Medical Surgical Diabetes #5

Question

The nurse is instructing a Type 1 diabetic on “sick day rules” and stresses which key sick day advice?

Answers

  1. “You should perform more vigorous exercises to get well sooner.”
    • Rationale:

      This answer is not correct because vigorous exercise is not appropriate when the client is sick. Excess exercise will create further demand on the already stressed body. Activity in moderation may continue. The first and most important rule regarding sick days for a type 1 diabetic is to continue taking insulin to control blood glucose levels. Careful blood glucose monitoring (every 4 hours) and urine ketone monitoring is essential to properly control blood glucose levels during sickness. The amount of insulin taken may vary (more or less) depending on the sickness and the amount of food intake.

  2. “Sick day means not to take insulin on days that you are ill.”
    • Rationale:

      This answer is not correct because diabetes type 1 is a condition where the pancreas stops producing insulin completely, necessitating the client to have lifelong insulin therapy. This includes during times of illness, when the sickness may actually elevate blood glucose levels. The first and most important rule regarding sick days for a type 1 diabetic is to continue taking insulin.

  3. “The number one rule of thumb is to continue taking your insulin.”
    • Rationale:

      This answer is correct because diabetes type 1 is a condition where the pancreas stops producing insulin completely, necessitating the client to have lifelong insulin therapy. This includes during times of illness, when the sickness may actually elevate blood glucose levels. The first and most important rule regarding sick days for a type 1 diabetic is to continue taking insulin. Careful blood glucose monitoring (every 4 hours) and urine ketone monitoring is essential to properly control blood glucose levels during sickness. The amount of insulin taken may vary (more or less) depending on the sickness and the amount of food intake. Be in contact with the healthcare provider if the illness is prolonged, there is difficulty controlling blood glucose levels, or ketones are present in the urine.

  4. “Limit fluids when ill because fluids will be hypotonic and more harmful.”
    • Rationale:

      This answer is not correct because fluids should not be limited, instead fluids should be increased as much as possible. This will help with dehydration potentially associated with the illness, help maintain healthy blood glucose levels and fluids will help flush ketones from the system.

Overview

The first and most important rule regarding sick days for a type 1 diabetic is to continue taking insulin. The amount of insulin taken may vary (more or less) depending on the sickness and the amount of food taken in, but insulin is still taken.

Explanation

Learning Outcomes

Diabetes type 1 is a condition where the pancreas stops producing insulin completely, necessitating the client to have lifelong insulin therapy. This includes during times of illness, when the sickness may actually elevate blood glucose levels. The first and most important rule regarding sick days for a type 1 diabetic is to continue taking insulin. Careful blood glucose monitoring (every 4 hours) and urine ketone monitoring is essential to properly control blood glucose levels during sickness. The amount of insulin taken may vary (more or less) depending on the sickness and the amount of food intake. The client should drink plenty of calorie-free fluids and eat as normally as possible. The client should weigh themselves daily since decreasing weight could indicate elevated blood glucose. Be in contact with the healthcare provider if the illness is prolonged, there is difficulty controlling blood glucose levels, or ketones are present in the urine.

Test Taking Tip

Drinking more fluids and hydration is rarely contraindicated, unless the person has renal failure or heart failure.

Video Rationale