I was diagnosed as type 2 last year, my weight was kg, my doctor wanted me to start insulin and encouraged a diet with an alarming amount of carbs, so I went to boots and bought a blood sugar tester that I used every day, and started on a Atkins type diet. So lots of meats and fish, eggs etc. And to be honest when you cut out carbs you can eat a lot of really tasty things that help lose weight a fry up without the beans is fine, lamb chops and kebabs without the bread etc.
The only downside is because of the extra fat intake I need to be doing daily cardio. I really believe doctors are offered too many incentives by drug companies and tend to love writing prescriptions instead of encouraging a positive change in our lifestyles. I am wondering what the credentials of this nurse are. The qualifications for school nurses vary from state to state, and some states have no specific requirements for school nurses. In many states the school nurse is responsible for multiple buildings and if there is someone in the health office it may be unlicensed assistive personnel.
Some states have a required state certification for school nurses generally connected to teacher certification.
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That requires passing a standardized exam. To earn the NCSN credential, which reflects competence and professionalism, a registered nurse must demonstrate a high level of education, clinical practice, experience and knowledge. Clearly, there is not enough information to guide a discussion of the care provided. Perhaps the problem is that most schools do not have a nurse on site most of the time. The nurse assigned to the school could have responsibility for multiple schools and thousands of students.
Nursing with Diabetes: Tips for Coping on the Unit
I was a school nurse for almost 2 years and had three schools with approximately students. The nurse is responsible for delegating the care of the diabetic student to the aide. I live in Colorado and there is only one district in the entire state that puts a nurse in each school. Thank you Nancy J. Thank you Nancy, it is essential for schools to have their school nurses trained to take care of the needs of the student regardless of the health conditions of the students. Nurses can initially prepare for many common cases. Apart from these, their treatment should be known to the students themselves.
Previous Next. View Larger Image. These educators teach people with diabetes to understand and manage the following:. Diabetes educators give diabetic patients the tools and ongoing support they need to follow their diabetic care plan in their daily lives. Nurses who choose to specialize in diabetes education can become a Certified Diabetes Educator through the National Certification Board for Diabetes Educators. Nurses who want to go further in treating diabetes patients can earn an advanced degree.
Advanced practice registered nurses nurse practitioners or clinical nurse specialists can diagnose and prescribe medication and take on the added responsibilities of advanced diabetes management. They have the option of becoming board certified in Advanced Diabetes Management through the American Association of Diabetes Educators. A nurse can work with diabetes patients on many levels, each of which is critical to helping the millions of people who must live with the disease.
Ongoing education, be it an RN to BSN program or an advanced degree, is essential to providing the best possible care. Retrieved from Vera, Matt, RN.
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Reducing the risks of diabetes complications through diabetes self-management education and support. Have a question or concern about this article? Please contact us. Submit the form below, and a representative will contact you to answer any questions.
Prediabetes: What Nurses Need to Know : AJN The American Journal of Nursing
Nurses working with diabetic patients have five priorities, according to Nurselabs. It should be noted, too, that insulin absorption varies in different anatomical sites. For example, absorption from the leg is slower than from the abdomen and is quicker from the arm than both of these.
When a patient is changing injection site, the insulin dose may therefore need to be adapted according to the new site and some extra blood sugar monitoring should be advised when making changes. Trials are currently taking place on the use of inhaled insulin, and many people who are fearful of injections are watching the results of these studies with interest.
Studies are also under way to investigate the use of both inhaled and oral insulins. The only other treatment possibilities for people with type 1 diabetes are pancreas transplants and islet cell transplants. Again, work is under way, but as yet no viable alternative to insulin has been discovered. The basis of initial treatment is to pay attention to dietary intake and to encourage exercise so as to induce weight loss, the rationale being to improve nutrition, maintain normoglycaemia, be aware of cardiovascular risk factors and prevent the complications of diabetes.
When diet and exercise fail to control glycaemia, stepped therapy is used, starting with oral hypoglycaemic agents OHAs.
How Can Nurses Help Diabetes Patients?
These fall into four main categories; sulphonylureas and sulphonylurea-like drugs; metformin, a biguanide; thiazolidines, and post-prandial regulators. Metformin has the advantage of encouraging weight loss and does not cause hypoglycaemia if used alone. The choice of drug used will depend on the needs of the individual patient but it is clear that OHAs fail as time progresses. Therapy is stepped up by adding other drugs in combination, but when the maximum tolerated oral dosages are reached, insulin is required either alone or in combination to maintain normoglycaemia.
It should be made clear to the patient that he or she is not failing if insulin is eventually required but that it is an inevitable consequence of type 2 diabetes. There are both acute and long-term complications of diabetes. The acute complications are hypoglycaemia and hyperglycaemia. Hypoglycaemia is a clinical entity seen in people with diabetes on insulin and some OHAs. Hospital laboratories set a blood sugar level for hypoglycemia, and this is usually below 3. The signs and symptoms of hypoglycaemia are shown in Table 1.
These can be neuroglycopenic - characterised by impairment of cognitive function, irrational or aggressive behaviour - or they can be adrenergic, involving the sympathetic and parasympathetic systems. If hypoglycaemia is untreated, the individual becomes increasingly confused and eventually will become unconscious. Consciousness will be recovered when the effect of the injected insulin has worn off, but this may take some hours, depending on the amount of insulin injected. However, hypoglycaemia may have dangerous consequences in certain circumstances, for example if the person is driving a vehicle.
Some people have no awareness of an impending hypoglycaemic episode. This can be devastating for them and may lead to a major loss of confidence. Hyperglycaemia happens more slowly than hypoglycaemia and follows the pattern similar to that described in the development of the symptoms of diabetes see Part 1 last week. Physical and psychological stress can cause hyperglycaemia owing to stress hormones such as adrenalin and corticosteroids being released in times of illness and causing the blood glucose to rise.
People with diabetes who become ill and who are self-adjusting their treatment should therefore increase their insulin or OHA dose if they are not on the maximum dose of the latter and reduce to their normal dose for each when they start to feel better in themselves. The long-term complications of diabetes include retinopathy, cataracts, neuropathy, nephropathy, coronary heart disease, peripheral vascular disease.
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These result in visual impairment, foot ulcers and amputation, kidney failure, heart attacks and strokes. Even if complications are already present when an individual is first diagnosed, good glycaemic control prevents them from worsening. The cost of the complications of diabetes to individuals and their families is enormous. Much of diabetes care is therefore targeted at preventing or treating these. Wherever care is given, the emphasis is always on patient self-management.
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Diabetes UK formerly known as the British Diabetic Association is a patient and doctor organisation that was formed in The founders recognised that self-care was key to the management of diabetes, except, possibly, when the patient is ill with, for example, inter-current illness or has undergone surgery. Self-care should resume as soon as possible, however.
Nevertheless, when a person with diabetes does need assistance this needs to be from knowledgeable health professionals. Most of the work published today on the expert patient concept has come from the USA and has focused on mental health and chronic disease.