Question

Case Study, Chapter 51, Assessment and Management of Patients with Diabetes

1. Sallie Smith, 42 years of age, is newly diagnosed with type 2 diabetes. During the patient education, the patient asks the nurse, “What should I do if I am sick and can’t eat; should I still take my medicine for the diabetes?” (Learning Objective 10)

1. What management strategies should the nurse provide the patient to deal with “sick days”

   2. glucose testing? Ketone?

   3. what to eat/drink if vomiting? Need to be specific.

   4. When to call the MD?

Answer 1

a.Some of the management strategies which can help the patient during sick days are

• sickness will lead to hormone trigger and increase in blood sugar level ,to control the blood sugar level take medication as per order without skipping
• Try to drink at least 2 litre of water when sick to prevent dehydration
• Can eat a very small quantity of food which has a carbohydrate of 15gm every hour to meet the lost calorie
• Monitor blood glucose level once in every 2 to 4 hours
• Avoid OTC drug

b.Check blood sugar at least 4 times a day.In case the blood sugar levels are very high check for ketone by urine key one dip stick This can provide information related to diabetic ketoacidosis

c.In case of vomiting the following can be done

• Avoid strong drinks,citrus juices milk
• Try to consume clear liquids if tolerable can go for liquid diet followed by a bland diet
• BRAT diet own th commonly followed one (Banana, Rice,Applesauce, Toast)

d.The following are the state where a MD has to be called immediately

• Patient complaining of abdominal pain,vomiting,dizziness, fruity breath order indicates diabetic ketoacidosis needs immediate care
• When having a fever
• Dry skin,dry mouth ,dry eyes are sign of dehydration
• When the blood sugar and Kenton levels are very high than the doctor recommended rate