Sample essay on diabetes nursing thesis

Diabetic peripheral neuropathy is a common and frequent chronic complication that seriously harms the health of diabetic patients. Diabetes care is of great significance for rehabilitation. Below are the diabetes care papers I compiled for your reference.

Diabetes Nursing Paper Part 1: A Brief Analysis of Diabetes Nursing

Abstract: Diabetes is a common endocrine metabolic, chronic and lifelong disease. It is caused by insulin secretion due to various reasons. Absolute or relative deficiency and reduced sensitivity of target cells to insulin, resulting in abnormal metabolism of sugar, protein, and fat. In clinical practice, 95% of diabetes cases are type II diabetes, and the incidence rate is increasing year by year and becoming younger. Our hospital has treated dozens of patients with diabetes since July 2009. The nursing experience is summarized as follows.

Keywords: Diabetes care

Diabetes is a common endocrine-metabolic, chronic and lifelong disease. It is caused by an absolute or relative lack of insulin secretion and target cells caused by a variety of reasons. A disease in which sensitivity to insulin is reduced, resulting in abnormal metabolism of sugar, protein, and fat. In clinical practice, 95% of diabetes cases are type II diabetes, and the incidence rate is increasing year by year and becoming younger. Our hospital has treated dozens of patients with diabetes since July 2009. The nursing experience is summarized as follows:

1. Provide psychological care

Diabetes is a lifelong disease with a long course. There are many complications, and patients are burdened with thoughts and are prone to negative emotions such as irritability, pessimism, and disappointment. Research shows that excessive depression, anxiety and stress lead to excessive secretion of catecholamines, adrenocortical hormones, especially glucocorticoids in the body, which can affect the use of glucose by tissues, cause blood sugar to rise, and cortisol in the body under negative emotional states. Increased secretion. When the concentration of the latter increases, it can hinder the utilization of blood sugar by antagonizing insulin, causing blood sugar to increase. Therefore, medical staff should be caring and considerate to patients, do a good job of ideological explanation, and tell patients about diabetes, and their attitude should be kind. The language should be cordial, not only to listen to the patient's confession, but also to gain the patient's trust, encourage and try our best to help them overcome difficulties, so that they can establish their determination to fight the disease for a long time, so that the patient can maintain a good mood and actively cooperate with treatment and care.

　2 Diet therapy and care

Diet therapy is one of the basic methods of treating diabetes. It is also an important basic treatment measure throughout the treatment process and should be implemented strictly and long-term. ① Develop a diet plan and have a reasonable meal: Meals should be regular and rationed. Usually, the daily calories should be distributed according to 1/5, 2/5, 2/5 or 1/3, 1/3, 1/3 to morning, noon and evening. Among 3 meals, or eat less and more frequently, allocate the calories in 1 day to 1/7, 2/7, 2/7, 2/7; ② Balanced diet, reasonable distribution: the daily diet should ensure normal physiology need. Daily intake of the following basic foods is required: cereals, meat and eggs, vegetables and fruits, dairy products and fats and oils. Daily caloric distribution should meet the following standards: carbohydrates account for 50%-60%, protein <15%, and fat account for 30%; ③ Avoid the intake of high-sugar foods: reduce the intake of candies, cakes, etc., and reduce high cholesterol and fried foods, choose foods high in fiber; ④ low-salt diet, daily salt intake of less than 5 grams; ⑤ limit alcohol and quit smoking.

　3 Exercise therapy and care

Reasonable exercise can enhance the use of glucose by muscle tissue, improve insulin sensitivity, help lower blood sugar, eliminate excess fat in the body, and control weight. Improve blood lipid metabolism, strengthen myocardial contractility, promote blood circulation, increase vital capacity, improve lung ventilation function, and reduce and delay the occurrence and development of diabetic complications. The exercise time is chosen 1-1.5 hours after a meal, which is the best time to lower blood sugar. Exercise methods should pay attention to the principle of individualization. Elderly patients with diabetes should choose low-intensity, short-term exercise, such as walking, brisk walking, Tai Chi, Qigong, etc. Young and middle-aged diabetic patients can choose moderate-intensity, not too long exercise, such as jogging, brisk walking, aerobics, etc. Patients with severe diabetes should stay in bed and rest until their condition improves, and then gradually increase their activity level depending on their condition. Before exercising, patients must develop an effective exercise plan under the guidance of a doctor.

4 Drug treatment and care

① Oral hypoglycemic drugs should strictly control their effects, side effects, commonly used dosages and purposes. For example, sulfonylureas mainly promote insulin secretion, so they need to be taken 30 minutes before meals. ②When taking medicine, you should pay attention to the adverse reactions of the medicine to determine the taking time. If biguanides cause gastrointestinal reactions, we instruct patients to take the medicine with or after meals, which can reduce adverse reactions. Glucosidase inhibitors: The main adverse reactions include abdominal distension, abdominal pain, diarrhea or constipation. They should be chewed at the same time as the first meal. ③The medication time and interval should be fixed to reduce the occurrence of hypoglycemia. ④Monitor blood sugar regularly and record: The time to monitor blood sugar is usually fasting, before meals, 2 hours after meals, before going to bed and in the early morning. ⑤You should continue to follow the diet plan while taking the medicine to achieve the purpose of controlling blood sugar.

5 Basic care

Keep the bed clean and dry. Keep the mouth and skin clean, especially the vulva. Female patients should take good care of the urethra and vaginal opening to prevent urinary tract infections. For bedridden elderly people, bathe them with warm water every night, observe and massage the bony protrusions, and turn over every 2 hours to prevent the formation of pressure sores. Special emphasis is placed on foot care. It is recommended that patients wash their feet every day. It is generally required to soak their feet in warm water of about 40 degrees Celsius. The time should not be too long. Choose appropriate footwear and socks to avoid ulcers, infections and even gangrene caused by minor trauma. Feet are prone to dryness and cracking in autumn and winter. You can apply moisturizer evenly on the surface of the feet, and sprinkle some talcum powder on sweaty feet. Do not keep long nails and do not injure the skin when trimming toenails to avoid foot damage and irreversible consequences.

　6 Complication care

Acute complications: ①Ketoacidosis: Strictly implement the doctor’s instructions, quickly establish an intravenous channel, and ensure the input of fluid and insulin to correct water and electrolytes and acid-base balance disorders, for the purpose of controlling blood sugar. ② Hypoglycemia: Conscious people can take sugar water, candy, biscuits, bread, steamed buns and other foods orally to relieve the symptoms. Comatose people can intravenously inject 30-40ml of 50% glucose. Unconscious people cannot feed food orally to avoid suffocation. .

Chronic complications: ① Diabetic eye disease: If the patient has blurred vision, he or she should reduce activities and keep the stool unobstructed on weekdays to avoid straining to defecate and cause retinal detachment; when the patient's vision declines, attention should be paid to strengthening daily life Assistance and safe care to prevent accidents; ② Diabetic nephropathy: Actively and effectively control high blood pressure and limit protein intake. In addition to dietary control, oral lipid-lowering drugs and anticoagulant drugs can be taken to improve intraglomerular circulation. .

7 Discharge Instructions

Since diabetes is a chronic lifelong disease, treatment is a long-term process. Instruct discharged patients and their families on insulin injection skills, use of blood glucose meters, operation of aseptic techniques, precautions for oral hypoglycemic drugs, etc. In particular, regular examinations can help monitor the development of the disease, actively prevent complications, and improve the quality of life.

8 Summary

Through the nursing analysis of all clinical cases, the author believes that dietary care and drug treatment care play a key role in diabetic patients, but other nursing care is not allowed. ignored, and its role is becoming increasingly important. As the number of patients with diabetes increases day by day, how to provide scientific and effective care is a topic worthy of continued discussion in the nursing profession.

References

[1] Yu Cuifeng. "Care of Diabetic Patients". Chinese Practical Medicine, May 2010

[2] You Liming , Wu Ying. Internal Medicine Nursing. Fourth Edition Diabetes Nursing Paper Sample 2: Diabetes Nursing

Abstract: With the improvement of people’s living standards, the prevalence of diabetes continues to increase. At present, the number of diabetic patients in my country The number is 3 to 4 times higher than 10 years ago. Diabetes is a chronic and lifelong disease, and patients need to be treated in complex social and family lives. Therefore, it is very important to provide good care for diabetic patients.

Keywords: etiology, clinical manifestations, laboratory tests, diabetes care

Summary of clinical work practice:

1 Causes of diabetes

1.1 Genetics factor. Significant genetic heterogeneity exists in either type 1 or type 2 diabetes.

Diabetes tends to occur in families, and 1/4 to 1/2 of patients have a family history of diabetes. Clinically, there are at least 60 kinds of genetic syndromes that can be associated with diabetes.

1.2 Environmental factors. Obesity caused by eating too much and reducing physical activity is the most important environmental factor for type 2 diabetes, making individuals with genetic susceptibility to type 2 diabetes prone to the disease. Patients with type 1 diabetes have immune system abnormalities. Infections with certain viruses such as coxsackie virus, rubella virus, parotid virus, etc. lead to autoimmune reactions and destroy insulin cells.

2 Clinical manifestations of diabetes

2.1 Polydipsia, polyuria, polyphagia and weight loss.

2.2 Fatigue and obesity.

3 Examinations

3.1 Blood glucose is the only criterion for diagnosing diabetes. For those with obvious symptoms of "three more and one less", only one abnormal blood sugar value can be diagnosed. Two abnormal blood glucose values ??are needed to diagnose diabetes in an asymptomatic person. Suspicious persons need to do a 75g glucose tolerance test.

3.2 Urine sugar. Often positive. Urine glucose is positive when the blood glucose concentration exceeds the renal glucose threshold (160 to 180 mg/dL). When the renal glucose threshold is elevated, the diagnosis of diabetes may be negative even if the blood glucose reaches it. Therefore, urine glucose measurement is not used as a diagnostic criterion.

3.3 Urinary ketone bodies. Urinary ketone bodies are positive in ketosis or ketoacidosis.

3.4 Glycosylated hemoglobin (HbA1c). It is the product of the non-enzymatic reaction between glucose and hemoglobin. The reaction is irreversible. The HbA1c level is stable and can reflect the average blood sugar level in the 2 months before blood collection. It is the most valuable indicator to judge the status of blood sugar control.

3.5 Glycated serum protein. It is the product of the non-enzymatic reaction between blood sugar and serum albumin, reflecting the average blood sugar level 1 to 3 weeks before blood collection.

3.6 Serum insulin and C-peptide levels. Reflects the reserve function of islet cells. In the early stage of type 2 diabetes or in obese patients, serum insulin is normal or increased. As the disease progresses, pancreatic islet function gradually decreases and insulin secretion capacity decreases.

3.7 blood lipids. Dyslipidemia is common in patients with diabetes, especially when blood sugar control is poor. Manifested as elevated levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol. HDL cholesterol levels are reduced.

3.8 Immune indicators. Islet cell antibodies (ICA), insulin autoantibodies (IAA) and glutamic acid decarboxylase (GAD) antibodies are three important indicators of humoral immune abnormalities in type 1 diabetes. Among them, GAD antibodies have a high positive rate, long duration, and are important for 1 The diagnostic value of type 2 diabetes is great. There is also a certain positive rate among first-degree relatives of type 1 diabetes, which has significance in predicting type 1 diabetes.

3.9 Urinary albumin excretion, radioimmunoassay or enzyme-linked method. Urinary albumin excretion can be sensitively detected, and urinary albumin is slightly elevated in early diabetic nephropathy.

4 Diabetes care

4.1 Dietary care. Diet therapy is the most basic nursing measure for diabetic patients. Effective diet control aims to reduce the burden on pancreatic islet cells, correct metabolic disorders, and eliminate symptoms. The diet should be based on the principle of controlling total calories, with low sugar, low fat, appropriate protein, high vitamins, and high fiber. At the same time, it should be measured regularly.

4.2 Psychological care. It is necessary to educate diabetic patients on the basic knowledge of diabetes, build confidence in defeating the disease, how to control diabetes, and the health benefits of controlling diabetes. Develop appropriate treatment plans based on the characteristics of each diabetic patient.

Cognitive therapy is the theoretical basis for our education to patients. For some patients who have no clinical symptoms or mild clinical symptoms and are only discovered during physical examination, we let them understand chronic hyperglycemia and chronic diabetes and use support. Sexual psychotherapy, such as explaining, comforting, encouraging, reassuring and other means, explains the situation differently to the patient, allowing the patient to get out of confusion and adjust the patient's psychological state. Assist patients to adapt to life problems.

After being hospitalized, the roles of diabetic patients have changed, and their living environment has also changed. At the same time, they need to receive diabetes treatment, which means that patients are required to change their living habits that have been formed over the years. Dietary treatment is a basic treatment measure for diabetes, regardless of the patient's condition. Regardless of the age and severity of the disease, regardless of whether drugs are used, patients must strictly implement the long-term diet plan formulated for them.

4.3 Self-monitor blood sugar. With the gradual popularization of small and fast blood glucose meters, patients can adjust the dosage of hypoglycemic drugs at any time according to their blood sugar levels. When type 1 diabetes is undergoing intensive treatment, blood sugar should be monitored at least 4 times a day (before meals). When blood sugar is unstable, blood sugar should be monitored 8 times (before and after three meals, before going to bed and at 3:00 in the morning). During intensive treatment, fasting blood sugar should be controlled below 7.2 mmol/L, blood sugar two hours after a meal should be less than 10 mmol/L, and HbA1c less than 7%. Patients with type 2 diabetes can self-monitor their blood sugar less frequently.

4.4 Medication care. Oral hypoglycemic drugs include sulfonylureas and biguanides. Educate patients to take medicines on time and in dosage, and not to increase or decrease the dosage at will. Observe changes in patients' blood sugar, GHB, FA, urine sugar, urine output and weight, and observe drug efficacy, drug dosage and adverse drug reactions. When using insulin, close observation and prevention of adverse reactions to insulin are required. Common hypoglycemic reactions are related to excessive insulin dosage, eating disorders or excessive exercise, and are more common in patients with type 1 diabetes. Symptoms include fatigue, dizziness, palpitations, sweating, hunger, and in severe cases, coma. For those who respond to hypoglycemia, they should lie down and rest immediately to check their blood sugar in a timely manner. According to the condition, they should eat sugary foods such as candies, biscuits, and sugary drinks to relieve symptoms. Comatose patients should immediately draw blood and check blood sugar, and then intravenously inject 20 to 30 mL of 50% glucose. Adjusting the effective dosage and time of insulin according to the situation, regular and quantitative eating, and moderate exercise are the keys to preventing hypoglycemic reactions. If the meal time is postponed, you can eat some biscuits first. Note that the main manifestations of insulin allergic reaction are local itching and urticaria after injection, and systemic rash is rare.

4.5 Diabetic foot care. Choose appropriate shoes and socks, wash and protect your feet properly, keep your feet checked and go to the hospital for treatment in a timely manner.

In addition, patients and their families should also be provided with diabetes knowledge guidance, so that they can understand the importance of dietary treatment, and teach patients how to self-test blood sugar and urine sugar, so as to keep abreast of the development of the disease at any time. In order to achieve the purpose of control.

5 Conclusion

Through the above simple analysis of the causes of diabetes and practical life care, patients can actively accept diabetes education, improve their mastery of diabetes-related knowledge and skills, and actively participate in the treatment of the disease. Control, improve quality of life, effectively promote blood sugar control, reduce the occurrence of complications, and improve your quality of life. Diabetes Nursing Paper Three: Application of Humanized Nursing Intervention in Diabetes Care

[Abstract] Objective To explore the application effect of humanized nursing intervention in diabetes care. Methods 38 patients with diabetes who received humanized nursing intervention during hospitalization from January 2015 to January 2016 were selected as the intervention group, and 30 patients who received routine nursing measures from the Department of Endocrinology were selected as the routine group, and the two groups of patients were compared. Clinical treatment effects, changes in blood sugar before and after care, and satisfaction with care services. Results The clinical treatment effect of the patients in the intervention group was significantly higher than that of the conventional group (P<0.05); there was no statistically significant difference in the blood sugar status of the two groups of patients before care. After care, the fasting blood sugar, 2 h postprandial blood sugar, and glycated hemoglobin of the patients in the intervention group The levels were significantly better than those of the conventional group (P<0.05). Conclusion Humanized nursing intervention can not only effectively improve the blood sugar level and clinical treatment effect of diabetic patients, but also significantly improve patients' satisfaction with nursing services.

Because diabetes requires a long time to be treated, the condition is difficult to effectively control, and treatment costs are high, so it is very important to provide effective nursing services to patients [1]. The hospital implemented humanized nursing intervention on 38 patients with diabetes who were hospitalized from January 2015 to January 2016, and compared the nursing effects with those of routine nursing patients. The report is as follows.

1 Materials and Methods

1.1 General Information

Select 38 cases of humanized nursing intervention during hospitalization from January 2015 to January 2016. Patients with diabetes were selected as the intervention group, and 30 patients who received routine nursing measures from the endocrinology department were selected as the routine group. The average blood glucose level of all patients at the time of onset was >7.8 mmol/L. There were ***30 patients in the conventional group, 19 male patients and 11 female patients. The minimum age was 50 years old and the maximum age was 85 years old. The average age was (66.2-10.3) years old. The treatment method was to use hypoglycemic drugs alone. 11 cases, 19 cases combined with anti-diabetic drugs, the average fasting blood glucose level was (7.6?1.5) mmol/L; ***38 patients in the intervention group, 23 male patients, 15 female patients, the minimum age was 52 years old , the maximum age was 81 years old, the average age was (65.7-9.9) years old, the treatment methods were 16 cases using anti-diabetic drugs alone and 22 cases using anti-diabetic drugs in combination, the average blood sugar level was (8.0-1.8) mmol/L . There was no statistically significant difference in the above indicators between the two groups of patients and they were comparable.

1.2 Methods

Patients in the conventional group received routine endocrinology care, such as intravenous injection treatment. Patients in the intervention group will receive humanized nursing intervention on the basis of the conventional group. The specific contents include:

①Implement comprehensive care: Nursing staff will implement comprehensive care according to the patient's specific condition to improve the quality of nursing services and reduce the occurrence of nursing defects. rate; after the patient is hospitalized, the nursing staff conducts hospitalization assessment of the patient, establishes a personal file for the diabetic patient, and makes preparations; during the patient's hospitalization, the medical staff strengthens communication with the patient, provides effective psychological care to the patient, and provides Promote disease and health knowledge; provide targeted care to patients based on the learned situation and relevant nursing processes.

②Humanistic care: Nursing staff effectively infiltrate humanistic care during the nursing period, such as effectively protecting the patient's privacy, providing love and care to the patient in response to the patient's mental and physical pain, and providing targeted psychological counseling to the patient on different occasions. ; Before treating the patient, keep the patient's hands warm, ensure that the intravenous infusion site is filled, and at the same time explain to the patient the relevant methods and precautions for vascular protection [2].

③Individualized care: Nursing staff implement effective care according to the individualized situation of the patient, such as introducing the types, specifications, usage, clinical effects and adverse reactions of hypoglycemic drugs to the patient in detail, and giving instructions when using insulin at the same time. Patients pay special attention to dosage, injection site, and injection time.

④ Diet care: The diet must be balanced between the amount of medication and food consumed. Diet care plays a key role in controlling blood sugar in patients with diabetes; nursing staff should develop a reasonable and healthy diet for the patient based on the patient's specific condition and eating habits. Plan, and at the same time guide patients to eat a reasonable diet, use more fiber-, vitamin- and high-protein, low-glycemic, low-fat and low-calorie foods, eat less spicy and irritating foods, prohibit drinking sugary drinks, and ban smoking and alcohol.

⑤Exercise guidance: Reasonable exercise can improve the sensitivity of insulin receptors, which is of great significance in reducing the dosage of hypoglycemic drugs and reducing the patient's weight. Nursing staff can guide patients to perform appropriate exercises, such as yoga and Tai Chi. Boxing and walking, daily exercise time and amount should be appropriate, avoid strenuous exercise, exercise time should be selected 1 hour after meals, and patients with retinopathy, infection, and serious cardiovascular and cerebrovascular diseases should not exercise.

⑥Health education: Medical staff should closely observe the phenomenon of hypoglycemia during diabetes treatment, and inform them that the clinical symptoms are drowsiness, palpitations, pale complexion, sweating, and disturbance of consciousness. If hypoglycemia occurs, Biscuits and fruit candies can be used appropriately; anyone with clinical symptoms of impaired consciousness or drowsiness needs to immediately review their blood sugar levels and inform their doctor immediately for treatment to prevent the occurrence of hypoglycemia [3].

1.3 Observation indicators

Observe and compare the clinical treatment effects, blood sugar levels before and after care, and patient satisfaction with nursing services between the two groups of patients.

The clinical treatment effect is evaluated based on the patient's fasting blood glucose and 2 h postprandial blood glucose levels. The evaluation criteria include markedly effective, effective and ineffective; markedly effective means that the patient's fasting blood glucose is lower than 7.2 mmol/L or the blood glucose level decreases by >30%. Postprandial blood glucose The level is lower than 8.3 mmol/L or the blood sugar level drops by 10% to 30%; effective means that the patient's fasting blood sugar ranges from 7.2 to 8.3 mmol/L or the blood sugar level drops by >30%, and the postprandial blood sugar level is between 8.3 and 10 mmol. /L or the degree of decrease in blood sugar level is 10% to 30%; invalid means that the patient’s blood sugar level has not been significantly improved. A self-made satisfaction questionnaire was used to investigate the nursing service satisfaction. The total score is 100 points. A score of 90 or above is considered satisfactory, a score of 80 to 90 is considered relatively satisfactory, and a score below 80 is considered dissatisfied.

1.4 Statistical methods

SPSS18.0 statistical software is used to process the data. Measurement data are represented by (x?s), and t test is performed. P<0.05 means the difference is statistically significant. learning meaning.

2 Results

2.1 Comparison of clinical treatment effects between the conventional group and the intervention group

The total clinical treatment effectiveness rate of patients in the intervention group was 94.7% (16 cases were markedly effective, 20 cases were effective, 2 cases were ineffective), the total effective rate of clinical treatment in the conventional group was 76.7% (9 cases were markedly effective, 14 cases were effective, 7 cases were ineffective), the difference between the two groups of patients was statistically significant (?2=4.7670, P =0.0290)

2.2 Comparison of blood sugar changes between the conventional group and the intervention group before and after care

There was no significant difference in blood sugar between the two groups of patients before care. After care, the patients in the intervention group were fasting Blood glucose, 2-hour postprandial blood glucose and glycosylated hemoglobin levels were significantly better than those of the conventional group (P<0.05).

2.3 Comparison of patients’ satisfaction with nursing services between the conventional group and the intervention group

The patients in the intervention group were 100% satisfied with the nursing services (20 cases were satisfied, 18 cases were relatively satisfied, and 18 cases were not satisfied) 0 cases), the patients in the conventional group were 90.0% satisfied with the nursing service (15 cases were satisfied, 12 cases were relatively satisfied, and 3 cases were dissatisfied). The difference between the two groups of patients was statistically significant (?2=3.9754, P=0.0462) .

3 Discussion

Diabetes is a disease caused by multiple factors. It mainly refers to the relative or absolute deficiency of the patient's own insulin function, which leads to an increase in blood sugar. This disease is a common clinical Symptoms can be summarized as “three more and one less”, namely polyphagia, polydipsia, polyuria, and weight loss [4]. Diabetes is a long-term chronic disease. There is currently a lack of better treatment methods. Patients often need to take hypoglycemic drugs for life, and clinical treatment costs are high. This has a great impact on patients' psychology and physiology. Therefore, effective measures should be taken for patients with diabetes. Nursing intervention is very important [5].

The research results of this article show that the clinical treatment effects, post-nursing blood sugar changes, and patient satisfaction with nursing services of patients who receive humanized nursing services are significantly better than those of the conventional group (P<0.05).