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Case: Mrs Patel is an 89 year old widow. She has been living in a nursing home for the past 2 years because her family have been unable to cope with her nursing needs following a stroke in 2002, which has affected her right side and her speech. Mrs Patel is unable to manage the normal activities of daily living. She was diagnosed with type 2 diabetes 20 years ago. Mrs Patel had taken a great interest in her diabetes when she was able to but since having the stroke and the death of her spouse in 2003, she has not been able to participate in her own personal and diabetes care. Over time Mrs Patel has become increasingly frustrated because she is unable to communicate how she is feeling, or what her needs are. Mrs Patel is on Gliclazide 80 mgs twice daily and metformin 1gm twice daily. You notice that Mrs Patel is off her food and has had very little to eat that day. The nurse in charge has given Mrs Patel her medication as prescribed at 10 am. At 2 pm you notice Mrs Patel is sweating profusely, she is pale and appears to be drowsy but responds to her name.
QUESTION # 1: What is the clinical term for a low blood glucose?
QUESTION #2: As Mrs Patel is still conscious and responding to her name, and her swallowing reflex is intact you would aim to treat her hypo following the guidelines for the management of hypoglycemia in the nursing home. What are possible recommended treatments for hypoglycemia?
QUESTION #3: What are the signs that Mrs Patel had that indicated hypoglycemia? What are other signs?
QUESTION #4: How would you prevent Mrs Patel from getting hypoglycemia in the future?
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