General Nursing©

DIABETES: facts and what we can do about it?

I handled many diabetic cases when I was assigned in a Medical-Surgical Ward. We monitor the patients' CBG according to the doctor's order. We normally record fluid intake and output carefully. We maintain fluid intake in order to prevent severe dehydration. We watch for signs of hypovolemic shock, monitor blood pressure, heart, and respiratory rates regularly, especially during water restriction test. We also check the patients' weight daily.

The urine specific gravity between doses was also monitored. We watch for a disease in specific gravity, with increasing urinary output, indicating return of polyuria.

We monitor patient receiving chlorpropamide for signs of hypoglycemia. We tell the patient about possible drug adverse reactions. We make sure calorie intake is adequate; keep orange juice or another carbohydrate handy to treat hypoglycemic attacks.

If constipation develops, we add more bulk foods and fruit juices to diet. If necessary, we obtain an order for a mild laxative, such as milk of magnesia.

Let me tackle what is diabetes all about. As we age or if we are overweight, our bodies are not able to handle a high sugar load. The glucose (sugar) stays in higher levels in the blood and for longer periods of time. The problem is greatly increased if exercise is inadequate. As a result of the high blood sugar, some of this sugar is wastefully excreted in the urine. This results in the typical early symptoms of frequent thirst and frequent, heavy urination. The condition is a relative lack of insulin because insulin is required for uptake (absorption) of sugar by the cells. For reasons that are not entirely clear, diabetes itself becomes a risk factor for atherosclerosis. Diabetes also can cause complications affecting vision, kidney function, and nervous-system function.

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