diabetic-foot-care!
Taught that following prescribed diabetic diet is a measure aimed to managing/controlling Diabetes Mellitus (DM).
SN instructed patient on diabetic diet:it is commonly thought that people with diabetes should avoid all forms of sugar. Most people with diabetes can eat foods containing sugar as long as the total amount of carbohydrates (carbs) for that meal or snack is consistent.Many research studies have shown that meals which contain sugar do not make the blood sugar rise higher than meals of equal carbohydrate levels which do not contain sugar. However, if the sugar-containing meal contains more carbs, the blood sugar levels will go up.
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 on diabetic dinner and snack example: Dinner- 3 ounces meat or protein, such as baked cod or salmon / 2 starches, such as 2/3 cup cooked brown rice, / 2 vegetables, such as 1 cup steamed asparagus and 1/2 cup cooked carrots / 1 fat, such as 1 tsp margarine or 1 tsp olive oil / 1 fruit, such as 3/4 cup fresh pineapple / 1 milk, such as 1 cup skim milk. Evening Snack - 1 bread, such as 3 cups air-popped popcorn / 1 meat or protein, such as 1/4 cup lowfat cottage cheese or 1 ounce turkey breast.
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 patient and caregiver that potassium is available in foods such as asparagus, tomatoes and green leafy vegetables such as spinach. Some salt substitutes contain potassium. Avoid fruits like bananas and oranges if you are on a diabetic diet. If levels drop too low or spike too high, your heart function suffers, becoming slow or erratic, a condition known as arrhythmias. Because abnormal potassium levels greatly impact your heart function and can ultimately lead to a heart attack, it’s essential to follow your doctor’s advice carefully. Most common reasons for potassium loss is from vomiting, diarrhea, laxative use and diuretic use.