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Create a teaching plan for the patient requiring: Self-administration of insulin
Educate on types of insulin, how to draw up insulin, and administration
Discuss rotation of sites, cleansing of skin for glucose check and insulin admin.
Checking sugar before eating
Give at room temperature
How to use sliding scale
Disposal of sharps

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Create a teaching plan for the patient requiring: Sick Day Management
Monitor glucose levels at least 4 times a day- more during sick days
Check urine ketones if glucose is 300
Take usual insulin and oral dose
Maintain hydration adequate intake of fluids 8-12 oz
If solid food cannot be tolerated, substitute fluids of soft foods that are easily digested
If cannot eat for more than 24 hours notify doctor
In case of vomiting or diarrhea that lasts for more than 6 hours notify hcp
Stress can cause increase in blood sugar

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Create a teaching plan for the patient requiring: Foot Care
Proper fitting shoes (wear patterns)
Hygiene (lukewarm water and mild hand soap, dry completely between toes)
Thin layer of lotion (not between toes)
Toe-nails trimmed after washing (softer and easier to trim)
Podiatrist visits regularly (special shoes)
Inspect feet daily (lesions/blisters)
Protect feet from hot/cold

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Teaching Plan for Nutrition

-Always check blood glucose before a meal or snack

-Need to learn how to carb count in order to determine insulin dose

-Restrict refined sugars

-Attempt to eat meals and snacks at the same time each day

-40-60% of calories from carbs, 20% from protein 30% or fewer from fat is recommended(Balanced)-Low in saturated fat
-Limit alcohol intake
-Look for sugar-free meal options

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Create a teaching plan for the patient requiring: Exercise
Self monitor before and after exercise- priority
Monitor fluid intake and drink plenty of water
Don’t exercise at peak insulin action time
Encourage low impact aerobic exercise
Prolonged sessions cause hypoglycemia

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Create a teaching plan for the patient requiring: Management at school
Make sure they have insulin, testing strips and a log book at the nurses office.
Make sure the teachers are aware of the kids they have that have diabetes.
Behavior modification with sports or gyms. Test before recess/gym.
Limit snacks, do meal planning.
Encourage peer support groups.
Educate child that they need to come to the nurses office before meals and ,especially when they are feeling low.

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How would you attempt to reduce stress or anxiety in a parent newly diagnosed with a child with diabetes?
Educate the parents of the prevelance of the disease so they know they’re not alone and it’s not their fault.

Offer them information on support groups for family’s in the same situation.
Provide them with good information on websites and books that have more information on management and the disease process.

Creative ways to reduce the child’s stress about the injections like making it some sort of game to reduce their stress which will help reduce the parents stress.
Give them plenty of opportunities to ask questions and answer them all and provide more information when possible.

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Considering developmental level, how would you approach diabetes teaching for an 8 year old?
Assess development level and encourage them to be part of their care
Ask what foods they enjoy, what sports they play
Avoid complicated explanations
Teach how to recognize signs and symptoms of hyper and hypoglycemia
Teach them how to check blood glucose levels
Teach to wear shoes (outdoors, beach, etc.)
Hygiene and wash hands - very important
Get involved with other peers that have diabetes
Teach safety - helmets, knee pads, etc.

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When teaching a 15 year old about diabetes, how would teaching differ from an adult based on developmental level?
Buddy system
Teach s/s of what to look for in regards to change in BG levels
Support groups
Various technology apps to use to count carbs
Provide opportunities to express emotions
Don’t skip meals
Manage stress levels
Travel with sugar source (candy, juice, etc)
Suggest treatment options (insulin pump)
Allow for independence in disease management and options
Talk about possible complications and actions to take in response
Encourage typical teenage activities such as sports and hanging out with friends

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Create a teaching plan for the patient requiring:  Urine testing and self monitoring of glucose
Test for the 1st month check daily. After 1st month only check if bs is greater than 300. If positive call healthcare provider.
Reasons to check ... infections, injury, symptoms of acidosis, pregnancy

Glucose Monitoring
Check 4 to 5 x a day before meals and at bedtime
Check before exercise
Dont reuse lancets, rotate sites, use outside of finger, clean with alcohol
Make sure monitor is working properly take to doctors or pharmacy
Signs and symptoms of hypo and hyper glycemia
Call HCP for symptoms