A diabetic educator is discussing "sick day rules" with a newly diagnosed type 1 diabetic. The educator is aware that the patient will require further teaching when the patient states what?
A) "I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours."
B) "If I cannot eat a meal, I will eat a soft food such as soup, gelatin, or pudding six to eight times a day."
C) "I will call the doctor if I am not able to keep liquids in my body due to vomiting or diarrhea."
D) "I will call the doctor if my blood sugar is over 300 mg/dL or if I have ketones in my urine."
Ans: A
Feedback:
The nurse must explanation the "sick day rules" again to the patient who plans to stop taking insulin when sick. The nurse should emphasize that the patient should take insulin agents as usual and test one's blood sugar and urine ketones every 3 to 4 hours. In fact, insulin-requiring patients may need supplemental doses of regular insulin every 3 to 4 hours. The patient should report elevated glucose levels (greater than 300 mg/dL or as otherwise instructed) or urine ketones to the physician. If the patient is not able to eat normally, the patient should be instructed to substitute soft foods such a gelatin, soup, and pudding. If vomiting, diarrhea, or fever persists, the patient should have an intake of liquids every 30 to 60 minutes to prevent dehydration.
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