Nursing for Diabetic Brain Disease

Diabetic brain disease, among severe diabetic complications, mainly includes diabetic ketoacidosis and diabetic hyperosmolar nonketonic coma. In light conditions, patients may just present consciousness disturbance, such as lethargy, drowsiness or confusion, but patients can still react to external irritation. For the nursing of those patients, besides regular blood sugar test, there are some other aspects that should be paid attention to, which can be seen as follows:
1. Keep close observation to consciousness change so as to know the extent of consciousness disturbance and evaluate the illness condition:
1>visit the patient every two to four hours. For patients suffering from coma, bed frames are needed so as to prevent accidents.
2> call the patient. If patient can be called up, answer questions correctly and soon falls asleep, then it can sleepiness; if the patient can be waken up only with loud voices for many times and can not answer question correctly, it is a drowsiness; if the patient can not be waken up and has no response, then it is a coma.
2. Close observation of temperature, breath, pulse and blood pressure changes
Pay attention for breath depth and make sure whether there exist irregular breathing or suspension. In case of diabetic ketacodosis, there exist deep breath and ketone odor. If conditions such as increased coma, slowed pulse, irregular breathing and different pupil sizes appear, then it is likely that brain edema and brain herniation have developed. Immediate contact with doctors is needed.
3. Keep smooth respiratory tract
Patients had better lie in lateral position and turn the head to one side so as to prevent secretions or vomiting from straying into the trachea and avoid suffocation.
4. Prevent infections in the lungs and urinary tract. Prevent aspiratory or falling pneumonia. Nursing should be intensified if there exist urinary incontinence.
5. Pay attention to oral nursing for patients suffering from coma.
6. For diabetics suffering from coma, urine volume at each hour should be recorded carefully. In case oliguria(less than 400ml/24h) occurs, report to the doctors immediately.

7. Confirm enough water and enough nutrients. For patients suffering from coma and have no swallowing abilities, besides liquid supplement through intravenous infusion, nasal lipid food supplement is also needed. As such patients usually suffer from worse gastrointestinal function and severe acidosis, high-energy and digestible liquid that can not impair gastrointestinal mucosa.