An older patient being treated for pneumonia has signs of metabolic syndrome but denies the presence of diabetes. Serum glucose is 220 mg/dL and the hemoglobin A1C is 5%. What can be induced from these findings?
1. The nurse should anticipate discharge teaching related to insulin to manage blood sugars at home.
2. The nurse anticipates that the doctor will diagnose the patient with type 1 diabetes.
3. The nurse would anticipate treatment with sliding scale insulin even though diabetes is not yet evident.
4. The nurse anticipates that the doctor will diagnose the patient with type 2 diabetes.
3
Rationale 1: The patient would not require insulin at home. If treatment became necessary, oral agents are initiated in the patient with type 2 diabetes.
Rationale 2: Type 1 diabetes mellitus is not usually diagnosed in older patients.
Rationale 3: High glucose would be treated with sliding scale insulin to prevent or reduce short-term complications of hyperglycemia. As the infection is treated, the nurse would expect glucose to return to normal.
Rationale 4: Though the serum glucose is elevated, the hemoglobin A1C is normal, meaning the blood glucose has been normal over approximately the past 3 months. The patient does not have diabetes but is at high risk for the development of type 2 diabetes.
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