Answer to Question 1
Illness, infection, or injury can cause hormonal changes that raise blood glucose levels and increase the risk of developing diabetic ketoacidosis or the hyperosmolar hyperglycemic syndrome. During illness, patients with diabetes should measure blood glucose and ketone levels several times daily. They should continue to use antidiabetic drugs, including insulin, as prescribed; adjustments in dosages may be necessary if they alter their diet or have persistent hyperglycemia. If patients use over-the-counter drugs, they should be cautioned that some types of drugs may raise blood glucose levels or interact with antidiabetic drugs. During illness, individuals with diabetes should consume their usual diet, if possible. If appetite is poor, they should select easy-to-manage foods and beverages that provide the prescribed amount of carbohydrate at each meal. Foods that are easily tolerated include toast, crackers, soup, yogurt, fruit, fruit juices, frozen juice bars, and carbohydrate-sweetened beverages. To prevent dehydration, especially if vomiting or diarrhea is present, patients should make sure they consume adequate amounts of liquids throughout the day.
Answer to Question 2
A
The patient and his family meet with the nurse to discuss progress on the patient care plan.
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