Michael S R, Sabo C E
Focus Crit Care. 1990 Aug;17(4):331-8.
The diabetic patient receiving nutritional support presents a particular challenge to critical care nurses and other members of the health care team. Typical protocols concerning TPN administration must be reevaluated given the special considerations associated with the pathology of diabetes mellitus. These patients are particularly susceptible to the development of acute complications including those associated with glucose metabolism abnormalities and electrolyte imbalances. In addition, diabetic patients receiving TPN have the added stress of an acute illness complicating a chronic illness. An understanding of the interrelationships between the pathophysiology of diabetes mellitus and the stress response will provide the nurse with the background information necessary to meet the challenges imposed by TPN administration. The critical care nurse will be able to recognize early signs and symptoms of complications and implement appropriate nursing interventions. An overview of primary nursing diagnoses, goals, and interventions has been presented and will apply to most patients receiving nutritional support. Individualized care plans can now be formulated as an extension of the basic plan, thus ensuring optimum nursing care to the diabetic patient receiving nutritional support.
接受营养支持的糖尿病患者对重症护理护士及医疗团队的其他成员来说是一项特殊挑战。鉴于与糖尿病病理相关的特殊考量，必须重新评估有关全胃肠外营养（TPN）管理的典型方案。这些患者尤其易发生急性并发症，包括与葡萄糖代谢异常和电解质失衡相关的并发症。此外，接受TPN的糖尿病患者还承受着急性疾病使慢性疾病复杂化的额外压力。了解糖尿病的病理生理学与应激反应之间的相互关系，将为护士提供应对TPN管理带来的挑战所需的背景信息。重症护理护士将能够识别并发症的早期迹象和症状，并实施适当的护理干预措施。本文已概述了主要护理诊断、目标和干预措施，这些适用于大多数接受营养支持的患者。现在可以制定个性化护理计划作为基本计划的延伸，从而确保为接受营养支持的糖尿病患者提供最佳护理。
