Diabetes mellitus is a common metabolic disorder of elevated blood glucose levels that causes symptoms due to either a lack of insulin (type 1 diabetes) or the body's resistance to insulin (type 2 diabetes). The disorder, which affects more than 34 million Americans, alters the way the body utilizes food for energy. Nursing assistants must be observant of their diabetic patients due to the myriad of complications and dangers caused by diabetes.
There are two types of diabetes. Type 2 diabetes is the most common kind of diabetes in the United States, affecting almost nine out of ten diabetics. In type 2 diabetes, the body does not use insulin effectively due to insulin resistance. The body's cells have difficulty converting glucose into energy; therefore, blood sugar levels rise. As a result, the body's cells are starved for energy. The following are signs and symptoms of very high blood sugar levels that the nursing assistant must report to the charge nurse immediately (CNA Training Advisor, 2011):
- Extreme thirst/hunger
- Rapid weight loss
- Frequent urination
- Decreased vision
- Dry skin and mouth
- Fatigue, drowsiness
- Fruity-smelling breath
- Very deep, gasping breath
Nursing assistants must know about diabetes since they will encounter numerous diabetic patients in all types of healthcare settings throughout their careers. The alert nursing assistant should be able to recognize dangerous situations such as low blood sugar, also known as hypoglycemia, or high blood sugar, also referred to as hyperglycemia.
If symptoms such as pale moist skin, shallow rapid breathing, irritability, or nervousness are observed, it is important to contact the nurse immediately because these are symptoms of low blood sugar. If the patient’s blood glucose is too low for too long, brain damage can occur. You don’t need the nurse’s permission to give juice to the resident if the blood sugar is low.
The nursing assistant also passes meal trays and helps diabetic clients adhere to dietary restrictions. When assisting with activities of daily living (ADLs), nursing assistants check the patient’s oral hygiene, overall cleanliness, and ensure they bathe regularly to prevent skin infections. Additionally, the state-testable skill of foot care is related to diabetes because it allows nursing assistants to observe for cuts and discoloration on the feet.
Routine diabetic foot care also prevents infections by keeping the feet clean and reducing the number of disease-causing germs,
thereby lowering amputation risk. Diabetics are more prone to infections of all types than patients that do not have diabetes. Therefore, the nursing assistant must help diabetics with personal hygiene to reduce the germ counts on their bodies. Good personal hygiene lowers the risk of infection.