Nurse's Pocket Guide

ACTIONS/INTERVENTIONS RATIONALE
Instruct in signs/symptoms Knowing what to watch for
of insulin reaction/ and appropriate treatment
hypoglycemia (i.e., fatigue, (such as 1/2 cup of grape
nausea, headache, hunger, juice for immediate
sweating, irritability, response and snack within
shakiness, anxiety, difficulty 1/2 hr [e.g., 1 slice bread
concentrating). with peanut butter or
cheese, fruit and slice of
cheese for sustained
effect]) may prevent/
minimize complications.
Review “Sick Day Rules” Understanding of necessary
(e.g., call the doctor if too actions in the event of
sick to eat normally/stay mild/severe illness
active), take insulin as promotes competent
ordered. Keep record as self-care and reduces risk
noted in Sick Day Guide. of hyper/hypoglycemia.
Instruct client/wife in Fingerstick monitoring
fingerstick glucose provides accurate and
monitoring to be done qid timely information
until stable, then BID regarding diabetic status.
rotating times (e.g., FBS Return demonstration
and before dinner; before verifies correct learning.
lunch and HS). Observe
return demonstrations of
the procedure.
Recommend client maintain Provides accurate record for
record/log of fingerstick review by caregivers for
testing, antidiabetic assessment of therapy
medication, and insulin effectiveness/needs.
dosage/site, unusual
physiological response,
dietary intake. Outline
desired goals (e.g., FBS
80–110, premeal 80–130).
Discuss other healthcare Encourages client involveissues,
such as smoking ment, awareness, and
habits, self-monitoring for responsibility for own
cancer (breasts/testicles), health; promotes wellness.
and reporting changes in Note: Smoking tends to
general well-being. increase client’s resistance
to insulin.
62 NURSE’S POCKET GUIDE