Pharmacology and the Nursing Process, 8e
Pharmacology and the Nursing Process, 8e
8th Edition
ISBN: 9780323358286
Author: Linda Lane Lilley PhD RN, Shelly Rainforth Collins PharmD, Julie S. Snyder MSN RN-BC
Publisher: Elsevier Science
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Chapter 32, Problem 2CTPQ
Summary Introduction

To describe:

A patient with type 2 diabetes comes to the department with an acute asthma attack and pneumonia. Her condition is stabilized, and she is admitted to the hospital to receive intravenous doses of antibiotics and corticosteroids. She says that, before this episode, she took oral drugs for diabetes and had her diabetes “under control”, with fasting blood glucose levels ranging from 99 to 106 mg/dl, on most mornings. However, the next morning, her fasting blood glucose level is 177 mg/dl, and her glucose levels remain elevated for the next few days. The patient is upset and declares, “I’m hardly eating anything extra. Why is my blood sugar so high?” What is the nurse’s best answer to the patient’s concerns?

Concept introduction:

Diabetes mellitus is a clinical condition that is related to metabolism. Insulin decreases the blood glucose concentration; hence, deficiency of insulin and insulin receptor defects cause this major disorder. The type 2 diabetes mellitus is commonly found in adults, and it is not dependent on insulin. This type is characterized by a defect in insulin receptors.

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A 65 year old male with a small bowel obstruction is to be started on TPN. He is 5’ 9” and weighs 70 kg.  3.1 What is his kcal requirements using Mifflin St Jeor equation? Assume an activity factor of 1.2. 1770 kcal 1980 kcal 2020 kcal 2080 kcal 3.2 What is his fluid requirements (ml)? 2000 ml 2100 ml 2200 ml 2300 ml 3.3 The patient has just undergone a small bowel resection. His albumin dropped to 2.2. He has no significant past medical history except for a minor bicycle accident when he was 10 years old. How many grams of protein will this patient require based on your assessment? 105 – 126 g/day 110 – 130 g/day 84 – 105 g/day 110 – 180 g/day
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