The nurse assists an older male adult who has type 2 diabetes mellitus to improve his glucose control. Which does the nurse instruct this individual to do when he plans to walk more than usual in one day?

Question

a. Omit antidiabetic medication.
b. Wear sturdy open-toed shoes.
c. Supplement the caloric intake.
d. Prepare to administer insulin.

Answer 1

C

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A Incorrect. The nurse cannot tell the patient to omit medication because this is not within a nurse's scope of practice.
B Incorrect. The nurse instructs the older adult to wear closed, well-fitting leather shoes to protect the feet from trauma.
C Correct. Diabetes mellitus is controlled by balancing exercise, calories, and hy-poglycemic medication; if one element of therapy is altered, one or both of the remaining elements must be adjusted. When the patient's activity is going to metabolize more calories, the medication has to be reduced or the calories have to increase. For a patient with type 2 diabetes mellitus, adjusting the medication can be difficult; so the nurse instructs this older adult to supplement his caloric intake. This can be accomplished by eating snacks during the walk or by in-creasing the glycemic load before walking. The patient ensures glucose control during these activities by testing the blood sugar.
D Incorrect. Although many individuals with type 2 diabetes mellitus take insulin periodically, insulin is administered to induce hypoglycemia. Because the indi-vidual plans to walk more than usual, more calories are needed to prevent hy-poglycemia.