Nursing Care for DN

Nursing Care for DN

There are many ways and levels at which a nurse can help care for a patient with DN. Care for patients with DN will differ depending on how far along their disease has progressed. I will break the care into what I consider "out-patient care" and "in-patient care" because that makes the most sense to me, and I think that is the most significant way to break them down. However, lots of care techniques could overlap, and obviously nurses can do "in-patient type care" if they do home visits, etc...

Out-patient care
Nurse who care for DN patients in out-patient setting will do a lot of patient education on diet/medications, urine screening, BP control, and blood glucose control. Patients who are on ACE inhibitors, like enalapril or lisinopril, for their BP may feel the side effects cough, low BP or dizziness; this may lead them to believe they are getting sicker. Nurses will need to educate patients on how to incorporate a low-sodium diet into their lifestyle. Regular urine screenings are also important to monitor the regular release of protein in the urine, to track whether the condition is wrsening or improving.

In-patient care
For patients who are in the hospital because of the severity of their kidney disease, the nurse will care for them in a more involved manner. To prevent edema and retained ECF, daily weigh-ins allow nurses to see exactly how much fluid their patients are retaining. Monitoring stricts I/O's also aids the nurse in getting a clear picture of exactly how much fluid his/her patient is retaining. The nurse will be the first person aware of his/her patient's edema/fluid status, and is in prime position to recommend a diuertic if necessary. When treating DN patients on diuertics, the nurse should monitor serum levels of potassium, as diuretics can lead to a K deficiency. With patients in the hospital, the nurse is also able to more closely monitor glucose and BP.


"Diabetic Nephropathy." Diabetes Care. 25 (2002): 585-89. Retrieved from http://care.diabetesjournals.org/content/25/suppl_1/s85.full#sec-5

Aiello, J. H. "Preventing Diabetic Nephropathy: The Role of Primary Care." Nurse Practitioner 23.2 (1998): n. pag. Web