A client is brought into the urgent care clinic with complaints of weakness and confusion. A finger stick reveals blood glucose of 480. What response would be most likely to help make a diagnosis?
1. The client always takes his insulin as prescribed and follows a healthy diet.
2. The client drank a bottle of beer last night before bed.
3. The client did not eat breakfast this morning because he was late for work.
4. The client has not taken insulin for the past four days because of a flu-like illness.
4
Rationale: The fact that the client always takes his insulin as prescribed and follows a healthy diet does not provide any clues for his current condition. Although alcohol in excess may result in a hypoglycemia episode, one bottle of beer would not be considered excessive even for a diabetic client. Skipping meals after taking insulin could result in a hypoglycemia episode. Illness is the most likely cause of hyperglycemic episodes among clients with usual good glucose control.
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