Question

Max is an 11-year-old boy who was admitted to the hospital after he passed out while playing with friends. Tests confirm a diagnosis of type 1 diabetes mellitus. Max remains in the hospi- tal for several days until his blood glucose and ketone levels are under control. During this time, he and his family learn about diabetes; the diet Max needs to follow; the use of insulin; the monitoring of blood glucose levels; and the required coordination of diet, insulin, and physical activity. The details of diabetes mellitus are reserved for Chapter 26, but for now you can consider the steps that are necessary for implementing Max’s nutrition care.

1. Given the chronic nature of Max’s illness and his age, what approaches should be used when discussing the required dietary and medical treatments with Max and his family? What factors need consideration when designing a nutrition education program for Max and his parents?

2. After a first visit with Max and his family, what information should the dietitian add to Max’s medical record? Is enough information given above for designing a SOAP note? If not, what elements are missing?

3. Max will need additional care to learn more about diabetes and to make the adjust- ments that will allow him to cope with his condition. Why is it important to address follow-up care before Max leaves the hospital?