Chapter 32, Problem 1CS

(1)

Summary Introduction

To determine:

Before his surgery, B.G’s hemoglobin A1C level was 9%. This value implies about his glycemic control.

Case summary:

B.G., age 58 years, was diagnosed with type 2 adult-onset diabetes mellitus 10 years ago. Although he has type 2 diabetes mellitus, he needed to take insulin for the past 2 years. He had been recovering, without complications, from a laparoscopic cholecystectomy, but his blood glucose levels have shown some wide fluctuations over the past 24 hours. The physician has changed B.G.’s insulin from regular to lispro (Humalog) to see if it will provide better control of his blood glucose levels.

(2)

Summary Introduction

To answer:

While reviewing the instructions for the lispro insulin, B.G.states, “I took my regular insulin shots about 30 minutes before my meals. Hopefully, I can keep that same routine.” How will the nurse respond to this statement?

Case summary:

B.G., age 58 years, was diagnosed with type 2 adult-onset diabetes mellitus 10 years ago. Although he has type 2 diabetes mellitus, he needed to take insulin for the past 2 years. He had been recovering, without complications, from a laparoscopic cholecystectomy, but his blood glucose levels have shown some wide fluctuations over the past 24 hours. The physician has changed B.G.’s insulin from regular to lispro (Humalog) to see if it will provide better control of his blood glucose levels.

(3)

Summary Introduction

To determine:

After his discharge, B.G. wakes up one morning feeling nauseated. He gives himself the lispro insulin injection, but then after eating breakfast, he vomits and cannot keep any food down. What must he do this time?

Case summary:

B.G., age 58 years, was diagnosed with type 2 adult-onset diabetes mellitus 10 years ago. Although he has type 2 diabetes mellitus, he needed to take insulin for the past 2 years. He had been recovering, without complications, from a laparoscopic cholecystectomy, but his blood glucose levels have shown some wide fluctuations over the past 24 hours. The physician has changed B.G.’s insulin from regular to lispro (Humalog) to see if it will provide better control of his blood glucose levels.