A client with type 1 diabetes calls the nurse because of nausea and not feeling well. What would be important for the nurse to tell the client?
1. "Hold the oral hypoglycemics until he can begin eating again."
2. "Take the insulin as scheduled, increase water intake, and continue to monitor the blood glucose."
3. "Take his regular dose of insulin, replace food with fruit juices, and monitor his blood glucose."
4. "Do not take any insulin as long as he is nauseous and cannot maintain intake."
Rationale: (3)
This client is on insulin for his diabetic control. He should continue taking the regularly scheduled dose of insulin and eating the prescribed diet, as well as increasing the amount of low-calorie fluids (e.g., broth, water, decaffeinated tea). If the client is unable to consume solid foods or keep food down, then he can increase his caloric intake by drinking carbohydrate fluids (e.g., juices and soups). It is important for the client to check his blood glucose levels every 4 hours. Additionally, for the type 1 diabetic client with blood glucose levels greater than 240 mg/dL, urine testing for ketones every 3 to 4 hours is required, and findings should be reported to the healthcare provider. The blood sugar may continue to rise because of the illness, which is why it is important to continue medication. (Lewis, et al, 8 ed., p. 1236-1238.)