Running head: CARE PLAN

Care Plan
June 26, 2015

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Care Plan

Assessment: Client is a 9 yr. old girl diagnosed with Type 1 diabetes 5 months ago. She
is expressing interest in preparing and administering her insulin. Client is able to draw up the
insulin into the syringe, but needs to be taught how to administer the injection.
Initial assessment of patient includes
Subjective:
Family history, diabetic history
Past and present health issues/illness
Social history, level of exercise, type of diet
Knowledge of the disease
Knowledge of insulin injections type and amount
Objective:
Medication current and historical
Height, weight, BMI
Vital signs Blood pressure, pulse, respirations, temperature
Examination of peripheral pulses
Examination of feet
Examination of eyes
Laboratory values

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Diagnosis: Readiness for enhanced knowledge: expresses an interest in learning.

Knowledge is sufficient for meeting health care goals and can be strengthened with teaching.
(Ladwig & Ackley, 2014, p. 518)

Plan: Client will meet personal health-related goals. This is a long term goal with
continued practice. Client will learn to continue to monitor health and adapt daily lifestyle to
accommodate continued health goals associated with Type 1 diabetes.
Client will explain how to incorporate the new health regimen (insulin injection) into her
lifestyle by the end of day 5 teaching.
Client will be able to demonstrate insulin preparation and administration by end of day 5.
Demonstrate technique for drawing up and administering insulin. Client will be able to
perform by day 5.
Identify age appropriate injection sites. Client will be able to identify appropriate sites
for insulin administration.

Nursing Interventions:
Determine the level of understanding client has about her disease. Explain the
importance of health management concerning diabetes, and answer any questions the client may
have. Consider the use of web browsing and computer programs to provide available
information. Computer programs aimed at Meghans specific age group are an excellent source
of information. Lilly diabetes has partnered with Disney to provide educational support to
children and caregivers diagnosed with diabetes. (http://www.lillydiabetes.com/about-lilly.aspx)

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They have camps and educational products, books, computer programs, etc., geared toward
applicable age categories.

Incorporate a step by step chart for Meghan to follow; Starting with how to test her blood
sugar with a monitoring device. Chart the time of day Meghan should test her blood sugar and
when insulin injections are to be done. This will ensure Meghan stays within the guidelines for
her insulin injections.

Many people practice injections on dolls. Draw the proper injection sites on the doll and
have Meghan practice injecting air into the doll body. Meghan could then practice drawing up
sterile water and injecting into her mother. (Chase & Suffaleta, n.d.)

Develop a chart demonstrating tools that need to be gathered, alcohol swabs, insulin, and
syringe; and a checklist that needs to be followed. This will ensure Meghan follows specific
instructions in a step by step technique.
Step 1 Gather supplies

Insulin, syringe, alchohol swabs

Log book with current tests and insulin dosage.

Step 2 Technique

Know correct dosage

Wipe tops of bottles with alcohol swabs

Vent bottles

Draw up clear insulin, remove air bubbles

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Mix the cloudy vial gently

Draw up the NPH insulin into the syringe

Give injection.

Meghan can follow the step by step plan. For a child Meghans age diagrams along with
wording are a good source of information.
Evaluation:
Assess client for proper technique when preparing and administering insulin.
Client will perform correct preparation and administration of insulin by the end of day 5
teaching. Client will perform these tasks under the nurses watch to ensure correct technique is
followed.
Client feels confident in preparing and administering the insulin dose.

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References

Chase, P., & Suffaleta, C. (n.d.). Drawing up and giving insulin. Understanding Diabetes.
Retrieved from
http://www.ucdenver.edu/academics/colleges/medicalschool/centers/BarbaraDavis/Docu
ments/book-understandingdiabetes/ud09.pdf
Ladwig, G. B., & Ackley, B. J. (2014). Guide to nursing diagnosis (4th ed.). Retrieved from