Reference no: EM133343549
Case Study: Diabetes Case Study Doug is 47 year old man admitted to your unit with an ulceration on his right foot. His blood glucose level is 473. He tells you that he takes NPH (Humulin R) insulin 40 units every morning and Regular (Humulin R) insulin with each meal and at bedtime.
1) With the insulin that he takes, what type of insulin are they? When is the onset, the peak, and what is the duration?
2) When you enter his room to check his 4 pm. vital signs, he complains of a headache. and he's started sweating before you finish taking his Vitals. Based on your nursing assessment, what do you suspect? How would you confirm your suspicions?
3) What nursing interventions should you implement?
4) Why do you think this incident occured at 4pm?
5) At 5 pm. you check Doug's glucose level before preparing his next dose of insulin. The finger stick shows that his blood glucose is currently 80mg/dL. What do you do?
6) Identify 2 possible reasons that Doug's blood glucose dropped lower than usual.
7) Explain the importance of eating regularly scheduled meals throughout the day. How would you explain/teach this to Doug?
8) You did such a good job educating Doug about his diabetes last year that after discharge he started exercising, eating nutritious meals, and lost 65 pounds. But almost 2 years after his last admission, he arrives in the ER with a blood glucose of 41. What made his glucose level go so low?
9) Doug's doctor switches him from insulin to glipizide (Glucotrol) 5 mg bid. What are the 2 mechanisms of action for this medication?
10) How often and at what times should Doug take his glucotrol every day?
11) Why?
12) Does Doug have type I or type II diabetes? How do you know?
13) When you checked his blood sugar level early in the morning it was 310. And upon checking his records he has spike in his blood glucose level most of the time at that time. What do you think causes this?
14) Differentiate Somogyi Effect vs Dawn Phenomenon. When does this happen? What causes these to happen?
15) Identify at least 3 complications of diabetes. How can diabetes cause these complications?
16) Create a sample nursing care plan for this case.