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Risk for Infection — Diabetes Mellitus

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Risk for Infection — Diabetes Mellitus Nursing Care Plans

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Nursing Diagnosis:  Risk for Infection
Risk factors may include:
  • High glucose levels, decreased leukocyte function, alterations in circulation
  • Preexisting respiratory infection, or UTI
Desired Outcomes:
  • Identify interventions to prevent/reduce risk of infection.
  • Demonstrate techniques, lifestyle changes to prevent development of infection.
Nursing Interventions Rationale
Observe for signs of infection and inflammation, e.g., fever, flushed appearance, wound drainage, purulent sputum, cloudy urine.  Patient may be admitted with infection, which could have precipitated the ketoacidotic state, or may develop a nosocomial infection.
Promote good handwashing by staff and patient.  Reduces risk of cross-contamination.
Maintain aseptic technique for IV insertion procedure, administration of medications, and providing maintenance/site care. Rotate IV sites as indicated. High glucose in the blood creates an excellent medium for bacterial growth.
 Provide catheter/perineal care. Teach the female patient to clean from front to back after elimination Minimizes risk of UTI. Comatose patient may be at particular risk if urinary retention occurred before hospitalization. Note: Elderly female diabetic patients are especially prone to urinary tract/vaginal yeast infections.
 Provide conscientious skin care; gently massage bony areas. Keep the skin dry, linens dry and wrinkle-free. Peripheral circulation may be impaired, placing patient at increased risk for skin irritation/breakdown and infection.
 Auscultate breath sounds. Rhonchi indicate accumulation of secretions possibly related to pneumonia/bronchitis (may have precipitated the DKA). Pulmonary congestion/edema (crackles) may result from rapid fluid replacement/HF.
 Place in semi-Fowler’s position. Facilitates lung expansion; reduces risk of aspiration.
 Reposition and encourage coughing/deep breathing if patient is alert and cooperative. Otherwise, suction airway, using sterile technique, as needed.  Aids in ventilating all lung areas and mobilizing secretions. Prevents stasis of secretions with increased risk of infection.
Provide tissues and trash bag in a convenient location for sputum and other secretions. Instruct patient in proper handling of secretions.  Minimizes spread of infection.
 Encourage/assist with oral hygiene.  Reduces risk of oral/gum disease.
Encourage adequate dietary and fluid intake (approximately3000 mL/day if not contraindicated by cardiac or renal dysfunction), including 8 oz of cranberry juice per day as appropriate.  Decreases susceptibility to infection. Increased urinary flow prevents stasis and aids in maintaining urine pH/acidity, reducing bacteria growth and flushing organisms out of system. Note: Use of cranberry juice can help prevent bacteria from adhering to the bladder wall, reducing the risk of recurrent UTI.
Administer antibiotics as appropriate. Early treatment may help prevent sepsis.