Nursing Diagnoses

Today, I am going to summarize five different nursing diagnoses that might be used for patients with diabetic nephropathy. For the last nursing diagnosis, I will detail the plan, nursing interventions and desired outcomes.

1.    Adult failure to thrive related to undetected disease process

·      In patients with chronic disease physical function progressively deteriorates and the patient’s ability to cope and manage his or her care is diminished.

2.    Noncompliance related to restrictive lifestyle; changes in diet, medication, exercise

·      The patient’s behavior may fail to comply with the plan of care that was agreed upon in conjunction with the healthcare professional.

3.   Risk for Infection related to chronic disease.

·      Patients with chronic disease are at increased risk of being immunocompromised.

4.    Risk for electrolyte imbalance related to renal dysfunction

·      This diagnosis is relevant for any patient that has kidney dysfunction, a defining factor of diabetic nephropathy.  As a nurse, I want to monitor electrolyte & acid base balance, fluid balance and nutritional status. 

5.    Ineffective health maintenance related to complexity of therapeutic regimen

·      Patients with diabetic nephropathy are managing complex medical needs and medication regimens.

Diagnosis:	Ineffective health maintenance r/t complexity of therapeutic regimen
Plan:	The healthcare provider will work with the patient on an individual basis to identify obstacles to following a therapeutic regimen and together they will develop strategies to help the patient be successful.
Nursing Interventions:	·      Assess for family patterns, economic issues and cultural patterns that influence compliance with a given medical regimen ·      Help client to choose a healthy lifestyle and to have appropriate diagnostic screening tests. ·      Help the client determine how to manage complex medication schedules ·      Identify support groups related to the disease process
Desired Outcomes:	·      Discuss fear of or blocks to implementing health regimen ·      Follow mutually agreed on healthcare maintenance plan ·      Meet goals for healthcare maintenance

For further information on nursing management of diabetic nephropathy, please see the following article written by Ahmed Abdelhafiz, Meguid Nahas, Jose de Oliveira: Management of Diabetic Nephropathy in Older Patients: A Need for Flexible Guidelines


Ackley, B.J. & Ladwig, G.B. (2011). Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care. St. Louis, Missouri: Elsevier.