Nursing DX #1:Risk for feral injury r/t disease process(gestational diabetes)
Intervention #1 Teach client signs of diabetic ketoacidosis and hypoglycemia.(Hypoglycemia may be more sudden or severe during the first trimester, owing to increased usage of glucose and glycogen by a client and developing fetus, as well as low levels of the insulin antagonist human placental lactogen (HPL).
Ketoacidosis occurs more frequently during the second and third trimester because of the resistance to insulin and elevated HPL levels.) DATA: Pt educated on the following signs of DKA; needing to pee more than usual, feeling very thirsty, being sick, tummy pain, breath that smells fruity. Pt educated on the following signs of hypoglycemia; shakiness, dizziness, sweating, hunger.
Intervention #2 Encourage client to monitor blood glucose levels. (Incidence of fetal and newborn abnormalities is decreased when fasting blood sugar levels range between 60 and 100 mg/dl,)DATA: Pt educated on monitoring blood glucose and verbally instructed how to check levels. Intervention #3 Encourage client to modify diet to low sugar diet. (Because pregnancy provides severe morning glucose intolerance, the first meal of the day should be small, with minimal carbohydrates.) DATA: Pt educated on the importance of a low sugar diet. Intervention #4 Assess understanding of knowledge regarding diabetes. (To help in evaluating client’s understanding and/or compliance to a strict dietary regimen.) PT: spoke with PT, and assessed understanding of diabetes using the teach back method. Pt seems to understand.