Roxbury Community College Health Science Division STUDENT CARE PLAN Student Name: ____Angelica Stepien Nursing Course

# ____252__ Date: __11/11/11__ Nursing Diagnosis: Imbalanced nutrition: More than body requirement r/t intake in excess of activity expenditure ASSESSMENT: SUBJECTIVE AND OBJECTIVE DATA SUBJECTIVE: Patient states: I have tried some diets in the past but was not successful; I figured I am just meant to be big so now I eat whatever I want. OBJECTIVE: Patients height- 54 Weight- 212 lbs Blood Glucose- 212 mg/dl BP 135/60 P 82 R 18 T 97.0 O2 98 % PATIENT EXPECTED OUTCOMES Nutrition Balance between needs and intake Weight loss Patient will understand the importance of exercise By the end of teaching patient will understand the importance of a balanced diet in order to lose weight and also to control her diabetes Patient will understand the need to control her diabetes in order to prevent complications like Peripheral Vascular disease NURSING d INTERVENTIONS SCIENTIFIC RATIONALE EVALUATION Goal not met but progress made. Patient voiced the importance of weight control in order to control her diabetes. Patient understand that diabetes has serious complications if not treated by stating: I had no idea that I could even become blind if I didnt treat my diabetes, I will for sure watch my diet and lose weight in order to become healthier

Advise patient on the importance of an individualized meal plan in meeting weight-loss goals. Reducing intake of carbohydrates may benefit some patients; however, fad diets or diet plans that stress one food group and eliminate another are generally not recommended. Discuss the goals of dietary therapy for the patient. Setting a goal of a 10% (of patients actual body weight) weight loss over several months is usually achievable and effective in reducing blood sugar and other metabolic parameters. Assist patient to identify problems that may have an impact on dietary adherence and possible solutions to these problems. Emphasize that lifestyle changes should be maintainable for life. Explain the importance of exercise in maintaining/reducing body weight. Caloric expenditure for energy in exercise Assist patient to establish goals for weekly weight loss and incentives to assist in achieving them. Teach patient about the complications of diabetes and how to prevent them.

Contrary to popular belief there is no specific type of weight loss diet for people with diabetes-such as low fat or low carb diets ( Havard Health Publications, 2009) Losing as little as 5%to 10% of body weight can help manage diabetes (Harvard Health Publications, 2009) Changes in schedule, trips, and other changes can make it difficult for patient to keep the lifestyle changes in place ( Havard Health Publications, 2009) Exercise lowers blood glucose levels and boots body sensitivity to insulin, countering insulin resistance ( Harvard Health Publications, 2009) If diabetes is a serious disease that can have many complications if not treated and/or controlled. Some of the complications are: Retinopathy, Neuropathy, Kidney disease and etc( Harvard Health Publications, 2009)

Clinical Forms/Care Plan Form August 2009