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Rabu, 22 Januari 2014

NCP for Hypoglycemia - Nursing Diagnosis and Interventions

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NCP for Hypoglycemia - Nursing Diagnosis and Interventions

Nursing Care Plan for Hypoglycemia

Hypoglycemia is a condition where the fasting plasma blood sugar levels less than 50 mg /%.

Populations that have a high risk of experiencing hypoglycemia are:
  • Diabetes mellitus.
  • Parenteral nutrition.
  • Sepsis.
  • Enteral feeding.
  • Corticosteroid therapy.
  • Infants with mothers with diabetic.
  • Infants, with small for gestational age.
  • Infants whose mothers drug addiction.
  • Burns.
  • Cancer of the pancreas.
  • Addison's disease.
  • Hyperfunctioning adrenal glands.
  • Liver disease.
Type of hypoglycemia are classified into several types namely:
  • Early neonatal transitional: large size or normal baby, with damage to the pancreatic production system, resulting in hyper-insulin.
  • Classic Transient Neonatal: occurs when infants are malnourished, so the deficiency of fat and glycogen reserves.
  • Secondary: as a response to the stress of the newborn resulting in increased metabolism that requires a lot of glycogen reserves.
  • Recurrent: caused by the enzymatic breakdown, or impaired insulin metabolism.


Assessment

Basic data that needs to be examined are:
1. The main complaint: often unclear, but usually symptomatic, more frequent hypoglycemia and a secondary diagnosis that accompanies other previous complaints such as asphyxia, seizures, sepsis.

2. History:
  • ANC.
  • Perinatal.
  • Post natal.
  • Immunization.
  • Diabetes mellitus in the elderly / family.
  • The use of parenteral nutrition.
  • Sepsis.
  • Enteral feeding.
  • Use of Corticosteroid therapy.
  • Mothers who use or drug addiction.
  • Cancer.

3. Focus Data
Subjective Data:
  • Often entered with complaints that are not clear.
  • Complaining baby cold sweat that much.
  • Hunger (babies often cry).
  • Headache.
  • Frequent yawning.
  • Irritabel.
Objective data:
  • Parestisia on the lips and fingers, restlessness, nervousness, tremors, convulsions, stiff,
  • Hight-pitched cry, lethargy, apathy, confusion, cyanosis, apnea, irregular rapid breathing, sweating, eye circles, refusing to eat and coma.
  • Plasma glucose less than 50 g /%.

Nursing Diagnosis and Interventions

1. Risk for complications
related to lower plasma glucose levels such as mental disorders, behavioral disorders, autonomic nerve function disorders, hypoglycemic coma

Interventions:
  • Check serum glucose before and after meals.
  • Monitor: glucose, pallor, cold sweat, skin moist.
  • Monitor vital signs.
  • Monitor consciousness.
  • Monitor sign of nerves, irritability.
  • Perform oral administration of sweet milk 20 cc X 12.
  • Analysis of environmental conditions that could potentially cause hypoglycemia.
  • Weight checks every day.
  • Check for signs of infection.
  • Avoid the occurrence of hypothermia.
  • Collaborate provision of oxygenation.
2. Risk for infection
related to a decrease in endurance

Inerventions:
  • Perform maintenance procedures hands before and after the action.
  • Ensure that every object that is used in contact with baby be clean or sterile.
  • Prevent contact with others who suffer from respiratory tract infections.
  • Note the condition of the baby feces.
  • Encourage families to follow aseptic procedures septic.
  • Give antibiotics as profolaksis in accordance with the order.

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