A patient with type 1 diabetes mellitus who had one episode of ...

[sjones]

A patient with type 1 diabetes mellitus who had one episode of vomiting in the past 2 hours asks if the routine insulin injection should be taken. What action by the nurse is best at this time?
 
  1. Contact the physician.
  2. Explain the need to take the insulin.
  3. Document the refusal and continue on with the planned care.
  4. Check the patient's fasting serum glucose level.

Question 2

A patient recently diagnosed with diabetes wants to check the urine for glucose instead of using capillary blood because of the cost. Which response should the nurse make to the patient?
 
  1. Urine testing is best when combined with serum testing.
  2. Urine testing is as reliable as finger stick testing.
  3. Yes, urine testing is cheaper than glucose test strips.
  4. Would you like to switch to this method of monitoring?

[lgoldst9]

Answer to Question 1

Correct Answer: 2
Taking the insulin is the best course of action. The usual dose of insulin should be taken even if ill. Contacting the physician at this time is premature. Documentation of the patient's refusal is premature, as efforts have not been made to discuss the need for the medication. Checking the morning fasting serum glucose will not reflect the patient's current glucose level.

Answer to Question 2

Correct Answer: 1
Urine glucose testing is no longer recommended for the patient with diabetes who is self-managing the condition. The blood glucose level is likely to be drastically different than a urine level because urine may sit in the bladder for several hours. If the result is negative, the blood glucose could be normal, hyperglycemic (up to 180 mg/dL), or hypoglycemic (less than 70 mg/dL). Advising the patient the method of testing is not reliable is not entirely correct and does not provide needed information to the patient. Telling the patient he is correct does not provide adequate information. It is inappropriate for the nurse to make such a suggestion about the method of testing to be utilized to the patient.

[sjones]

Thank you

[lgoldst9]

No problemo