FOCUS DATA ACTION RESPONSE
Risk for Subjective 1. Assess and record dietary pattern and caloric intake After 8 hours of
Altered cue: using a 24-hour recall. duty the
Nutrition: patient
Less Than "Pansin ko na R: To help in evaluating client’s understanding verbalized
medjo and/or compliance to a strict dietary regimen.
Body understanding
Requireme nawawalan of individual
ako ng gana 2. Assess understanding of the effect of stress on
nts diabetes. Teach patient about stress management and treatment
kumain" as regimen and
verbalized relaxation measures.
the need for
R: It is proven that stress can increase serum blood frequent self-
glucose levels, creating variations in insulin monitoring.
Objective cue: requirements.
-dry mouth 3. Weigh the client every prenatal visit. Encourage the
client to periodically monitor weight at home
-weak
between visits.
-pale skin
R: Weight gain serves as an indicator for determining
-Vital signs: caloric adjustments
T: 36.0 C 4. Observe for the presence of nausea and vomiting,
especially during the first trimester.
RR:16 cpm
R: Nausea and vomiting may be brought about by a
PR: 86 bpm deficiency in carbohydrates, which may result in the
metabolism of fats and development of ketosis.
BP: 100/80
mmHhg 5. Teach the importance of regularity of meals and
snacks (e.g., three meals or 4 snacks) when taking
insulin.
Eating very frequent small meals improves insulin
function.
6. Teach and demonstrate client to monitor sugar
using a finger-stick method.
R: Insulin needs for the day can be adjusted based on
periodic serum glucose readings. Note: Values
obtained by reflectance meters may be 10-15%
lower/higher than plasma levels.
7. Provide information regarding any required
changes in diabetic management; e.g., use of human
insulin only, changing from oral diabetic drugs to
insulin, self-monitoring of serum blood glucose levels
at least twice a day and reducing/changing time for
ingesting carbohydrates.
R: Metabolism and maternal/fetal needs fluctuates
during the gestation period, requiring close
monitoring and adaptation. Because pregnancy
provides severe morning glucose intolerance, the first
meal of the day should be small, with minimal
8. Instruct client to treat symptomatic hypoglycemia,
if it occurs, with an 8-oz glass of milk and to repeat in
15 minutes if serum glucose levels remain below 70
mg/dl.
R: Using plenty of simple carbohydrates to treat
hypoglycemia causes serum glucose values to elevate.
9. Discuss the type of insulin, dosage and schedule
(e.g., usually 4 times/day: 7:30am-NPH; 10am-regular;
4pm-NPH; 6pm-regular).
R: Division of insulin dosage considers basal maternal
needs and mealtime insulin-to-food ratio and allows
more freedom in meal-scheduling.
10. Adjust diet or insulin regimen to meet individual
needs.
R: Prenatal metabolic needs change throughout the
trimesters, and adjustment is determined by weight
gain and laboratory test results.
11. Coordinate multispecialty care conference as
appropriate.
R: Provides an opportunity to review the management
of both pregnancy and diabetic condition, and to plan
for special needs during intrapartum and postpartum
periods.
12. Refer to a registered dietician to individualize diet
and counsel regarding dietary questions.
R: Diet-specific to the individual is necessary to
maintain normoglycemia and to obtained desired
weight gain.