TEACHING ENDOCRINE
DIABETES
Diabetes I
SN instructed patient/caregiver about Diabetes that is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.
Diabetes II
SN instructed patient/caregiver about Diabetes Mellitus that refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel. The underlying cause of diabetes varies by type. But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes and gestational diabetes. Prediabetes occurs when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes. And prediabetes is often the precursor of diabetes unless appropriate measures are taken to prevent progression. Gestational diabetes occurs during pregnancy but may resolve after the baby is delivered.
Diabetes and Kidney Problem
SN instructed patient/caregiver on diabetes and kidney problem, that diabetes mellitus (DM) is one of the leading cause of kidney failure in the United States. Approximately one-half of people who need dialysis have kidney disease from diabetes. With that, tight control of blood sugar must be done by avoiding concentrated sweets and high-carbohydrate content foods. Diabetic patients with hypertension have a special lower blood pressure target of less than 130 / 80 mmHg to reduce cardiovascular risk and delay progression of kidney disease.
Diabetes and Oral hypoglycemic
SN instructed patient/caregiver about type 2 diabetes and to use oral hypoglycemic long term. Oral hypoglycemic are anti-diabetic drugs designed to help people with type 2 diabetes manage their condition. You should not stop eating a healthy diet and doing regular exercise, and your healthcare professional should be able to teach you how to get the balance right. Testing blood sugar regularly, eating well and exercising daily are all important aspects of diabetes management.
Diabetes and Nerve Damage
SN instructed patient/caregiver on complications of diabetes such as nerve damage. One of the most common complications of diabetes is diabetic neuropathy. Neuropathy means damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels and other organs.
Diabetes and Injury
SN instructed patient/caregiver on diabetes with injury. People who have diabetes are vulnerable to nerve and vascular damage that can result in loss of protective sensation in the feet, poor circulation, and poor healing of foot ulcers. Careful attention needs to be paid to any abrasion or wound to ensure the quickest healing possible. It is important for people with diabetes to routinely inspect feet, in particular, to check for any issues.
Diabetes Complications
SN instructed patient/caregiver on diabetes complications. People with diabetes who have had high blood sugar levels for long periods of time can develop complications, including: Damage to the eyes (retinopathy) which can lead to blindness. Damage to the nerves (neuropathy), which can lead to numbness, tingling or pain in the legs and arms. Damage to the kidneys (nephropathy), which can result in kidney failure. Cardiovascular disease (coronary artery disease with chest pain/angina, heart attack, stroke and narrowing of arteries/atherosclerosis). Foot damage (serious infections). Skin conditions (bacterial and fungal infections). Hearing impairment. Alzheimer’s disease. Depression.
Diabetes and Diet I
SN instructed patient/caregiver on diabetic diet. It is commonly thought that people with diabetes should avoid all forms of sugar. Most people with diabetes can eat foods containing sugar as long as the total amount of carbohydrates (carbs) for that meal or snack is consistent. Many research studies have shown that meals which contain sugar do not make the blood sugar rise higher than meals of equal carbohydrate levels which do not contain sugar. However, if the sugar-containing meal contains more carbs, the blood sugar levels will go up.
Diabetes and Diet II
SN instructed patient/caregiver on diabetic diet. When you have diabetes, a meal plan is important. A meal plan tells you when to eat, how much to eat, and what kinds of food to eat for meals and snacks. You need to eat a variety of vegetables, fruits, and whole-grain foods. The meal plan can include sugar, salt, and saturated fats, but in a way that fits into the overall plan.
Diabetes and Monitoring
SN instructed patient/caregiver that blood glucose monitoring is the main tool you have to keep your diabetes under control. This check tells you your blood glucose level at any one time. Keeping a log of your results is vital. When you bring this record to your health care provider, he or she will have a good picture of your body’s response to your diabetes care plan. One type of test, the A1C, can also check on how you are managing your diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes.
Healthy mouth and Diabetes
SN instructed patient/caregiver on a healthy mouth and diabetes. Poor oral mouth can make diabetes more difficult to control. Infections may cause the blood sugar to rise and require more insulin to keep it under control. In addition, diabetes can diminish the ability to taste sweets influencing and changing food choices in favor of additional sweeter tasting foods, thereby affecting the dental health.
Skills to deal with DM
SN instructed patient/caregiver on to deal with DM such as A. Know when and what to eat. B. Know how to test and record blood glucose C. Know how to recognize and treat low blood sugar and high blood sugar. D. Know when and how to take insulin and/or oral medication. E. Know how to adjust insulin and/or food intake when changing exercise and eating habits.
Multi discipline visits (Insulin-dependent diabetes mellitus)
Patient/caregiver instructed that seeing physician, podiatrist, dentist and eye doctor regularly is a measure aimed to managing/controlling the debilitating physical effects caused by Diabetes Mellitus (DM).
DM and Hyperglycemia
High blood sugar (hyperglycemia). Your blood sugar level can rise for many reasons, including eating too much, being sick or not taking enough glucose-lowering medication. Check your blood sugar level as directed by your doctor, and watch for signs and symptoms of high blood sugar — frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea. If you have hyperglycemia, you’ll need to adjust your meal plan, medications or both.
DM and Hypoglycemia
SN instructed patient/caregiver about Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it’s known as low blood sugar (hypoglycemia). If you’re taking medication that lowers your blood sugar, including insulin, your blood sugar level can drop for many reasons, including skipping a meal and getting more physical activity than normal. Low blood sugar also occurs if you take too much insulin or an excess of a glucose-lowering medication that promotes the secretion of insulin by your pancreas. For signs and symptoms of low blood sugar – sweating, shakiness, weakness, hunger, dizziness, headache, blurred vision, heart palpitations, irritability, slurred speech, drowsiness, confusion, fainting and seizures. Low blood sugar is treated with quickly absorbed carbohydrates, such as fruit juice or glucose tablets.
HYPERTHYROIDISM
Hyperthyroidism I
SN instructed patient/caregiver about Hyperthyroidism. This condition occurs when your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body’s metabolism, causing unintentional weight loss and a rapid or irregular heartbeat. If not treated, hyperthyroidism can cause serious problems with your heart, bones, muscles, menstrual cycle, and fertility. Although hyperthyroidism can be serious if you ignore it, most people respond well once hyperthyroidism is diagnosed and treated.
Hyperthyroidism II
SN instructed patient/caregiver about Hyperthyroidism, or overactive thyroid, happens when your thyroid gland makes more thyroid hormones than your body needs. Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body’s most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods.
Hyperthyroidism Signs and Symptoms
SN instructed patient/caregiver about Hyperthyroidism can cause a wide variety of signs and symptoms, including: unintentional weight loss, even when your appetite and food intake stay the same or increase; rapid heartbeat (tachycardia) -commonly more than 100 beats a minute; irregular heartbeat (arrhythmia); pounding of your heart (palpitations); increased appetite; nervousness, anxiety and irritability; tremor-usually a fine trembling in your hands and fingers; sweating; changes in menstrual patterns; increased sensitivity to heat; changes in bowel patterns, especially more frequent bowel movements; an enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck; fatigue, muscle weakness; difficulty sleeping; skin thinning; fine, brittle hair.
Hyperthyroidism Ricks Factors
SN instructed patient/caregiver about Hyperthyroidism. People are at higher risk for hyperthyroidism if: are a woman; are older than age 60; have been pregnant or had a baby within the past 6 months; have had thyroid surgery or a thyroid problem, such as goiter; have a family history of thyroid disease; have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12; have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder; get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements.
Hyperthyroidism Complications
SN instructed patient/caregiver about Hyperthyroidism. This medical condition can lead to a number of complications: Heart problems (heart rhythm disorder, stroke and congestive heart failure). Brittle bones (osteoporosis). Eye problems (Graves’ ophthalmopathy). Red, swollen skin. Thyrotoxic crisis-a sudden intensification of your symptoms, leading to a fever, a rapid pulse and even delirium. If this occurs, seek immediate medical care.
Hyperthyroidism (Graves’ ophthalmopathy) Care
SN instructed patient/caregiver in hyperthyroidism (Graves’ ophthalmopathy) to care for eyes from sunny lights, corneal ulcerations, and infections and to wear sunglasses or eye patches. The patient was advised to put on calm compresses to the eyes if irritated. The patient was reviewed to apply lubricants to protect the cornea.
HYPOTHYROIDISM
Hypothyroidism I
SN instructed patient/caregiver on the disease process of hypothyroidism. The thyroid gland controls a lot of our body functions, when it is unable to produce the amount of thyroid hormone your body needs, you will need to take this hormone orally. Take this medication everyday as ordered by your MD. Report to SN or MD if you have sensitivity to cold temperature, dry skin, constipation, forgetfulness, chronic fatigue, decreased heart rate, depression, hair loss, weight gain, muscle stiffness and cramping, as these can be signs your medication is not the correct dose.
Hypothyroidism II
SN instructed patient/caregiver about Hypothyroidism, or underactive thyroid, happens when your thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs. Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body’s most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods. Without enough thyroid hormones, many of your body’s functions slow down. But there are treatments that can help.
Hypothyroidism Signs and Symptoms
SN instructed patient/caregiver about Hypothyroidism. The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone deficiency. Problems tend to develop slowly, often over a number of years and may include: fatigue; increased sensitivity to cold; constipation; dry skin; weight gain; puffy face; hoarseness; muscle weakness; elevated blood cholesterol level; muscle aches, tenderness and stiffness; pain, stiffness or swelling in your joints; heavier than normal or irregular menstrual periods; thinning hair; slowed heart rate; depression; impaired memory; enlarged thyroid gland (goiter).
Hypothyroidism Rick Factors
SN instructed patient/caregiver about Hypothyroidism. Although anyone can develop hypothyroidism, you’re at an increased risk if you: are a woman; are older than 60; have a family history of thyroid disease; have an autoimmune disease, such as type 1 diabetes or celiac disease; have been treated with radioactive iodine or anti-thyroid medications; received radiation to your neck or upper chest; have had thyroid surgery (partial thyroidectomy); have been pregnant or delivered a baby within the past six months.
Hypothyroidism Complications
SN instructed patient/caregiver about Hypothyroidism. Untreated hypothyroidism can lead to a number of health problems: goiter; heart problems (heart disease and heart failure); mental health issues (depression); peripheral neuropathy; myxedema (life-threatening condition is the result of long-term, undiagnosed hypothyroidism); infertility; birth defects.
MISCELLANEOUS
Symptoms and signs of high blood sugar (BS)
SN instructed patient/caregiver on S/S of High BS: polyuria (excessive or an abnormally large production or passage of urine greater than 2.5 L or 3 L over 24 hours in adults), polydipsia (increased thirst), polyphagia (abnormally strong sensation of hunger or desire to eat).
Symptoms and signs low blood sugar (BS)
SN instructed patient/caregiver on S/S of low blood sugar: sweating, tremors, anxiety, hunger, dizziness, H/A, cloudy vision, confusion, abnormal behavior, convulsions, loss of consciousness.
Site rotation I (Insulin-dependent diabetes mellitus)
SN instructed patient/caregiver on the importance of injection site rotation; rotating your injection sites is very important. When insulin is injected into the same spot repeatedly, scar tissue may develop, and insulin will not be absorbed appropriately.
Site rotation II (Insulin-dependent diabetes mellitus)
SN instructed patient/caregiver on the location of injection site; Individual injection spots should be kept about an inch apart. The absorption rate of insulin varies from site to site. Tummy injections absorb the quickest, then arms, legs and buttocks.
Site rotation III (Insulin-dependent diabetes mellitus)
SN instructed patient/caregiver on the importance of injection site rotation; it prevents the site from becoming compromised and unsightly skin changes due to the development of scar tissue.
Food Preparation (Insulin-dependent diabetes mellitus)
SN instructed patient/caregiver that when pt is on a NCS diet; Pt should try to consume the following: meat, poultry or fish that are prepared without sweet and sour marinades (made with sugar), barbecue sauces that have catsup, chili sauce, honey or brown sugar, and teriyaki sauce. These will raise the blood sugar levels and have no added value to the Pt’s diet.
Foot care I (Insulin-dependent diabetes mellitus)
SN instructed patient/caregiver on foot care: to wear shoes that are clean, avoid tight fitting shoes, to report redness, blisters or cuts noted on feet.
Foot care II (Insulin-dependent diabetes mellitus)
SN instructed patient/caregiver to check Pt’s feet daily for corns, calluses, blisters, red areas, swelling, ingrown toenails and toenail infections. That with Diabetic patients it is important to have toe nails trimmed by a licensed Podiatrist due to increased risk of wounds /infections.
