(^358) Medical-Surgical Nursing Demystified
- Force fluids.
- Give the patient acid-ash juices such as cranberry juice.
- Strain urine for kidney stones.
- Place the patient on a low-calcium and high-phosphorus diet.
- Explain to patient:
- Avoid over-the-counter calcium supplements.
- Maintain daily activities.
Diabetes Mellitus
WHAT WENT WRONG?
Our body converts certain foods into glucose, which is the body’s primary energy
supply. Insulin from the beta cells of the pancreas is necessary to transport glu-
cose into cells where it is used for cell metabolism. Diabetes mellitus occurs
when beta cells either are unable to produce insulin (Type I diabetes mellitus) or
produce an insufficient amount of insulin (Type II diabetes mellitus). As a result,
glucose does not enter cells but remains in the blood. Increased glucose levels in
the blood signal to the patient to increase intake of fluid in an effort to flush glu-
cose out of the body in urine. Patients then experience increased thirst and
increased urination. Cells become starved for energy because of the lack of glu-
cose and signal to the patient to eat, causing the patient to experience an increase
in hunger. There are three types of diabetes mellitus. These are Type I, known as
insulin-dependent (IDDM), where beta cells are destroyed by an autoimmune
process; Type II, known as non-insulin-dependent (NIDDM), where beta cells
produce insufficient insulin; and gestational diabetes mellitus (DM that occurs
during pregnancy).PROGNOSIS
Patients with Type I and Type II diabetes mellitus are at risk for complications
such as vision loss (diabetic retinopathy), damage to blood vessels and nerves
(diabetic neuropathy), and kidney damage (nephropathy). However, complications
can be minimized by maintaining a normal blood glucose level through consistent
monitoring, administering insulin, and dieting. Patients with gestational diabetes
mellitus will recover following pregnancy; however, they are at risk for develop-
ing Type II diabetes mellitus later in life.15