F.R., age 63, had recently been diagnosed with bronchial carcinoma. There was a history of smoking stretching back over 40 years and Frank was maintained on inhaled bronchodilator therapy for his COPD. Five years ago, F.R. had been diagnosed with type 2 diabetes. This had always been well controlled with lifestyle measures and metformin (now 1000 mg twice daily). His most recent HbA1c came back at 6.63%. To relieve obstruction and edema associated with the bronchial carcinoma, Frank was prescribed dexamethasone 4 mg once daily. At a medical examination prior to further investigations and treatment, Frank was found to have a finger-prick blood glucose reading of 400 mg/dL. Further management of his bronchial carcinoma was put on hold until blood glucose readings were adequately controlled. Corticosteroid Equivalent dose Prednisolone 5 mg Hydrocortisone 20 mg Dexamethasone 0.75 mg Identify the physiologic reasons why blood glucose is elevated. What are priority nursing interventions for this client? What education is needed for this client? What are the anticipated medications needed to address the hyperglycemia due to corticosteroid treatment for this client?
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[Answered]: F.R., age 63, had recently been diagnosed…