A nursing home resident who has type 1 diabetes mellitus is gradually requiring more and more insulin on a PRN basis to treat hyperglycemia
Which of the following should the nurse assess to plan care for improving this individual's glucose metabolism? a. New-onset urinary tract infection
b. Trends over time in activity level
c. Sudden increase in caloric intake
d. Big change in diabetic medication use
B
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A Incorrect. A new event is likely to cause an abrupt change in the serum glucose. Although infections are frequently detected in an individual with diabetes, in-fections are more closely associated with sudden-onset hyperglycemia.
B Correct. Standard diabetic therapy includes diet, hypoglycemic agents, and ex-ercise. If one aspect of the therapy changes, the other two aspects must be ad-justed to avoid hyperglycemia. Improving glucose metabolism is a huge benefit of exercise for a diabetic. In all people, exercise helps to maintain aerobic con-ditioning, stabilize mood, improve the quality of sleep, and especially important for diabetics, promote and maintain collateral circulation. For this resident, a slow decline in physical activity will necessitate a change in the amount of insu-lin given or the total amount of daily calories to prevent hyperglycemia; howev-er, the best solution for this resident is to increase daily physical activity.
C Incorrect. A sudden increase in caloric intake is likely to cause a sudden increase in blood glucose.
D Incorrect. A big change in medication use is likely to cause an abrupt change in the serum glucose.
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