The 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?

Question

A) "I will not take my insulin on the days when I am sick, but I will 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."

Answer 1

Ans: A
Feedback: The nurse must explanation the "sick day rules" again to the patient. The nurse should emphasize that the patient should take insulin agents as usual and test their 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 1/2 hour to hour to prevent dehydration. Fluid loss is dangerous and nausea, vomiting, and diarrhea should be reported to the physician. Patients with type 1 diabetes who cannot retain oral fluids may need hospitalization to avoid diabetic ketoacidosis and possibly coma.