Nursing Diagnosis: Anxiety related to threat to self-concept, changes in health status resulting in apprehension and fear consequences of chronic disorder. Other possible diagnoses: Knowledge deficit related to lack of exposure to new diagnosis of diabetes mellitus resulting in possible noncomplicance and complications; High risk for impaired skin integrity related to altered circulation and sensation resulting in infection, poor healing; High risk for activity intolerance related to inexperience with exercise/activity requirements resulting in insulin-diet-activity imbalance and hyperglycemia; and High risk for altered nutrition: less than body requirements related to inability to digest foods resulting in increased blood glucose and urinary ketones caused by insulin-diet-activity imbalance; Ineffective peripheral tissue Perfusion related to decreased arterial flow.
Nursing care plan Expected Outcomes: Anxiety within manageable levels evidence by verbalization that anxiety is decreasing, relaxed muscles and facial expression, ability to relax and sleep.
Nursing care plan Intervention and Rationale:
I. Assess for:
- Levels of anxiety, stated reasons for apprehension - anxiety may range from mild to severe and affects ability to comprehend instruction necessary for self-care.
- Verbal and nonverbal clues of anxiety, precipitating factors and corresponding reactions - may not be able to communicate feelings but reveals physical response.
- Responses to information and treatments - these may increase or decrease anxiety.
- Personal resources to cope with stress, anxiety - support systems and personal strengths assist to reduce anxiety
- Time to remain with patient and listen to expression of concerns and fears - allows for venting of feelings, which reduces anxiety.
- Positive response to reasonable demands and requests without experiencing anger or disappointment - allows patient to control his/her environment.
- Environment that avoids anxiety-producing situations - stimuli increase anxiety.
- Relaxation techniques, guided imagery, diversionary activities - allows control over anxiety-producing situations.
- Cause, treatment, and expectations, possible effect on life-style and role - fear of unknown results in higher anxiety levels.
- The treatment includes diet, medication, activity, and will allow for return to living arrangement and work life with modifications - provides general information for future life-style changes.