Joseph is a 58-year-old bus driver who received a diagnosis of type2 diabetes 10 years ago; he has n

Joseph is a 58-year-old bus driver who received a diagnosis of type2 diabetes 10 years ago; he has needed to take insulin for the last 2 years. He has been recovering, without complications, from a laparoscopic cholecystectomy; however, his plasma glucose levels have shown significant fluctuations over the last 24 hours. The health care provider has changed his insulin to lispro (Humalog) to evaluate whether this improves control of his plasma glucose levels.1. What is the rationale for the use of oral antihyperglycemic drugs in a patient with type 2 diabetes?Why do some patients with type 2 diabetes need to begin taking insulin?What can be done to measure the control of a patient’s diabetes over the short term and long term?2. What are the pharmacokinetics of insulin lispro?3. What special instructions, if any, should be given to Joseph about insulin lispro before he is discharged home from the hospital? Additional questions: Critical Thinking4.  A 25-year-old woman has been diagnosed with type 1 diabetes. She has been placed on a 1500-calorie diabetic diet and is to be started on insulin glargine. Today she received teaching about her diet, insulin injections, and management of diabetes. She received the first dose of insulin glargine at 9 PM; the next morning she reported feeling “dizzy.” The nurse assesses that she is diaphoretic, weak, and pale, with a heart rate of 110 beats per minute. What is the nurse’s priority action? What is the best explanation for these symptoms?5. While making morning rounds, the nurse assesses a patient’s ordered medications and finds that the patient is to be given NPH insulin each morning but is also on orders to receive nothing by mouth because of a scheduled surgical procedure. What is the nurse’s priority action at this time regarding the administration of the insulin?6. A patient with type 2 diabetes comes to the emergency department with an acute asthma attack and pneumonia. Her condition is stabilized, and she is admitted to the hospital to receive IV 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 plasma glucose levels ranging from 5.6 to 5.9 mmol/L on most mornings. However, the next morning, her fasting plasma glucose level is 9.9 mmol/L, 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?  Health Science Science Nursing PNM 300 Share QuestionEmailCopy link Comments (0)

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