2. Blood sugar management for a client who has type 2 diabetes with nausea and decreased appetite should include:
2. Blood sugar management for a client who has type 2 diabetes with nausea and decreased appetite should include:
. Continuing insulin even if the client is vomiting.
. Continuing insulin if blood sugar is less than 80 mg/dL.
. Stopping insulin if urine is positive for ketones.
. Stopping insulin until the client is able to tolerate food.
Test-Taking Tip
Totally stopping insulin is not advised as a general management strategy; therefore, eliminate Answers 3 and 4.
Content Area: Adult Health, Endocrine; Integrated Process: Nursing Process, Planning; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
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Answer 1 is correct because during illness the cells still need insulin. Failure to give it will likely put the client into a hyperosmolar, if nonketotic state (type 1 diabetes is more likely to cause ketoacidosis). Since the client will not be eating very much, the insulin dose may be reduced, and it is hard to predict by how much. Clients with diabetes need to prepare a "sick day strategy," which will include checking blood sugar, and possibly ketone level, more frequently. Answer 2 is incorrect because insulin should not be administered if the blood glucose is low. Answer 3 is incorrect because ketone-positive urine indicates that there is inadequate insulin carrying glucose into the cells. Insulin is needed. Answer 4 is incorrect because, when unable to ingest food, the liver breaks down glycogen, which provides glucose for the body. Insulin is still required to take this glucose into the cell.