Question

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 cant eat; should I still take my medicine for the diabetes? (Learning Objective 10) a. What management strategies should the nurse provide the patient to deal with sick days? 2. Jerry Thomas is a 26-year-old type 1 diabetic. He was originally diagnosed at the age of 14, and currently manages his disease with an intensive regimen of insulin injections. Jerry is employed as a schoolteacher and soccer coach. He presents today with a 2-day history of vomiting and diarrhea. He has been closely monitoring his blood glucoses, and is using regular insulin for high blood glucose levels. He has only been able to tolerate liquids such as Gatorade, but today he is unable to even tolerate that, and comes to the clinic for evaluation of possible diabetic ketoacidosis (DKA). (Learning Objective 9) a. Describe the pathophysiology of DKA and why it occurs in patients with type 1 diabetes. b. Based on the diagnosis of DKA, what assessment findings does the nurse correlate to this disorder? c. The physician orders a complete metabolic panel, and Jerrys blood glucose is 425. Other lab values include a serum sodium of 152, serum potassium of 3.0, and BUN of 64. What is your assessment of these results? d. Explain why it is important for Jerry to continue to take his insulin even though his oral intake is decreased.

Answer 1

1) A-

Continue to take diabetic pills

Regular blood glucose level testing after 4-5 hours

Drink liquid as much as you can

Check temperature in case of fever in morning or evening

2)

A) pathophysiology of type 1 diabetes mellitus by following methods

Peripheral insulin resistance

Hepatic glucose production is impaired

Beta cell function decreased

It occurs in type 1 diabetes because uncontrolled blood sugar level and illness and leads to formation of acidic body like ketone and causes diabetic ketoacidosis

B)assessment findings are

Polydipsia,( increased thirst) polyuria,( increased urination) ployphagia ( increased appetite)

Weight loss, blurred vision

C)  

Blood glucose of 425 is very high and it can lead to emergency situation so IV fluids or insulin should be given . It represents condition of hyperglycemia

Sodium level of 152 represent electrolyte disturbance in body, potassium level of 3 also represents electrolyte disturbance and BUN 64 represent dehydration ( excessive water loss)

D) Jerry continue to take insulin because it maintain blood glucose otherwise it can lead to complications