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Microvascular complications slide03-1 - Coggle Diagram
Microvascular complications
Definition
Are those long-term complications that affect small blood vessels
Causes
Basement membranes of the capillaries thicken due to the accummulation of sugars which impair the exchange of nutrients ,gases and wastes
Signs and Symtoms
Venous loops
Retinal haemorrhage
Microaneurysms
Pathophysiology
Microaneurysm formation is the earliest manifestation of diabetic retinopathy. Microaneurysms may form due to the release of vasoprolife factors, weakness in the capillary wall,or increased intra-luminal pressures. Microaneurysm can cause vascular permeability in the macula, which can lead to
mascular edema that threatens central vision
Nursing Care Plan
Risk for Decreased Cardiac Output
Nursing Diagnosis
Inadequate blood pumped by the heart to meet metabolic demands of the body
Nursing Intervention
Monitor Blood Glucose Levels
Monitor and documents effects or adverse response to
medications, noting BP, heart rate, and rhythm
Monitor vital signs and cardiac rhythm.
Evaluation
Glucose and bloop pressure shoud be within normal ranges
Expected Outcomes
Report/display decreased episodes of dyspnea, angina, and dysrhythmias.
Risk for Unstable Blood Glucose
Nursing Diagnosis
At risk for variation of blood glucose levels from the normal range that may compromise health.
Expected outcomes
Patient has a blood glucose reading of less than 180 mg/dL;
fasting blood glucose levels of less than <140 mg/dL hemoglobin A1C level <7%
Nursing Interventions
Assess feet for temperature, pulses, color, and sensation.
Assess for signs of hyperglycemia
Evaluation
Bood glucose levels should be norma
Nursing Management
Emphasize adherence to check up appointments
Administer medication as prescribed
Tak to the patient regarding the end stage compications of diabetes
Medical Management
Administration of ACE Inhibitors
BP must be kept below 140/80 mm/hg or if recognised
treated lower than 125/75 mm/hg
Health Education
Blood glucose levels in the normal range or as close to normal as is safely possible
Blood pressure levels that reduce risk for vascular disease
Lipid and lipoprotein profiles that reduce risk for macrovascular disease
Modify nutrient intake and lifestyle as appropriate to prevent and treat obesity, dyslipidemia, CVD, hypertension, and nephropathy
Surgical management
Laser surgery
Risk factors
Protein in urine
High blood pressure
Raised fats in blood
References
Vinik AI, Mitchell BD, Leichter SB, Wagner AL, O'Brian IT, Georges LP. Epidemiology of the complications of diabetes. In: Leslie RDG, Robbins DC, eds. Diabetes: Clinical Science in Practice Cambridge, MA: Cambridge University Press; 1995:221.
Bax JJ, Young LH, Frye RL, Bonow RO, Steinberg HO, Barrett EJ. Screening for coronary artery disease in patients with diabetes. Diabetes Care 2007; 30:2729–2736.
