LESSON PLAN

ON
DIABETES MELLITUS
SUBJECT:- MEDICAL SURGICAL NURSING

SUBMITTED BY:- poulami Chandra

IDENTIFICATION DATA
Name of the teacher : poulami Chandra
Subject: Medical-Surgical Nursing1

Topic: Diabetes Mellitus

Group: GNM 2nd year

Venue: Classroom

Teaching method : Lecture cum discussion

A.V. aids used: Charts, blackboard

Previous knowledge: Little

GENERAL OBJECTIVES:
After the class stu will be able to develop the knowledge about- the complete topic of the diabetes
mellitus.
 SPECIFIC OBJECTIVES:
After the classes students will be able to tell about the:
- What it is diabetes mellitus

-Types of diabetes mellitus

-Diagnostic evaluation

-Clinical manifestations

-Management of DM

-Home care for DM patiet

SR. TIME SPECIFIC CONTENT TEACHING- EVALUATION
NO. OBJECTIVE LEARNING
ACTIVITIES
1. 5min To define DEFINITION: Lecture cum Group
the diabetes Diabetes mellitus is a chronic metabolic disorder of discussion understands
mellitus carbohydrate, protein and fat resulting from insulin well
deficiency or abnormality in the use of insulin.
OR
Diabetes mellitus is a metabolic disorder
characterized by hyperglycemia and results from
defective insulin production, secretion or utilization.

To explain TYPES OF DM: Lecture cum

the types of  TYPE-I (IDDM) discussion
DM  TYPE-II (NIDDM)
 GESTATIONAL DM
 DM DUE TO OTHER REASONS

2. 5min TYPE-I DM:

To explain  It occurs due to absolute or complete deficiency Lecture cum
the type-I of insulin. discussion Group
DM  There is no endogenous production of insulin, understands
so body depends on the exogenous supply of well
insulin, that’s why it is known as insulin
dependent diabetes mellitus.
 Type-1 is mainly occurs in children's or <30yrs
of age, so it is also known as juvenile diabetes
mellitus
  Only 5-10% of all diabetic cases have type-I
DM

CAUSES OF TYPE-I DM
 Autoimmune destruction of b-cells of the
pancreas
 Carcinoma of pancreas
3. 5min  Removal of pancreas due to any infection etc.
Lecture cum
To explain discussion
type-II DM TYPE-II DM: Patient
 In this type there is relative or partial deficiency understands
of insulin. the type-II DM
 There is endogenous production of insulin but
in small amount, so body doesn't depend on
exogenous supply of insulin, and is called as
non-insulin dependent diabetes mellitus.
 Type-II DM is mainly occurs in adults or
>30yrs of age, so it is also known as adult onset
diabetes mellitus.
 Approximately 90-95% of all diabetic cases
have type-II DM

CAUSES OF TYPE-II DM:

 Decreased production of insulin
4. 5min  Resistance of the body against the insulin
 Increased demand of insulin by the body Lecture cum
To explain discussion
the risk RISK FACTORS: Group
factors of  Race understands
DM  Obesity the risk factors
 History of CVD
 HTN
 Physical inactivity
 Family history
 Polycystic ovary
5. 10mi  Gestational diabetes
n Lecture cum
CLINICAL MANIFESTATION:- discussion
To explain  Polyuria Patient
the signs  Polydipsia understands
and  Polyphagia the signs and
symptoms  Weight loss symptoms of
of  Nausea/ vomiting DM
 Weakness
 Fatigue
 Increase blood sugar level
 Recurrent infection
 Prolonged wound healing
 DIAGNOSTIC EVALUATION:
 Fasting plasma glucose level
6.  Oral glucose tolerance test
3min  Urinalysis:-Glycosuria Lecture cum Patient
-Ketone bodies discussion understands
MANAGEMENT OF DM: the diagnostic
 DIET evaluation
7. To explain  EXERCISE
10mi the  ORAL HYPOGLYCEMIC AGENTS Lecture cum Understands
n diagnostic  INSULIN THERAPY discussion the
evaluation management
of DM of DM in
1. DIETARY MANAGEMENT: detail.
To explain  Follow individualized meal plan and snacks as
the adviced
managemen  Balanced diabetic diet-50% CHO, 30% fats and
t of DM in 20% other vitamins and minerals
detail.  Diet should be based on patients age,
occupation and activity
 Patient must have adequate CHO intake to
correspond to the time when insulin is more
effective
  Routine blood glucose testing before each meal
and bedtime is necessary during initial control,
unstable patient and during illness
 Do not skip meals
 Measure foods accurately, do not estimate
 Less added fat, fewer fatty foods and low
cholesterol
 Meal should include more fibre and starch or
fewer simple and refined sugars
 Avoid concentrated sweets, high in sugars
(jellies jams cakes)
 If taking insulin, eat extra food before periods
of exercise
 Avoid periods of fasting
 Keep weight at normal level as much as
possible.
EXERCISE:
 Promotes use of CHO and enhances action of
insulin.
 Decrease blood glucose level
 Decrease eed for insulin
 Perform exercise after meal to ensure adequate
level of blood glucose.
 Excessive or unplanned exercise may trigger
hypoglycemia.
  Take insulin or food before active exercise.
 Never do exercise without insulin

HEALTH HABITS:
 Teach patient about foot care
 Teach the patient to manage the minor ailment
(cold, flu etc.) or hypoglycemia and
hyperglycemia.
 Maintain fluid intake
 Increase frequency of blood testing and urine
testing
 Help the patient identify the stressful situations
in life style that help in good dietary control
 Encourage for good and proper daily hygiene
8.  Advice for regular eyes examination Lecture cum
 Teach aggressive care for minor cuts or discussion
10mi injuries. Patient
n understandsab
ADMINISTRATION OF INSULIN OR OTHER out taking of
HYPOGLYCEMIC AGENTS: insulin and
 Insulin in current use should be kept at room other
To explain temperature and all others in refrigerator medicines
the about  Avoid injecting cold insulin, leads to tissue
taking of reaction
insulin and  Roll insulin vial to mix, do not shake and
other remove air bubbles from the syringe
medicines  Press (do not rub) the site after injection
(rubbing may alter the rate of absorption
 Avoid smoking for 30min after injection.
 Insulin in current use can be put at room
temperature and all others should be kept in
refrigerator
 Avoid injecting cold insulin because it can lead
to tissue reaction
 Roll on the insulin vial, don’t shake.
 Press the site after injection, do not rub.
(rubbing may alter the rate of absorption).
 Avoid smoking for 30 min. after injection.

PREVENTING HYPOGLYCEMIC
REACTIONS DUE TO INSULIN:
 Hypoglycemia may be prevented by
maintaining regular exercise, diet and insulin
 Early symptoms of hypoglycemia should be
recognized and treated
 Carry all times some of simple sugars such as
candy, orange juice etc.
 Extra food should be taken before unusual
physical activity or prolonged exercise
 Between meal and bedtime snacks may be
 necessary to maintain a normal blood glucose
level
 Maintain personal hygiene and skin care is also
most essential to prevent any cracking etc.
COMPLICATIONS OF DM:
 HYPOGLYCEMIA
 HYPERGLYCEMIA
9.  DIABETIC KETOACIDOSIS Lecture cum
 INSULIN SHOCK discussion

7min Ask for any

SUMMARY: query.
Now I summarize the topic diabetes mellitus
 diabetes mellitus what it is
 types of diabetes mellitus
To  diagnostic evaluation
summarize  clinical manifestations
the topic  management of DM
 home care for DM patients