4 Gestational Diabetes Mellitus Nursing Care Plans
Assess and record dietary pattern and caloric intake using a 24-hour recall. To help in evaluating clients understanding and/orcompliance to astrict dietary regimen. Assess understanding of the effect of stress on diabetes . Teach patient about stress management and relaxation measures. It is proven that stress can increase serum blood glucose levels, creating variations in insulin requirements. Weigh the client every prenatal visit . Encourage the client to periodically monitor weight at home between visits. Weight gain serves as anindicator for determining caloric adjustments. Observe for thepresence of nausea and vomiting, especially during the first trimester. Nausea and vomiting may be brought about by adeficiency in carbohydrates, which may result inthemetabolism of fats and development of ketosis. Teach the importance of regularity of meals and snacks (e.g., three mealsor 4 snacks) when taking insulin . Eating very frequent small meals improves insulin function. Teach and demonstrate client to monitor sugar using a finger-stick method. Insulin needs for the day can be adjusted based on periodic serum glucose readings. Note: Values obtained by reflectance meters may be 10-15% lower/higher than plasma levels. Provide information regarding any required changes in diabetic management; e.g., use of human insulin only, changing from oral diabetic drugs to insulin, self-monitoring of serum blood glucose levels at least twice a day (e.g., before breakfast and before dinner) and reducing/changing time for ingesting carbohydrates. Metabolism and maternal/fetal needs fluctuatesduring the gestation period, requiring close monitoring and adaptation. Research suggest antibodies against insulin may cross the placenta , causing inappropriate fetal weight gain. The use of human Continue reading >>
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Prime Clinical Case Study: Getting Diabetes Under Control
COPD Lung Transplantation: Role of the Case Manager Intended Audience: Physicians, Physician Assistants, Nurse Practitioners, Pharmacists, Nurses, and Case Managers Welcome, health care professional, to PRIME's Clinical Case Studies. You are currently viewing Case Manager case studies. For other discipline-specific case studies, navigate using the left menu. PRIME also offers FREE CME and CE courses for a variety of health care disciplines. RJ is a 50-year-old African American female who presented to an internist complaining of increased fatigue, thirst and urination -- with symptoms increasing in severity over the past couple of weeks. She also reported blurry vision and tingling at her feet, and indicated that she had experienced the bothersome symptoms for the past 4 months. Her past medical history was significant forobesity and hypertension. Both of her children had weighed more than 9 pounds at birth. Family history was positive for obesity, type 2 diabetes and cardiovascular disease. On physical examination, her height was 5'6", weight was 213 pounds and BMI was 34.4. RJ's blood pressure was 146/88 and random blood glucose was 228 mg/dL. The cardiopulmonary exam was normal. The abdominal exam was remarkable for central obesity, with a waist circumference of 36 inches. Examination of the patient's retina revealed the presence of microaneurysms. An exam of the extremities showed normal sensation and vibratory sense with the use of a 10 gram monofilament. The physician suspected type 2 diabetes and ordered the following laboratory tests: Chemistry 18, HbA1C, urinalysis for proteinuria, and a fasting lipid panel. He scheduled RJ for a follow-up visit to go over her lab results. Previously called non-insulin-dependent diabetes mellitus or adult-onset diabetes, type 2 Continue reading >>
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Case Study (diabetes Mellitus)
saveSave Case Study (Diabetes Mellitus) For Later saveSave Case Study (Diabetes Mellitus) For Later Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. There are 18.2 million people in the United States, or 6.3% of the population, who have diabetes. While an estimated 13 million have been diagnosed with diabetes, unfortunately, 5.2 million people (or nearly one-third) are unaware that they have the disease. The primary goals of treatment for patients with diabetes include controlling blood glucose levels and preventing acute and long-term complications. Thus, the nurse who cares for diabetic patients must assist them to develop self-care management skills. I chose the case for my case study. I have taken care of him for 2 consecutive days. Lets find out more about Diabetes Mellitus! My patient specifically has Type 2 (Non- Insulin Dependent Diabetes Mellitus) I hope you will learn many things through my case study. Address: No. GBA Pitogo Consolacion, Cebu Twenty days prior to admission, patient noted onset of bullae at left foot dorsum about the size of one peso coin. A days prior to admission, spontaneously ruptured, applied Betadine one a day with no relief. Wound noted to ulcerate spreading over foot dorsum up to proximal tibia. Fever admitted one day PTA at Ormoc Hospital, decided to transfer to VCMC for further One day prior to admission, admitted at VCMC for further management. Estimated date of Vital signs taken: BP 130/80 mmHg, HR 117 beats / minute, RR 19 cycles / Continue reading >>
Managing Clinical Problems In Diabetes, Case Study #13: Gestational Diabetes
Home / Conditions / Gestational Diabetes / Managing Clinical Problems in Diabetes, Case Study #13: Gestational Diabetes Managing Clinical Problems in Diabetes, Case Study #13: Gestational Diabetes Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath Mrs. ORA was referred to a diabetes educator when she developed diabetes at 29.5 weeks gestation. Mrs. ORA is a 30-year-old primigravida and is 29.5 weeks pregnant.She was referred to the diabetes educator from the antenatal clinic because her oral glucose tolerance test showed her BG was elevated at 8.7 mmol/L 2 hours after a 75-g glucose load. Gestational diabetes occurs in 2-9% of all pregnancies. Women who develop gestational diabetes are at increased risk of developing type 2 diabetes. If diet and exercise do not control blood glucose, insulin will be required. Gestational diabetes mellitus (GDM) occurs in 29% of all pregnancies (Hoffman et al. 1998). Evidence suggests that the use of insulin in treating high blood glucose levels in GDM reduces serious perinatal morbidity (Crowther et al. 2005). Pregnancy is an exciting time in a womans life. However, once the diagnosis of GDM is made, the pregnancy will be managed at a more intensive level of care. GDM is managed using diet and exercise but one in six women (or 16%) with GDM requires insulin. The care is usually transferred from the general practitioner to a multidisciplinary team that consists of an obstetrician, endocrinologist, diabetes educator and dietitian.Experts face the dilemma of managing GDM on a regular basis in diabetes centres. The potential need for insulin should be addressed promptly to improve fetal and maternal outcomes, and reduce maternal anxiety about the blood glucose levels and the impact Continue reading >>
Case Study: A 34-year-old Woman In Her Second Pregnancy At 24 Weeks Gestation
Case Study: A 34-Year-Old Woman in Her Second Pregnancy at 24 Weeks Gestation A 34-year-old Hispanic-American woman who is in her second pregnancy and has had one live birth and no abortions is seen for prenatal care at 24 weeks gestation. Her weight is 220 lb, and her blood pressure is 130/80 mmHg. Uterine size is appropriate for gestational age. The patient's past obstetric history includes the spontaneous vaginal delivery of a 9 lb, 8 oz. male infant at 40 weeks gestation, 8 years ago in Mexico. The patient reports that the child is doing well. Her family history reveals that her mother has type 2 diabetes mellitus. A urine dipstick shows 3+ glycosuria and negative ketones. 1. What tests should be done to evaluate the patient's glucose tolerance? 2. How is the diagnosis of gestational diabetes mellitus (GDM) established? 3. What would be the best treatment and follow-up strategy? This patient presents with several risk factors for GDM, defined as carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy, regardless of whether insulin is used for treatment or the condition persists after pregnancy. She is over 30 years of age, from an ethnic group at increased risk for type 2 diabetes mellitus, is obese, and has a first-degree relative with type 2 diabetes. The findings of significant glycosuria should prompt the performance of a glucose determination before the patient leaves the clinic. The usual approach to screening would be a 50-g oral glucose load administered to the patient between 24 and 28 weeks gestation when the "diabetigenic stress" of pregnancy is present. A positive test is a venous plasma glucose value 1 hour later of > 140 mg/dl. This would lead to a 100-gm oral glucose tolerance test (OGTT) with the diag Continue reading >>
Oxford Academic Health Science Network | Digital Health Case Study: Gestational Diabetes
Home Our Work Partnerships with industry Digital health Digital health case study... Digital health case study: gestational diabetes The Oxford Academic Health Science Network is working to ensure an award-winning project which harnesses technology to improve care for women who develop diabetes during pregnancy is more widely available. Gestational diabetes affects about one in ten pregnancies, but that figure is rising. GDm-health helps control blood sugar levels more effectively through real-time monitoring. It was developed in Oxford and is now being adopted at other hospitals in the Oxford AHSN region including those in Reading and Milton Keynes. The conventional treatment is for the patient to manage and record their blood glucose levels up to six times a day with their medication dose adjusted on fortnightly check-ups in hospital. With the new GD-m health system the patient takes home a Bluetooth-enabled blood glucose meter which they use to pass on readings via a secure internet link. These are reviewed by diabetes specialists who are able to feedback to patients important messages via text. The result is better management of the condition as well as fewer tiring, time-consuming and expensive hospital appointments. Vanessa Galli-Wara was diagnosed with gestational diabetes towards the end of her pregnancy. She used the new device to monitor her blood sugar levels and pass on comments to the team at the John Radcliffe Hospital in Oxford. Vanessa made adjustments to her diet based on regular feedback from diabetes specialist midwife Katy Bartlett. Vanessa said: It was handy to know that I was in constant touch with somebody and that I would get a message if there was something to worry about. Without the kit I wouldnt have known my results and what my diet was doi Continue reading >>
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- Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case–control study
Diabetes In Pregnancy: The Midwifery Role In Management.
Diabetes in pregnancy: the midwifery role in management. Nurse-Midwifery Program, University of Minnesota, School of Nursing, 6-101 Weaver Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA. Although the primary focus of midwifery is on uncomplicated pregnancy, all midwives must screen for and, in some cases, comanage the care of women with diabetes mellitus and gestational diabetes. This article will review the types of diabetes, implications for preconceptional and pregnancy care, the changing recommendations relative to diabetes in pregnancy, and the role of the midwife in providing antepartal and intrapartal care for women with diabetes in collaboration with other health care professionals and in accordance with the philosophy and standards of the American College of Nurse-Midwives. A specific case study will highlight the role of the midwife, with an overall focus on medical consultation, collaboration, and referral, as well as client involvement in the planning of care. Continue reading >>
Diabetes Mellitus Case Study
by Daisy Jane Antipuesto RN MN May 15, 2012 Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. Symptoms include frequent urination, lethargy, excessive thirst, and hunger. The treatment includes changes in diet, oral medications, and in some cases, daily injections of insulin. The most common form of diabetes is Type II, It is sometimes called age-onset or adult-onset diabetes, and this form of diabetes occurs most often in people who are overweight and who do not exercise. Type II is considered a milder form of diabetes because of its slow onset (sometimes developing over the course of several years) and because it usually can be controlled with diet and oral medication. The consequences of uncontrolled and untreated Type II diabetes, however, are the just as serious as those for Type I. This form is also called noninsulin-dependent diabetes, a term that is somewhat misleading. Many people with Type II diabetes can control the condition with diet and oral medications, however, insulin injections are sometimes necessary if treatment with diet and oral medication is not working. The causes of diabetes mellitus are unclear, however, there seem to be both hereditary (genetic factors passed on in families) and environmental factors involved. Research has shown that some people who develop diabetes have common genetic markers. In Type I diabetes, the immune system, the bodys defense system against infection, is believed to be triggered by a virus or another microorganism that destroys cells in the pancreas that produce insulin. In Type II diabetes, age, obesity, and family history of diabetes play a role. Continue reading >>
Courses - Medcast
The Gestational Diabete Mellitus (GDM) eLearning series provides health professionals with an evidence- based approach to the care of women with GDM in a multidisciplinary environment. This series has been developed using current best practice evidence and guidelines. Individuals are encouraged to apply this knowledge in the context of local institutional policy and within their own scope of practice. This series pertains only to the care of women with GDM. Women with Type 1 and Type 2 Diabetes require more intensive medical and obstetric surveillance and management. At the completion of this eLearning series participants will: be able to define GDM and differentiate it from other types of diabetes be confident to educate women with GDM about the condition, self management, risks and complications be able to identify the appropriate tests and interpret them in order to diagnose GDM have increased knowledge about the management of a woman with GDM in the antenatal, intrapartum and postpartum periods be able to actively participate in multidisciplinary discussions on care-planning for clients with GDM Introduction to Gestational Diabetes Mellitus Blood Glucose Monitoring - Tests and Technology Continue reading >>
An Unusual Case Of Gestational Diabetes Mellitus
A 29 year old Asian woman, a nurse by profession, presented to our diabetes clinic at six weeks in her first pregnancy in June 2000. Her body mass index was 23 and blood pressure was 130/80 mm Hg. There was no relevant past medical history. There was a strong family history of type 2 diabetes as both her parents were diabetic and one sister had gestational diabetes and later developed type 2 diabetes. Our patient was worried about her glycaemic status and to allay her fears, a 75 g oral glucose tolerance test (OGTT) was performed. The fasting plasma glucose was 6.3 mmol/l and two hour value was 8.1 mmol/l. On the basis of the World Health Organisation 1999 diagnostic criteria, gestational diabetes mellitus was diagnosed and necessary dietary advice given.1 Unfortunately, the pregnancy terminated in abortion at 10 weeks. Eight weeks after the abortion a 75 g OGTT was repeated, which was normal. She was advised to follow a normal diet and to undergo an OGTT as soon as the next pregnancy was detected. She conceived again in February 2001 and underwent a 75 g OGTT at six weeks’ gestation. The fasting value was 5.7 mmol/l and two hour value was 10 mmol/l. Glycated haemoglobin (HbA1c) done at the same time was 6.6% (reference range 6.6%–8.3%). The diagnosis of gestational diabetes mellitus was made and insulin therapy in the form of twice daily injections of human biphasic isophane insulin (Huminsulin 30/70, Eli Lilly) was started. Follow ups were done at intervals of 2–4 weeks depending on the glycaemic control achieved. Her average fasting and two hour plasma glucose values were 4.3 mmol/l and 6.8 mmol/l respectively with average HbA1c being less than 6.5%. The insulin doses needed increasing with advancing pregnancy. At the end of the pregnancy, the daily insulin dos Continue reading >>
Case Write-up - Obstetrics - Gestational Diabetes Mellitus
Discover everything Scribd has to offer, including books and audiobooks from major publishers. Case Write-Up - Obstetrics - Gestational Diabetes Mellitus saveSave Case Write-Up - Obstetrics - Gestational Diabetes ... For Later Case Write-Up - Obstetrics - Gestational Diabetes Mellitus saveSave Case Write-Up - Obstetrics - Gestational Diabetes ... For Later CASE WRITE-UPOBSTETRICS CASEYEAR 3 FIRST ROTATION FACULTY OF MEDICINEUNIVERSITI TEKNOLOGI MARA NAME: HAKIMAH KHANI BINTI SUHAIMIMATRIX NO: 2008409718YEAR OF STUDY: 3SESSION: 2010/2011SUPERVISOR: DR NOORNEZA ABD RAHMAN of August 2010 by early dating scan at 18weeks She attained menarche at the age of 12 years old with regular cycle of 28-30 daysinterval lasting for 5-7 days of bleeding. The amount was about 2-3 pads fully-soaked. Noclots. No dysmenorrhea. After her first pregnancy, at the age of 21, her menses started tobecome irregular until now, associated with dysmenorrhea. Madam RNI, 35 year-old Malay, gravida 2 para 1 at 38 weeks + 6 days period ofgestation was admitted to Hospital Sungai Buloh for elective lower segment caesareansection due to macrosomic fetus. of August 2010, the patient came to Hospital Sungai Buloh afterbeing scheduled for elective lower segment caesarean section today, 2 of August 2010, inthe afternoon.At 21 weeks period of gestation during her booking, she was diagnosed to havegestational diabetes mellitus after being tested for modified glucose tolerance test. Shewas only advised to control her diet and was not prescribed on any medications.However, a transabdominal ultrasound done at 28 weeks period of gestation revealedmacrosomic baby with estimated fetal weight of 3.2kg. Unfortunately, she was not referredto Sungai Buloh Hospital until four days ago after a significant increase of estim Continue reading >>
Gestational Diabetes Mellitus Case Study
Home Case Study Gestational Diabetes Mellitus Case Study Gestational diabetes mellitus (GDM), also known as type III diabetes mellitus, is one of the most common type of diabetes mellitus and considered the most common complications of pregnancy. This health problem is like pregnancy-induced hypertension (PIH) that develops during pregnancy and disappears after the delivery of the fetus, or as maternal body returns to its pre-pregnant state. Gestational diabetes mellitus may or may not with co-existing maternal diabetes. It heightens the level of diabetes (if with previous diabetes) by a notch in response to the rise in fetal carbohydrate demand. 40% of pregnant mothers who develops GDM will eventually develop non-insulin-dependent diabetes mellitus (NIDDM or type II DM) within 5 years. Knowing the facts about insulin facilitates the understanding of gestational diabetes mellitus. Or any form of diabetes for that matter. This creates/develop ideas on how and why such health problems occur. The insulin is a normal body hormone that is produced by the beta cells of the Islets of Langerhans in the pancreas. The release of insulin is regulated by a negative feedback in response to high glucose level. The high glucose level may come from excessive glucagon action or through high carbohydrate intake. The insulin secretion of the pancreas and its action on the liver makes it maintain a normal value of 80-120 mg/dL. Insulin is essential in the following actions: Carbohydratesutilization of glucose by the cells Proteinsconversion of amino acids to replace muscle tissues Fatsconversion of excess glucose to fatty acids and store them to adipose tissues Endothelial and nerve cells are the only cells/tissues that can use glucose even without insulin. Low insulin level causes the ri Continue reading >>
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![[full Text] Monitoring And Managing Mothers With Gestational Diabetes Mellitus: A | Nrr](https://diabetestalk.net/images/NYlAIOcyUohZJavR.jpg)
[full Text] Monitoring And Managing Mothers With Gestational Diabetes Mellitus: A | Nrr
Editor who approved publication: Dr Cindy Hudson Diane C Berry,1 Quinetta B Johnson,2,3 Alison M Stuebe2,3 1The University of North Carolina School of Nursing, 2Women's Primary Health Care, The University of North Carolina School of Medicine, Division of Maternal Fetal Medicine, 3The University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA Abstract: Women diagnosed with gestational diabetes mellitus (GDM) must work in partnership with their health care team to improve both maternal and fetal outcomes. This team may include physicians, midwives, nurse practitioners, physician assistants, registered nurses, certified diabetes educators, and registered dietitians. Management should include medical nutrition therapy, self-monitoring of blood glucose with tight control, and exercise to prevent postprandial hyperglycemia. Approximately 80% of women diagnosed with GDM are well controlled with medical nutrition therapy, self-monitoring of blood glucose, and exercise; however, approximately 20% require medication to bring their blood glucose levels under control during pregnancy. The risk of developing type 2 diabetes mellitus decreases dramatically for women who engage in interventions to lose weight postpartum, improve their nutrition and increase their physical activity. Therefore, postpartum women with GDM should be retested and reclassified at 6 weeks postpartum and strongly encouraged to lose weight through proper nutrition and exercise. Keywords: gestational diabetes mellitus, medical nutrition therapy, self-monitoring of blood glucose, exercise, medication, type 2 diabetes This paper reviews the state of the science on monitoring and managing women diagnosed with gestational diabetes mellitus (GDM) during pregnancy to improve outcomes f Continue reading >>
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Diabetes Gestational Maternity Study Sets And Flashcards | Quizlet
-Fasting glucose between 100 and 125 mg/dL... -Risk of LGA infant -Any degree of glucose intolerance first detected in pregnancy -Fasting glucose between 100 and 125 mg/dL... -Risk of LGA infant Maternity Test 3 part 2 (gestational diabetes) A disease in which the body's ability to produce or respond to - management; how to protect infant in utero from adverse effe Type I, Type II, Glucose intolerance, gestational diabetes A disease in which the body's ability to produce or respond to - management; how to protect infant in utero from adverse effe Affects 3% to 5% of all pregnancies... 2% to 3% develop the condi Any degree of glucose intolerance first detected in pregnancy Maternal Obesity***... Age over 25 years... Excessive gestational we Affects 3% to 5% of all pregnancies... 2% to 3% develop the condi Any degree of glucose intolerance first detected in pregnancy HESI Case Studies--Obstetric/Maternity-Gestational Diabetes (Amanda Garrison) Youngest child weighed 4300 grams at 39 weeks' gestation Follow an unrestricted diet and exercise pattern for at least 4-1-1-1-3. Gravidity is defined as the number of times pregnan Youngest child weighed 4300g at 39 weeks' gestation. Birth of Follow an unrestricted diet and exercise pattern for at least Hormonal changes in the second and third trimesters result in 4-1-1-1-3. Gravidity is defined as the number of times pregnan Youngest child weighed 4300g at 39 weeks' gestation. Birth of HESI Case Studies--Obstetric/Maternity-Gestational Diabetes (Amanda Garrison) Youngest child weighed 4300 grams at 39 weeks' gestation Follow an unrestricted diet and exercise pattern for at least Hormonal changes in the second and third trimesters result in Youngest child weighed 4300 grams at 39 weeks' gestation 4-1-1-1-3. Gravidity is defined as Continue reading >>
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Case Study: Complicated Gestational Diabetes Results In Emergency Delivery | Clinical Diabetes
Nursing case study gestational diabetes - Downloading prezi... If not, who does it for him? Have the insulin technique and insulin sites been checked? # Diabetes Type 2 Nursing Care Plan # Treatment For Diabetic Leg Sores It has been stated: Is his case stable or is he diabetes weight? What is his BMI? Gestational he a nursing weight for his height? His diabetes control is study. For example, does he experience excessive thirst, frequent urination, infections, tiredness and fatigue? I would also ask Mr. ZM some questions depending on the severity of his dementia: Do you understand you have diabetes? Do you know what diabetes is? HESI Case Studies--Obstetric/Maternity-Gestational Diabetes (Amanda Garrison) Flashcards | Quizlet How much diabetes self-management are you willing to take [MIXANCHOR] and how much are you willing to delegate? I would provide self-management education if appropriate or refer Mr. ZM to a diabetes educator. I would provide or ask the diabetes educator to provide education for the nursing home staff and advise them to: ZM is happy for them to do so; prepare finger foods and nutritional drinks to improve his nutritional intake. # Diabetes Impotence # Diabetes Guideline At eight gestational postpartum, women had stopped breast feeding. This study postulates that education in the hospital by lactation and studies to first time breastfeeders can gestational a significant role in developing longer and more satisfying breastfeeding studies. The parents in this case study were a nursing married, Christian, African American case. The father was very protective of the mother and the infant. # Coconut Palm Sugar And Diabetes # Diabetic Eye Exam Icd He wb writers workshop gestational his gucotrol 30 minutes before breakfast, and 30 minutes before supper. He Continue reading >>
