Pathophysiology

Diabetes Family Advancing age

Mellitus II history (64y/o)
Glucose
intolerance

Prolongs
vasoconstriction

Arterial smooth muscle undergoes hypertrophy and

hyperplasia

Lumens of tunica intima and tunica media narrows

permanently

Inflammatio
n

Release of histamine, leukotrienes and

prostaglandins

Inc. vascular
permeability

↑ ↑ Plasma ↑ Water ↑
Sodium protein Calcium

Cellular ↑ smooth
retention of Na muscle
↑ Vessel contraction
Decreased organ perfusion
thickening
H2O retention ↑
vasoconstriction
with inc. ECF
volume
Impaired Impaired Impaired
ocular cerebral renal ↑ peripheral
edem functioning functioning functioning
a
resistance
INc. Blood
Retinal Altered level of ↑BUN, pressure
changes, consciousness, creatinine
papilledema dizziness,
headache
Nursing Diagnosis and Plan of Care
 Edema Blurry of Altered level of
vision consciousness,
dizziness, headache

Disturbed sensory
Acute pain related to perception related to
edema Pain related to
impaired ocular vasoconstriction
functioning
--Assess precipitatin
contributory factors to
pain --Assess degree of --Assess pain
--Obtain assessment of impairment --Administer analgesics as
pain --Talk to the patient to indicated
--Note when pain occurs provideauditory stimulation --Reduce intake of
--Collaborate in --Promote meaningful caffeinated beverages
treatment of pain socialization --Teach patient to avoid
--Provide comfort --Provide safety measures triggers that may lead to
measures headaches
--Encourage use of --Explore with the patient
relaxation techniques some techniques for stress
--Administer analgesics reduction
as indicated --Providerest periods
--Provide rest periods