Nurse Teachings on Diabetes

Reference: https://www.homehealthpatienteducation.com

Home Health Patient Education offers more than 7200 nurse teachings and OASIS assessment templates for Start of Care, Resumption of Care, Recertification, Discharge, Wound Care and 60 Day Summary. These nurse teachings and OASIS assessment tools are very useful for home health nurses to save time on skilled nursing documentation.

We are presenting here some sample nurse teachings on diabetes offered by Home Health Patient Education.

Nurse Teachings on Diabetes: How to take Insulin

Patient/caregiver was instructed upon how to take insulin as follows:

1. Insulin is administered into the less sensitive layer of fatty tissue, just underneath the skin (subcutaneous fat). Injecting insulin into the fat layer beneath the skin can help absorption of insulin into the blood stream at a desired and consistent rate.
2. Subcutaneous fat is richly available in various body sites, such as, abdomen, upper & outer arms, hips, and upper & outer thighs. This makes them preferred sites for insulin administration.
3. Insulin can be injected into the subcutaneous fat available at various body sites by using insulin syringe, insulin pen, or even insulin pump infusion. For the most part, diabetic individuals use regular insulin syringe or insulin pen for insulin administration. Insulin pump is a rather newer means of insulin administration.
4. Usually, once opened or used, insulin vials or pens will be good for use for a time period ranging about 1 – 2 months. The expiration date on insulins can vary depending on the type of insulin being used. Keep a close watch on the expiration date marked on the insulin vial or insulin pen before each insulin administration.
5. If you are recommended sliding scale insulin, observe compliance with the blood sugar check to decide on the dose of insulin to be loaded and administered. Do not do a guess work on what your blood sugar numbers could be, as it can lead to the risk for overdosing or underdosing of insulin.
6. Administering rapid acting insulins, such as, Apidra, Humalog, Novolog, can require eating a meal or snack in about 30 minutes of insulin administration. This time interval may slightly vary between individuals, depending on factors such as, how well the blood sugars are usually managed in the individual, type of insulin administered (not all insulins act at the same pace), site at which insulin is administered (not all sites absorb insulin at the same pace), and how active the individual is during the time interval between insulin administration and meal/snack consumption (activity and physical exercise burn the sugar and change the requirements for insulin and calorie consumption on the meal). Check with your physician on what this interval for you could be. As these insulins act fast and lower the blood sugar levels in a short span, compliance with eating a meal or snack in about 30 minutes of administration can help prevent dangerous hypoglycemic episodes. So, diabetic individuals receiving rapid acting insulins must have their meal or snack handy before the shot is administered, to be consumed at the recommended time.
7. Load the appropriate/recommended dose of insulin into the insulin syringe or pen. Diabetic individuals with compromised vision can double check with their caregivers regarding the dose of insulin loaded into the syringe. This helps to avoid any incidents of insulin underdosing or overdosing.
8. It is a good practice for all diabetic individuals using regular insulin syringe or insulin pen to change the needle each time insulin is administered. Check with your physician on their recommendation for needle change. Changing the needle on every insulin administration can help reduce the risk for development of lipodystrophy or hardened lumps in the subcutaneous fat. Lipodystrophic changes in the fatty tissue can inhibit fair insulin absorption and thus, compromise therapeutic benefit of the insulin intake. Individuals using insulin pump add new insulin to the pump and change the infusion set every 2 – 3 days, depending on the recommendation made by your physician.
9. Diabetic individuals must maintain their personal set of glucometer, lancing device, lancets, insulin syringes/pens, and needles. Sharing of needles and lancets between friends and family can increase risk for transmission of blood borne pathogens. Sharing the glucometer between diabetic patients can pose difficulty with tracking the history of an individual’s blood sugar readings, as readings from many different individuals are stored on the same machine.
10. Follow the guidelines for insulin injection site rotation. Choosing a new site for every insulin administration by moving at least one finger breadth from the site of previous insulin administration can immensely help prevent development of lipodystrophy. Moving one finger breadth away from previous injection site for every insulin administration and limiting to one body part every week can offer enough sites for insulin administration. Do not use the same site for insulin administration more than once in every four weeks. Make sure the site chosen for insulin administration does not have any hard lumpy mass or scar tissue, which can interfere with fair insulin absorption and thus, compromise therapeutic benefit of the insulin intake.
11. Prepare the skin at the intended site of injection by wiping the site with an alcohol swab thoroughly for 10 seconds and let the site air dry.
12. Insert the needle at 90-degree angle to the skin surface straight down and inject all the loaded dose of insulin. Lean individuals with poor subcutaneous fat can pinch the skin and insert the needle at a 45-degree angle and administer all the loaded dose of insulin.
13. Discard all the lancets and needles appropriately into the sharps container.