Individualized Healthcare Plan
Medical Diagnosis:
Diabetes Mellitus: Type
Brownsville ISD: Health Services
Student Name:
DOB:
School Nurse:
Date of IHP:
NURSING DIAGNOSIS
STUDENT GOALS
1. Risk for Ineffective coping related to
normal adolescent development issues and
change in diabetes management regimen.
1. Student will have an IHP and ECP in
place to include student, staff, and
parental roles in preventing and managing
diabetes care needs.
2. Student will be able to verbalize feelings
regarding having a chronic illness and how
this affects peer relationships.
2. Knowledge deficit related to balance of
insulin, diet and exercise, insulin
administration; dietary regimen; blood
sugar monitoring and exercise
requirements.
1.Student will increase understanding of
pathophysiology of diabetes and develop
or improve the skills necessary to manage
diabetes.
.
Home Campus:
PLAN OF ACTION
BY WHOM/WHEN
EXPECTED OUTCOMES
1. Assist with interpretation of blood
glucose results and appropriate action to
take.
School Nurse
Student will demonstrate accurate
documentation and follow action plan for
blood glucose results.
2. Educate student regarding purpose,
mechanism of action of insulin.
School Nurse
School staff is informed of potential for
hypoglycemia and signs and symptoms and
action steps to take.
2. Educate school staff on the early signs of
hypoglycemia and the appropriate steps to
take for treatment.
School Nurse, Classroom teacher as
needed.
4. Provide positive reinforcement
regarding follow-through on diabetes
management regimen.
School nurse, teacher - ongoing
1. Instruct student in pathophysiology of
diabetes at level the student is capable of
understanding.
School Nurse
2. Monitor blood glucose levels at school.
A. Arrange space and time for student
to perform blood glucose levels,
insulin injection, diet inventory and
snack consumption.
B. Maintain blood glucose record and
send to MD as needed appts or
concerns; PRN
C. Obtain insulin order from MD sliding
scale if necessary
D. Parent/guardian will provide blood
glucose testing equipment, insulin
supplied and snacks.
E. Other: ______________________
School Nurse, physician, diabetes
educator, parents, teaching staff as
necessary
3. Instruct student in meaning of glucose
levels, and appropriate action required at
readings based on MD orders.
School Nurse
The student will be successful in diabetes
management in the school setting.
The student will demonstrate increasing
knowledge and skill in medication
management.
The student will demonstrate increasing
knowledge and skill in diet management.
Diabetes Health Care Plan
NURSING DIAGNOSIS
3. Risk for self-esteem disturbance due to
lifestyle changes demanded by diabetes
and its management.
STUDENT GOALS
1. Student will demonstrate increased
adaptation to and psychological comfort
with body changes and lifestyle
requirements.
PLAN OF ACTION
BY WHOM/WHEN
EXPECTED OUTCOMES
1. Intervene with teachers, as needed to
assure student appropriate control over
his/her environment and diabetes.
School Nurse, classroom teacher – as
needed
The student will be successful in diabetes
management in the school setting.
2. Establish communication and reporting
system between school and home.
School Nurse, teacher – as needed
The student will begin to demonstrate
(beginning, progressing) adaptation to
having diabetes.
3. Create opportunities for student to
verbalize feelings about having diabetes,
management requirements, and feelings of
isolation, differentness, or peer rejection.
School Nurse/Counselor – ongoing
4. Provide referral and access to youth
diabetes group if needed.
School nurse, counselor – as needed