Foundation University

COLLEGE OF NURSING
Dumaguete City

Submitted to:

Ms. Michelle B. Dales, B.S.N. - R.N.

Level III Clinical Instructor

Submitted by:

Faelnar, Germaine, S.N.

Real, Julie Christy, S.N.
Level III - B1 & B2

Date Submitted:

September 04, 2008

COURSE TITLE : NURSING CARE MANAGEMENT 101

TOPIC : CARE OF THE CLIENT WITH DIABETES MELLITUS

PLACEMENT : Level III Medicine Rotation 1st Semester 2008-2009 Negros Oriental Provincial Hospital

TIME ALLOTMENT : 1.5 hours

TITLE DESCRIPTION : This topic discusses on the care of the client with diabetes mellitus and its common classifications. It also
touches on the endocrine system where the pancreas, which is responsible for insulin production, is located.
It talks about the signs and symptoms of diabetes mellitus, the complications the clients experience, the drugs
to be administered, the therapy and management of diabetes mellitus.
GENERAL OBJECTIVE: At the end of one hour and thirty minutes discussion using the various T-L Activities, the learners shall be able to gain additional
knowledge, enhance skills, and acquire positive attitude and values towards caring for clients with Diabetes Mellitus.

SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION

OBJECTIVES ACTIVITIES
Throughout the After One (1) hour
One (1) hour and and thirty (30)
thirty (30) minutes minutes of
teaching with the teaching with the
use of various T-L use of various T-L
activities, the activities, the
learners shall: learners were
able to:

1. discuss the I. Introduction 5 Socialized Shyrock, Harold. MD. 1. discussed the

overview of the mins discussion (2002). Modern Medical overview of the
topic briefly; The word diabetes is derived from the Greek word meaning Guide, Revised Edition. topic briefly
“going through” and Melilitus from the Latin word for “honey” or Philippines: Phillippine
“sweet.” Reports of the disorder dates back to the first century Publishing House. p.495.
AD wherein it characterizes the 3Ps. Polyuria, Polydipsia, and
Polyphagia. It was the discovery of insulin by Banting and Best Porth, Carol Mattson. et. al.
in 1922 that transformed the disease into a manageable chronic (2002).Pathophysiology
health problem. Concepts of Altered Health
States, 6th Edition. USA
Diabetes is a serious metabolic disorder , characterized by (Philadelpia) : Lippincott
defects in the body’s use of carbohydrates. It also includes the Williams and Wilkins. p.930.
disorder aside from carbohydrates, of proteins and fat
metabolism resulting from an imbalance between insulin Kee, Joyce LeFever, RN
availability and insulin need. MS., et. al. (1993)
Pharmacology: a Nursing
Process Approach, 2nd ed.
USA: WB Saunders

2. define at least II. Definition of terms 5 Socialized 2. define at least

five (5) out of 8 mins discussion five (5) related
related terms in A. Glucose: The simple sugar (monosaccharide) that serves www.emedicinehealth.com terms correctly
their own words; as the chief source of energy in the body. Glucose is the Crossword
principal sugar the body makes. The body makes glucose from Puzzle
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
proteins, fats and, in largest part, carbohydrates. Glucose is Price, Sylvia A. et al. A. Glucose: The
carried to each cell through the bloodstream. Cells, however, (2003). Pathophysiology simple sugar
cannot use glucose without the help of insulin. Clinical Concepts of (monosaccharide)
Disease Processes, 6th that serves as the
B. Hormone: a specific messenger molecule synthesized Edition. p.950. chief source of
and secreted by a group of specialized cells called an energy in the
endocrine gland. A chemical substance produced in the body www.wikepedia.com body.
that controls and regulates the activity of certain cells or organs. B. Glucagon:
Blackwell's Nursing hormone
C. Glucagon: hormone produced in alpha cells of Dictionary, 2nd ed.(2005). produced in alpha
pancreatic islets of langerhans. Causes breakdown of glycogen Blackwell Publishing Ltd. cells of pancreatic
into glucose, thus preventing blood sugar from falling too low p.179,286,289, 304, islets of
during fasting. 358,253 langerhans.
C. Insulin: A
D. Insulin: A natural hormone made by the pancreas that natural hormone
controls the level of the sugar glucose in the blood. Insulin made by the
permits cells to use glucose for energy. Cells cannot utilize pancreas that
glucose without insulin. controls the level
of the sugar
E. Metabolism – the sum of physical and chemical changes glucose in the
in the body by which nutrition is effected, It encompasses the blood.
total collection of chemical reactions in the body and reflects the D. Hypoglycemia:
ability of the body to capture and store energy derived from abnormally low
foods and to make that energy available in the appropriate form blood glucose
when needed. levels.
E. Hyperglycemia:
F. Hypoglycemia: abnormally low blood glucose levels. an excessive
amount of
G. Hyperglycemia: an excessive amount of glucose in the glucose in the
circulating blood. circulating blood.

H. Diabetes Mellitus: Diabetes mellitus (DM) is a set of

related diseases in which the body cannot regulate the amount
of sugar in the blood.
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
3. pinpoint the III. Anatomy and Physiology of the Endocrine System 5 Socialized
gland responsible mins discussion
for diabetes A. Endocrine System
mellitus correctly; Pin Me! Seeley, Rod R. et al.
The Endocrine System and Nervous System have similar Game (2005). Essentials of
regulatory functions. The nervous system sends electrical Anatomy and Physiology,
messages to control and coordinate the body while the 5th ed. New York: Mc-Graw-
endocrine system has a similar job, but uses chemicals to Hill Companies, Inc. pp. 272
“communicate”. These chemicals are known as hormones. – 296.

The glands in the endocrine system are ductless, which http://en.wikipedia.org/wiki/

means that their secretions (hormones) are released directly Endocrine_system
into the bloodstream and travel to elsewhere in the body to
target organs, upon which they act.

1. Glands of the Endocrine System

2. Functions of the Endocrine System

The main regulatory functions of the endocrine system

include:

a. Water balance – The endocrine system regulates

water balance by controlling the solute concentration of the
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
blood.

b. Uterine contractions and milk release - .regulates

uterine contractions during delivery of the newborn and
stimulates milk release from breasts in lactating females.

c. Growth, metabolism and tissue maturation –

regulates the growth of many tissues, such as bone and
muscle, and the rate of metabolism f many tissues which helps
maintain a normal body temperature and normal mental
functions.

d. Ion regulation – it regulates sodium, potassium and

calcium concentrations in the blood.

e. Heart rate and Blood pressure regulation – the

endocrine systems helps regulate the heart rate and blood
pressure and helps prepare the body or physical activity.

f. Immune system regulation - helps control the

reproduction and function of immune cells.

g. Reproductive functions control – controls the

development and the functions of the reproductive system in
males and females.

h. Blood glucose control – regulates blood glucose

levels and other nutrients levels in the blood.

4. differentiate the IV. Classification of Diabetes Mellitus 10 Socialized Waugh, Anne. et.al. (2002) 4. differentiate the
two types of mins Discussion Ross and Wilson. Anatomy two types of
Diabetes Mellitus A. Type 1 Diabetes: also known as IDDM or Insulin- and Physiology in Health Diabetes Mellitus
accurately in their dependent diabetes mellitus, occurs mainly in children and and Illness, 9th Edition. accurately in their
own words; young adults and the onset is usually sudden. The deficiency Elsevier Science Ltd. pp. own words;
234- 236.
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
or absence of insulin is due to the destruction or dysfunction of Shyrock, Harold. MD.p.497. Type I Diabetes is
beta cells by the cells of the immune system. The causes are also known as
unknown but there is a familial tendency, suggesting genetic Insulin-dependent
involvement. In many cases an autoimmune reaction has diabetes mellitus.
occurred in which antibodies to beta cells are present. As of
today, this type is not curable. Type II is the non
insulin-dependent
B. Type 2 Diabetes: this is the non-insulin dependent type Porth, Carol Mattson. et. al. diabetic mellitus.
or NIDDM that occurs later in life, the body has an adequate p. 936.
supply of insulin , but a defect has developed in the mechanism
by which insulin enables cells to make use of glucose. The www.emedicinehealth.com
pancreas secretes insulin, but the body is partially or completely
unable to use the insulin. This is sometimes referred to as
insulin resistance. The body tries to overcome this resistance
by secreting more and more insulin. People with insulin
resistance develop type 2 diabetes when they do not continue
to secrete enough insulin to cope with the higher demands.

5. enumerate 6 out V. Common Signs and Symptoms of Diabetes Mellitus 5 Lecture Porth, Carol Mattson. et. al. 5. Give 6 out 10
of the 10 signs and mins discussion p.936. signs and
symptoms of A. Polyuria: excessive urination. Another way the body tries symptoms of
Diabetes Mellitus to get rid of the extra sugar in the blood is to excrete it in the urine. Match Me! diabetes mellitus.
correctly ; This can also lead to dehydration because excreting the sugar carries Game
a large amount of water out of the body along with it. A. Polyuria
B. Polydipsia
B. Polydipsia: excessive thirst. The body encourages more C. Polyphagia
water consumption to dilute the high blood sugar back to normal www.emedicinehealth.com D. Weight loss
levels and to compensate for the water lost by excessive urination. E. Blurred Vision
F. Fatigue

C. Polyphagia: excessive hunger. One of the functions of

insulin is to stimulate hunger. Therefore, higher insulin levels lead to
increased hunger and eating. Despite increased caloric intake, the
person may gain very little weight and may even lose weight.
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
D. Unexplained Weight loss: People with diabetes are
unable to process many of the calories in the foods they eat.
Thus, they may lose weight even though they eat an apparently
appropriate or even excessive amount of food. Losing sugar
and water in the urine and the accompanying dehydration also
contributes to weight loss.

E. Blurred Vision: Blurred vision develops as the lens and

retina are exposed to hyperosmolar fluids or very high blood
glucose levels.

F. Fatigue: In diabetes, the body is inefficient and

sometimes unable to use glucose for fuel. The body switches
over to metabolizing fat, partially or completely, as a fuel
source. This process requires the body to use more energy.
The end result is feeling fatigued or constantly tired.

G. Paresthesias: is a sensation of tingling, pricking, or

numbness of a person's skin with no apparent long-term
physical effect. It is more generally known as the feeling of "pins
and needles" or of a limb being "asleep."

H. Infections: Certain infection syndromes, such as

frequent yeast infections of the genitals, skin infections, and
frequent urinary tract infections, may result from suppression of
the immune system by diabetes and by the presence of glucose
in the tissues, which allows bacteria to grow well. They can also
be an indicator of poor blood sugar control in a person known to
have diabetes.

I. Poor wound healing: High blood sugar levels prevent

white blood cells, which are important in defending the body
against bacteria and also in cleaning up dead tissue and cells,
from functioning normally.
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
6. classify the VI. Complications of Diabetes Mellitus 10 Socialized 6. Give at least
different mins discussion one two (2)
complications of A. Acute complications of
Diabetes Mellitus diabetes mellitus
appropriately; 1. Diabetic Ketoacidosis: diabetic ketoacidosis occurs www.wikepedia.com and classify;
when ketone production by the liver exceeds cellular use and
renal excretion. The most serious complication of type 1 Waugh, Anne. et.al. p.235. A. Hypoglycemia:
diabetes. This develops due to increased insulin requirement or acute
increased resistance to insulin due to some added stress such B. Diabetic
as pregnancy, microbial infection, infarction, cerebrovascular neuropathy:
accident. Severe hyperglycemia is developed. chronic
a. Management: This can be treated by restoring www.diabetesmellitus-
water and electrolyte balance. IV therapy by means of information.com
unmodified insulin to allow glucose utilization and antibiotics to
overcome infections.

2. Hyperglycemic Hypersmolar Nonketotic Syndrome:

occurs most often in older individuals with type 2 diabetes.
Because of relative but not absolute insulin deficiency,
hyperglycemia develops without ketosis. It is caused by severe
dehydration due to the continuous removal of sugar in urine
known as hyperglycaemic diuresis. The patient may become
unconscious and may die if the condition is not quickly
reversed. The major difference between HHNK and DKA is the
lack of ketosis with HHNK.

a. Management: The treatment of HHNK consists of

rehydration, electrolyte replacement, IV of large amount of
bicarbonates and half a dose of regular insulin.

3. Hypoglycemia: also known as insulin reaction or

insulin shock which is mainly a complication of insulin therapy.
Insulin-dependent diabetic patients may occasionally receive
insulin in amounts larger than that needed to maintain normal
glucose levels with resulting hypoglycaemia.
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
Management: Administering quickly absorbed
glucose source such as softdrinks, orange juice, pinch of cake
frosting, foods rich in vitamins C, E and B complex and glucose
containing tablets. IM of glucagon.

B. Chronic

1. Diabetic nephropathy- kidney damage from diabetes.

The diseased small blood vessels in the kidney. As the disease
progress, the kidney stops filtering and cleaning the blood
leading to accumulation of toxic waste products in blood.
a. Management: Controlling high blood pressure
,dialysis.

2. Diabetic retinopathy: diabetic retinopathy is the

leading cause of blindness and is cause by an underlying
microangiopathy
a. Management: Controlling high blood pressure ,
blood sugar level, eating raw natural foods, rich in vitamin A
foods and exercise of the eyes.

3. Diabetic neuropathy: A family of nerve disorders

caused by diabetes. It involves temporary or permanent
damage to nerve tissues. Diabetic neuropathies cause
numbness and sometimes pain and weakness in the hands,
arms, feet, and legs. Neurologic problems in diabetes may
occur in every organ system, including the digestive tract, heart,
and genitalia. People with diabetes can develop nerve problems
at any time, but the longer a person has diabetes, the greater is
the risk.
a. Management: Controlling, blood sugar level,
analgesics, regular foot examination, oral and topical
medications.
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
7. name at least VII. Medical Management for Diabetes Mellitus 20 Socialized- Kee, Joyce LeFever, RN 7. Name at least
one (1) drug and mins discussion MS., et. al. p. 635-637. one (1) drug and
one (1) laboratory A. Drugs one (1) laboratory
test in the medical test in the medical
management of 1. Insulin: Regular and NPH insulin; can be classified as management of
diabetes mellitus intermediate and long acting insulin. (2008) Nursing 2008 Drug diabetes mellitus;
concisely; Handbook, 28th Edition.
a. Action: Increases glucose transport across muscle New York: Lippincott A. Sulfonylureas
and fat cell membrane to reduce glucose level. Helps convert Williams & Wilkins. p. 795 – (Dymelor)
glucose to glycogen; 828.
B. Benedicts
b. Indication and dosage: This is for type 1 diabetes Test
mellitus Many people with type 2 diabetes eventually require
insulin therapy.varies according to the clients’ blood sugar.

c. Side effects: hunger, tremors, weakness,

headache, lethargy, fatigue, redness, irritation or swelling at
insulin injection site, flushing, confusion, agitation.

d. Adverse effects: urticaria, tachycardia,

palpitations, hypoglycaemic reaction, rebound hyperglycemia
(somogi effect), lipodystrophy, life threatening adverse
reactions are shock and anaphylaxis.

• 2. Sulfonylureas: Dymelor

• a. Action: These drugs stimulate the pancreas to

make more insulin. This increases the insulin cell receptors,
thus increasing the cells’ ability to bind insulin for glucose
metabolism.

b. Indication and dosage

The sulfonylureas are used in the treatment of type
2 diabetes or NIDDM. metabolism. P.O.: 250 to 1,000mg daily
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
in 1 or 2 divided doses. Maximum dosage is 1.5 grams daily
and maintenance is 1000 mg daily.

c. Side effects: Nausea, vomiting, diarrhea, rash,

pruritis, headache and photosensitivity.

d. Adverse effects: Hypoglycemic reaction, life

threatening adverse effects are aplastic anemia, leukopenia,
thrombocytopenia.

3. Nonsulfonylureas: expanding knowledge of glucose

metabolism has revealed new mechanisms for the
management of NIDDM or type 2 diabetes. These new drugs,
metformin and acarbose, use different methods to control
serum glucose levels following a meal. Unlike the sulfonylureas,
which enhance insulin release.

Metformin (Glucophage)

a. Indication and dosage: for NIDDM when no

response to Sulfonylureas. Take with meals. May be
combined with sulfonylurea (dose reduction of metformin would
be needed). PO: Initial:500. mg, daily b.i.d.; increase dose
gradually; max:2500 mg/daily.

b. Adverse effects : diarrhea, nausea, vomiting,

abdominal bloating, flatulence, anorexia, taste perversion,
anemia, lactic acidosis, hypoglycaemia.

4. Hypoglycemic

a. Action: Raises glucose level by promoting catalytic

depolymerization of hepatic glycogen to glucose. Relaxes the
smooth muscle of the stomach, duodenum, small bowel and
colon.
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
b. Indication and dosage: Adults and children who
weigh more than 20 kg or 44 lbs.: 1 mg IV , IM, or
subcutaneously.
Children who weigh 20 kg or less: .5 mg or 20 to 30
mcg/kg. IV, IM, or subcutaneously: maximum dose 1 mg. May
repeat in 15 minutes, if needed. IV glucose must be given if
patient fails to respond.

b. Adverse effects : nausea, vomiting, bronchospasm,

respiratory distress, hypersensitivity reactions.

d. Nursing considerations: Use drug only in

emergency situations. Monitor glucose level before, during, and
after administration. Alert: arouse patient from coma as quickly
as possible, and give additional carbohydrates orally to prevent
hypoglycaemic reactions.

B. Laboratory and Diagnostic Tests

1. Blood Tests: Blood glucose measurements are used

in both diagnosis and management of diabetes.

a. Fasting Blood Glucose Test- the fasting blood

glucose has been suggested as the preferred diagnostic test
because of ease of administration, convenience, patient
acceptability, and cost. Glucose levels are measured after food
has been withheld for 8-12 hours. If the fasting plasma glucose
level is higher than 126 mg/dl, on two occasions diabetes is
diagnosed. A fasting plasma glucose level below 110 mg/dl, is
normal. A level between 110 mg/dl to 126 mg/dl, is significant
and is defined as impaired fasting glucose.

b. Random Blood Glucose Test: a random blood

glucose is one that is done without regard to meals or time of
day random blood glucose concentration that is unequivalent
elevated (>200 mg/dl,) in the presence of classic symptoms of
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
diabetes such as polydipsia, polyphagia, polyuria, and blurred
vision is diagnostic of diabetes mellitus of any age

c. Glucose Tolerance Test: the oral glucose tolerance

test ensures the body’s ability to store glucose by removing
from the blood. In men and women, the test measures the
plasma glucose response to 75 g of concentrated glucosylution
at selected intervals, usually 1 hour to 2 hours. Persons with
diabetes lacks the ability to respond to an increase in blood
glucose by releasing adequate insulin to facilitate storage,
blood glucose levels rise above the served in normal people
and remain elevated for long periods.

d. Capillary Blood Tests and Self-Monitoring of

Capillary: These methods use a drop of capillary blood
obtained by pricking the finger or forearm with a special needle
or lancet. Small trigger devices make use of the lancet usually
painless. The drop of capillary blood is placed on absorbed by a
reagent strip, and glucose levels are defined electronically
using a glucose meter

e. Glycosylated Hemoglobin Test: is a blood test that

reflects average blood glucose levels over a period of
approximately 2 to 3 months.

2. Urine Tests

a. Benedicts test :determines the presence of sugar

in the body.
b. Urine test for ketones: a urine test to determine if
your blood glucose is dangerously high and if you are producing
substances called ketones. Ketones are the by-product of the
fat burning process that occurs in the absence of insulin. When
a person with diabetes has a high blood glucose, if there is not
enough insulin around (type 1 diabetes) or if their body is
unable to utilize the insulin properly (type 2 diabetes) and break
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
down glucose, the body turns to fat stores to create energy for
the cells. While ketones can be a source of energy for many
cells, they can be toxic in large amounts and cause a life-
threatening emergency condition called ketoacidosis.

8. itemize the VIII. Nursing Care Management for Patients with Diabetes 20 Socialized 8. Give at least 3
Nursing Care Mellitus mins discussion the Nursing Care
Management for Management for
Diabetic patients A. Assessment Diabetic patients?
thoroughly;
1. Vital Signs
2. Client’s level of knowledge
3. Lab results
4. Blood Sugar
5. Skin
6. Blood Pressure
7. Eyesight
8. Urine Output
9. Activity
10. Diet
11. Weight
12. Fluid Intake

B. Diagnoses

1. Self-care Deficit: potential self-care deficit related to

physical impairments or social factors
2. High Risk for Injury
3.Altered Nutrition: imbalanced nutrition related to
imbalance of insulin, food, and physical activity
4. Risk for Infection
5. Risk for Impaired Tissue Integrity
6. Knowledge Deficit: deficient knowledge about diabetes
self-care skills/information
7. Risk for Impaired Adjustment
8. Risk for Disturbed Sensory Perception
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
9.Compromised Family Coping
10. Anxiety- related to loss of control, fear of inability to
manage diabetes, misinformation related to diabetes, fear of
diabetes complications
11.Risk for Fluid Volume Deficit- related to polyuria and
dehydration

C. Interventions

1. Dependent Smeltzer, S., Bare, B.

(2004). Medical Surgical
a. Insulin Therapy: insulin regimens vary from 1 or Nursing, Vol. 2, 10th ed.
more injections per day. Usually there is a combination of a New York: Lippincott
short-acting insulin and a longer-acting insulin. The goal of all Williams & Wilkins. pp.
but the simplest, one injection insulin regimens is to mimic this 1163.
normal pattern of insulin secretion in response to food intake
and activity patterns. In people without diabetes, insulin
secretion compensates for varying amounts of food intake and
exercise. In contrast, individuals with diabetes are unable to
secrete sufficient quantity of insulin to maintain their blood
glucose level. As a consequence, blood glucose rise to high
levels in response to meals, and levels are high in the fasting
state. Patients with severe insulin insufficiency require
injections of insulin in addition to a meal plan.

b. Medications – the use of antidiabetics help patients

blood glucose level return to its normal balanced state.

2. Independent

a. Exercise and Limitations in Activity: exercise

appears to facilitate the transport of glucose into cells and to
increase sensitivity to insulin. However, patients with diabetes
complications should limit their activity and is advised to consult
the doctor before taking up an exercise regimen or doing any
activity.
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
b. Diabetes education: patients with diabetes mellitus
can lead to a relatively normal life if they are well informed
about their disease and its management. Patients can learn to
administer their own insulin, monitor their blood glucose level,
and use this information to regulate their insulin dosage and
plan their diet and exercise to minimize hyperglycemia and
hypoglycemia.

3. Collaborative

a. Meal Planning - the meal planning of diabetic

patients is aimed at controlling the number of calories and the
amount of carbohydrates ingested daily. The recommended
number of calories varies, depending on the need for
maintaining, reducing, or increasing body weight. The meal Price, Sylvia A. p. 946.
plan should be developed in consultation with a registered
dietitian and based on a patient’s diet history, food preferences,
lifestyle, cultural background, and physical activity.

b. Glucose Monitoring – various self-monitoring of

blood glucose (SMBG) methods are available. Most involved
obtaining a drop of blood from fingertip, applying the blood to a
special reagent strip, and allowing the blood to stay on the strip
for the amount of time specified by the manufacturer. The meter
gives a digital readout of the blood glucose value.

c. Planning of Care - must be done with the patient to

fit his lifestyle. Self-care at home should include diet, exercise,
alcohol use, smoking, self monitoring.

9. Do you have
9. evaluate the IX. Open Forum 5 Question any questions,
presentation mins and Answer clarifications and
objectively portion comments?
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
X. Quiz 5 Pen and 10. get a
mins paper quiz seventy-five
percent (75%) out
of one hundred
percent (100%)
level of
competency.

1. It is a serious
metabolic
disorder ,
characterized by
defects in the
body’s use of
carbohydrates.
(Diabetes
Mellitus)

2. Give the 3 P’s

of diabetes
mellitus
(Polyuria,
polydipsia,
Polyphagia)

3-6. Give and

Differentiate the
two common
types of diabetes
mellitus.
(Type I – insulin
dependent and
Type 2 – non-
insulin
dependent).
 SPECIFIC CONTENT T.A. T–L REFERENCES EVALUATION
OBJECTIVES ACTIVITIES
7. Is also known
as insulin reaction
or insulin shock
which is mainly a
complication of
insulin therapy.
(Hypoglycemia)

8. What is the
gland in the
endocrine system
that is responsible
for insulin
production?
(pancreas)

9 -10. What are

the two hormones
produced by this
gland?

(insulin and
glucagons)
BIBLIOGRAPHY:

BOOKS:

(2005). Blackwell's Nursing Dictionary, 2nd ed. Blackwell Publishing Ltd.

(2008) Nursing 2008 Drug Handbook, 28th Edition. New York: Lippincott Williams & Wilkins. p. 795 – 828.

Seeley, Rod R. et al. (2005). Essentials of Anatomy and Physiology, 5th ed. New York: Mc-Graw-Hill Companies, Inc.

Kee, Joyce LeFever, RN MS., et. al. (1993). Pharmacology: a Nursing Process Approach, 2nd ed. USA: WB Saunders Company.

Price, Sylvia A. et al. (2003). Pathophysiology Clinical Concepts of Disease Processes, 6th Edition.

Porth, Carol Mattson. et. al. (2002). Pathophysiology Concepts of Altered Health States, 6th Edition. USA (Philadelpia) : Lippincott Williams and Wilkins.

Shyrock, Harold. MD. (2002). Modern Medical Guide, Revised Edition. Philippines: Phillippine Publishing House.

Smeltzer, S., Bare, B. (2004). Medical Surgical Nursing, Vol. 2, 10th ed. New York: Lippincott Williams & Wilkins. pp. 1163.

Waugh, Anne. et.al. (2002) Ross and Wilson. Anatomy and Physiology in Health and Illness, 9th Edition. Elsevier Science Ltd.

INTERNET SOURCES:

http://www.diabetesmellitus-information.com

http://www.emedicinehealth.com

http://www.wikipedia.com