According to Tarwoto (2012). There are 15 nursing intervention that can be carried out to diagnose imbalanced nutrition: less than body requirements related to insulin insufficiency and a decrease in oral intake as follows:
- Assess the patient's nutritional status, this plan is done to determine the nutritional needs of the patient.
- Observation of Vital Signs, to find out the client's general condition because blood pressure can affect the increase in sugar levels in patients. Someone who is at risk of developing DM is someone who has high blood pressure (hypertension), which is a blood pressure of more than 140/90 mmHg, in general patients with DM also suffer from hypertension. Poorly managed hypertension will accelerate kidney damage and cardiovascular disorders.
- Measure the patient's weight and do it regularly every 3 days or as indicated, this intervention is carried out to determine the Basal Mass Index and plan nutrition therapy. Rapid changes in body weight can be an indication of changes in blood sugar control. Weight gain can indicate blood sugar is starting to decline, maybe also because of excessive calorie intake in food and lack of exercise. While weight loss can be caused by high blood sugar, complications in the lungs, liver, or other body organs, besides the possibility of other diseases such as hyperthyroidism, depression, or digestive disorders.
- Encourage eating a little but often, this is done to help control energy and fulfill nutrition.
- Measure the body mass of the patient index, this intervention was carried out to determine the nutritional needs of the client's body because it was also determined by the BMI.
- Identification of factors that influence the nutritional status of patients is done to find out the causes of lack of nutrition and plan for the fulfillment of nutrition.
- Periodic blood sugar monitory of patients according to indications, this intervention can be done because changes in blood sugar levels can occur at any time and can determine the planning of caloric needs. This examination is recommended for patients with unstable DM disease, tendency to have severe ketosis, hyperglycemia and hypoglycemia without mild symptoms. In connection with administering insulin, the insulin dose needed by the patient is determined by accurate blood glucose levels.
- Assess patient and family knowledge about the diabetic diet. This needs to be done to determine the extent of family and client knowledge about DM disease, because DM patients have complications so patients and families must understand acute and chronic complications.
- Assess patient diet and activities, interventions need to be done
- because factors that can affect blood glucose levels in clients are diet and activity. Regular exercise activities help reduce complications of heart disease and reduce blood sugar levels.
- Consult a dietician to identify and plan the patient's nutritional needs, this needs to be done because nutritionists are more competent in determining and planning the patient's nutritional needs. Individual and group nutritional counseling improves diet quality in patients with diabetes mellitus.
- Involve patients and families in planning nutritional needs, this intervention needs to be done because clients can determine according to their resources and provide confidence that a nutrition program plan can be implemented.
- Carry out therapeutic programs such as giving antidiabetic drugs or insulin, this intervention can be done every day to stabilize blood glucose levels and treatment is an integral part of improving the nutritional status of patients.
- Monitoring for signs of hypoglycemia, this intervention needs to be done because after administration of antidiabetic drugs or insulin can cause hypoglycemia. Complaints and symptoms of hypoglycemia can vary, depending on the extent to which blood sugar drops, complaints due to the brain do not get enough calories to interfere with intellectual functions including headaches, lack of concentration, blurred eyes, tiredness, confusion, convulsions, or coma. Provide health education about DM diets, medicines and the risk of not adhering to what has been programmed and program activities, this is done to increase knowledge of DM patients or families so that they can control blood sugar levels properly and prevent complications.
- Give positive support if the patient is able to carry out the nutrition program properly, this plan is done so that the client is motivated and confident to continue implementing the diet program.
