Medliorate

Improving medical students

Teach Patients to Count Carbs

Posted by medliorator on April 13, 2008

Using a 10-step guide called C-O-U-N-T C-A-R-B-S.

1. Create a typical meal. The nurse is supposed to talk through the details of an ordinary meal the patient eats on a regular basis, including sauces, condiments, and beverages.

2. Offer information. Here the nurse defines carbohydrate, and explains which foods from the previous step contain them.

3. Use food lists and labels. A quick lesson in reading food packaging labels, including paying close attention to Serving Size, and the idea of 15-carb “units.”

4. Now it’s the patient’s turn. The patient is next asked to try to estimate the total carb value of their typical meal in Step 1.

5. Take time. “Answer questions and provide clarification and performance feedback.”

6. Compare patient choices to written dietitian recommendations. The nurse is encouraged to be constructive and focus on the positive.

7. Adjust meal. Talk about ways to alter meal choices based on dietitian recommendations. Here’s where the nurse can use “visualization” for portion sizes, etc.

8. Recalculate, record, reinforce. The patient gets to recalculate their initial meal as a sample entry in a food diary. The nurse demonstrates how to record BG readings and insulin doses. Learning is reinforced using “case scenarios.”

9. Bolus. the nurse is supposed to assist with administering an appropriate bolus.

10. Support learning. provide resources for the patient to consult later on, like web sites, support groups, and customized food lists based on the patient’s preferences.

Teaching Patients to Carb-Count [Diabetes Mine]

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