Case study 2

James is a 47-year-old man with PMH of obesity, HTN, and HLD admitted to a medical unit with an ulceration on his right foot. His blood glucose level is 480. He tells you that he takes NPH (Humulin R) insulin 30 units every morning and 5 units of Regular (Humulin R) insulin with each meal and at bedtime.

James said his doctor told him to keep his glucose between 100 and 140. What is the normal range for blood glucose? Why didn’t the doctor recommend that James keep his glucose in the normal range?

What diagnostics and tests would his doctor order to manage his condition?

When you enter his room to check his 4 p.m vital signs, he complains of a headache and started sweating before you finish taking his vitals. Based on your nursing assessment, what do you suspect? How would you confirm your suspicions?

Based on the previous scenario, what do you think occurred, and what nursing interventions should you implement?

Explain the importance of regularly scheduled meals throughout the day. How would you explain/teach this to James?