diabetic diet/1000
Instructed caregiver reducing additional risk factors, such as , high cholesterol, and elevated blood glucose, are important in prevention and treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will go a long way in reducing risks. the patient podiatrist can provide guidance in selecting the proper shoes.
SN instructed patient / caregiver about Bethanechol. Sometimes given orally or subcutaneously to treat urinary retention resulting from general anesthetic, diabetic neuropathy of the bladder, or a side effect of antidepressants or to treat gastrointestinal atony (lack of muscular tone). Adverse reaction are rare following oral administration of Bethanechol, but are more common following subcutaneous injection. Adverse reactions are more likely to occur when dosage is increased. Adverse reactions that have been observed: Body as a Whole: malaise; Digestive: abdominal cramps or discomfort, colicky pain, nausea and belching, diarrhea, borborygmi, salivation; Renal: urinary urgency; Nervous System: headache; Cardiovascular: a fall in blood pressure with reflux tachycardia, vasomotor response; Skin: flushing producing a feeling of warmth, sensation of heat about the face, sweating; Respiratory: bronchial constriction, asthmatic attacks; Special Senses: lacrimation, miosis.
SN instructed patient about Gabapentin ( Neurontin ). It is a medication used to treat epilepsy, neuropathic pain and hot flashes. It is also used for restless leg syndrome. It is a first line agent for the treatment of neuropathic pain arising from diabetic neuropathy, post-herpetic neuralgia, and central neuropathic pain. Most common side effects of gabapentin in adult patients include dizziness, fatigue, drowsiness, weight gain, and peripheral edema. It may also produce sexual dysfunction in some patients, symptoms of which may include loss of libido, inability to reach sexual climax, and erectile dysfunction. It should be used carefully in patients with renal impairment due to possible accumulation and toxicity. Warning of an increased risk of depression and suicidal thoughts and behaviors in patients taking gabapentin. Report to Physician or nurse if any of those side effect / adverse reaction occurs.
SN instructed patient on diabetes and kidney problem, that diabetes mellitus ( DM ) is one of the leading cause of kidney failure in the United States. Approximately one-half of people who need dialysis have kidney disease from diabetes.With that, tight control of blood sugar must be done by avoiding concentrated sweets and high-carbohydrate content foods.Diabetic patients with hypertension have a special lower blood pressure target of less than 130 / 80 mmHg to reduce cardiovascular risk and delay progression of kidney disease.
Sn instructed patient on diabetes management. Aim for your A1c level to be between 6-7%. For every 1% you decrease your A1c levels you decrease your risk of Diabetic complications. Physical activity helps to decrease blood sugar levels and monitor your food intake such as carbohydrates and fats. Patient verbalized understanding.
SN instructed patient / caregiver regarding medication Metformin. SN explained to patient / caregiver that metformin is an oral anti - diabetic medication and is used to treat type 2 diabetes mellitus. SN explained that it is the first - line drug of choice for the treatment of type 2 diabetes, particularly in overweight and obese people. SN explained that using metformin alone will help to lower blood sugar when it is too high and help restore the way food is used to make energy. SN instructed patient to notify physician ( MD ) if experiencing symptoms / signs ( S / S ) of hypoglycemia such as shakiness, nervousness, sweating associated with dizziness / lightheadedness.
SN explained that the Diabetes can affect the small blood vessels of the body that supply the skin with blood. Changes to the blood vessels because of diabetes can cause a skin condition called diabetic dermopathy. This appears as scaly patches that are light brown or red, often on the front of the legs.
SN instructed early signs and symptoms of diabetic hypoglycemia include shakiness, dizziness, sweating, hunger, irritability or moodiness, anxiety or nervousness, headache.Patient is drinking her water and healthy choices.Explained early signs of hyperglycemia include increased thirst, headaches, trouble concentrating, blurred vision, frequent peeing, fatigue (weak, tired feeling), weight loss. Patient verbalized understanding.
Instructed patient about diabetic ulcer keep your blood sugar under control. In addition to reducing your risk of ulcers, tight blood sugar control helps your body heal existing ulcers
Instructed in measures to decrease risk of angina pectoris: exercise regularly, take regular rest periods, eat small frequent meals, dress warmly in cold weather, take medications as prescribed, eat diet high in fiber and others.