she is
house wife
5.
PHYSICAL
EXAMINATION

6.
Gordans Functional Health
Pattern
 I.Health Percetion and
Health Management

 Opinion about health. Health is a

great blessing
 Visit to doctor for check up. Monthly
 Last physical Examination. One week
ago
 Taking any medicine. No

 Any allergies. No

 II. Nutritional-Metabolic
status
 Drink 1 litres of water daily. ; Yes
 Any food restriction.: Soft drinks and oily
food
Patient on soft diet. : No
 Eat three meals a day: : yes
 Fruit twice a day. : Yes


III.Eliminatin pattern
 Urine frequency: 4 to 6 times a
day
 Urine output : Normal
 Catherized or self voiding: self
voiding
 Color of urine : Yellowish
 Urinary problem : No
 Constipation : No
 Difficulty passing stool: No
 Using any laxatives : No
IV.Activity and Exercise
 Lifestyle : Active
 Breathing problems: Dyspnea
 Active ROM: Yes
 Cough: Yes
 Charges in breathing during exercise: yes
 Expansion : yes
 Activities decrease: yes due to breathing
problems and cough

V. Cognitive and Perception

 Lack of consciousness : Normal
 Dark circles under eyes: yes
  Pain : yes
 Loss of memory: NO
 Orientation about time person place and time
Good

VI.Self Perception and Self

Concept

 Manage Normal lifestyle practices:

yes
 Dressing:
good
 Eye contact.:
Normal
 Major concern:
towards recovery
 VII.Rest and Sleep
 Sleep hours: At5 to 6 hrs
 At hospital : 4 hrs
 At home: 5hr
 Problem to fall asleep. Yes due to
cough
 Naps: for
sometime
 Position: semi fowlers
 Any medicine to sleep : yes often
 Walking before sleeping : No

VIII.Roles and relationship

 Family. Joint family
 Children: one daughter
 Satisfaction with family.: Satisfied
  Decision maker: her husband
 Financial status: Normal
 Cooperative behaviour: yes

IX. Sexuality and

Reproductive pattern
 Age of puberty : 14 y
 Marital Status : married

X.Coping and stress

 Mood: have mood swings

 Worried; Sometimes
 Shared with: husband
 Stress coping style : pray
  Drugs : No

XI.Value and belief

 Religion : Islam
 Family : Muslim
 Nationality : Pakistani
 Satisfaction with life: good

Physical
Examination

General appearance of client

 2.The general appearance of client give clues to
the illness severity of disease and patient’s
values social status and personality

Physique
The physique of the patient is normal .
Skin
General Palor
colour
Texture Smooth
Temperature Afebrile
Turgor Normal
Moisture Normal
Nails

Palor Positive
Cynosis Positive
Clubbing Negative
Eyes
Lids Symmetrical
Conjuctiva Normal
Sclera Normal
Reaction Normal
to light
Eye sight Normal

Nose
Mucosa Pink
Smell Normal
Sinuses Non
 tender

Mouth
Teeth All
present
Gums Normal

Experiment

Deformity Absent
Range of Active
motion
Muscular Fair
strength
Gait Coordinated
Respiratory status
Breathing 24 breath per
rate min
Breathing Irregular
pattern
Position of Middle
trachea
Lung Asymmetrical
expansion
Percussion Hyper
sonund resonance

Adventious
sounds
Neurological Assessment
Communication Difficulty
in speech
Level pf Awake
consciousness
GBS Awake

Behaviour Anxious
Abdomen
Shape Normal
Sear Absent
Bowel Active
sound

Cardiovascular system
Hear beat 15beats/mint

Heart Regular
sound
Periphera Regular
l pulse
Capillary Normal
refill
Blood 130/90mmHg
pressure
Vital signs
Temperatur 98F
e
Pulse 105
beats/
minutes
Respiration 15/minute
rate
Bp 130/80
mmHg

Laboratory Investigations
Compon Referen Uni Prese
ent ce t nt
value value
White 4 10⁹/ 12.5
blood _11.0 L
cells
Red 4.00_ 10¹² 4.5
blood 5.00 /L
cells
Hemoglo 12_ g/dl 13.0
bin 16.5
Mean cell 80_ 96 fl 82
volume
Mean cell 30_ 35 g/dl 31
hemoglob
in
concentra
tion
volume
Platelet 150_ 10⁹/ 350
459 L
Neutrophi 2.5 _7.5 10⁹/ 4.5
ls L
Eosinophi 0.04_0. 10⁹/ 1.0
l 44 L
Basophils 0.015_0 10⁹/ 0.1
.1 L
Monocyte 1. 2_ 10⁹/ 0.6
s 0. L
8
Lymphoc 1.5_3.5 10⁹/ 2.5
ytes L
Renal Function test

Compon Referen Unit Patie

ent ce nt
value value
Urea 7_8 mg/ 9
gl
Creatinin 0.6_1.3 Mg/ 1.1
e gl

Liver function test

Compon Referen Uni Patie
ent ce value t nt
 value
Bilirubin 1. 0_ mg/ 0.6
1. dl
0
Albumin 3.5_5 g/ dl 3.3
.0
SGPT More U/L 21
than 63
SGOT More U/L 33
than 37

Serum electrolyte
Compon Refere Unit Patie
ent nce nt
 value value
Sodium 135_ mmol 139
145 /L
Potassiu _3.5_5. mmol 3.9
m 0 /L
Chloride 96_ mmol 98
108 /L
Calcium 8_ 10 mg/gl 9

Arterial blood gases

Compon Refere Unit Patie
ent nce nt
value value
pH 7.35_ 7.31
7.45
PaCO2 35_ 45 mmH 48
g
HCO2 22_26 mmol 27
/L
PaO2 80_ mm 73
110 Hg

Serological Test
Component Findings
Hepatitis A Negative
Hepatitis B Negative
Hepatitis c Negative
HIV Negative
 CONTENTS

Sr# Topics

1 Definition
2 Types

3 Comparison between type 1 and type2 diabetes mellitus

4 Etiology/risk factors

5 Pathophysiology

6 Clinical manifestations

7 Diagnostic Evaluation

8 Nursing diagnosis

9 Pharmacological management

10 Insulin therapy

11 Dietary management

12 Complications
13 Nursing care plan
Diabetes mellitus:
Definition: It is the condition in which
carbohydrates metabolism disturbed due to
insufficient secretion of insulin hormones.
Insulin: It is a hormone produced by pancreas.it
maintains the level of blood glucose by regulating
the production and storage of glucose.
Types of diabetes mellitus:
Type1 DM (Insulin dependent diabetes
mellitus)
Type 2 DM (Non-insulin dependent
diabetes mellitus)
Type 3 DM associated with other conditions
or syndromes
Gestational DM (during pregnancy)
 ETIOLOGY/RISK FACTOR
 Heredity
 Obesity
 Stress
 Old age (pancreatic functions become slowly)
 Other systemic disease like heart disease, MI, stroke.
 Renal disease
 Virus (coxsackie B, Strepto)
Africans and Asians are more susceptible.
PATHOPHYSIOLOGY OF TYPE
1/TYPE 2 DIABETES
MELLITUS
Clinical Manifestation
DIAGNOSTIC EVALUATION:
 Blood glucose level test (fasting, random)
 Oral glucose tolerance test (GTT)
 HB A1C TEST
 Ketonurea.
 Proteinurea


Pharmacological management
 Insulin therapy
 Combination therapy
 Surgical management
Insulin therapy:
 Time course
 According to specie
 Manufacturer
 Types of insuline
 Rapid acting insulin
 Short acting insulin.
 Intermediate acting insulin
 Long acting insulin

Patient teaching about insulin

administration
 Insulin preparation
 Insulin syringes
 Insulin storage
 Insulin preparation and injection
 Site selection and rotation
Self injection of insuline
NURSING MANAGEMENT:
 Teach the patient about following a prescribed meal plan.
 Assess patients for cognitive or sensory impairments,
which may interfere with the ability to accurately
administer insulin.
 Demonstrate and explain thoroughly the procedure for
insulin self-injection.
 Rewire dosage and time of injections in relation to meals.
Instruct importance of routine daily examination of feet and
proper feet care
 Instruct/teach the patient to inspect shoes daily, to avoid
sharp objects to reduce risk for injury.
 Instruct the patient to wear appropriate size of footwear
DIETARY MANAGEMENT:
 Sufficient quantity of diet is very necessary which satisfy to
appetite.
 About 1/2 energy should be get from carbohydrates, and
1/3 energy get from fat and 15-20% from protein
 Meal should be taken at regular time. If meal will be late, it
may cause hypoglycemic attack.
 Avoid adding sugar to food.
 Complications:
Acute:
 Diabetic ketoacidosis
 Hypoglycemia
 Diabetic non-ketonic

Chronic:
Micro vascular:
 Retinopathy
 Neuropathy
 Myelopathy
 Nephropathy
 Diabetic foot

Macro vascular:
 Cerebrovascular
 Cardiovascular
 Peripheral vascular diseas
 Nursing care plan
Assessment Diagnosis Planning Intervention Evaluation

Subjective Impaired Numbness Administer Weight is

data nutrition is resolved insulin maintained.
Alter less than within few Instruct to take Nutrition is
nutrition body hours . anti-diabetic maintained.
Weight loss requirement medication Numbness
Very hungry related to and tingling
insufficienc is resolved.
y of insulin
Numbness Weight is Administer
and tingling maintained medication to
in hands and within few prevent
feet. weeks. hypoglycemia