Nutrition and Diet Therapy 6th Edition by Carroll Lutz, Erin Mazur , Nancy Litch

تمرين 7

Mrs. P has terminal brain cancer and insulin dependent diabetes mellitus; her life expectancy is a few days. She and her caregiver have been selfmonitoring her blood glucose levels. The caregiver is quite concerned because 1.Mrs. P's blood glucose levels are running between 400 and 500 mg/dL. Historically, the client claims to have followed her 1200-kcalorie diet faithfully. Recently, her appetite is markedly reduced, and her blood glucose levels are elevated. The physician has been contacted and refuses to increase the client's insulin further but recommends to 1.Mrs. P's caregiver to stop monitoring the client's blood glucose levels. The nurse should:
A) Encourage the caregiver to offer 1.Mrs. P frequent sips of clear liquid fruit juices (about 30 grams of carbohydrate every 3 hours)
B) Encourage the caregiver to continue to offer the client the 1200-kcalorie diet to avoid a hypoglycemic episode
C) Recommend the caregiver look for a new doctor because obviously the doctor does not know how to treat clients with insulindependent diabetes
D) Contact the hospice medical director and ask for an order to increase the client's insulin