[DSA] Anticipatory Guidance and Documentation [Howell]

Question 1

What does anticipatory guidance mean?

Answer 1

Clinician provides patient specific education by anticipating upcoming changes or needs of the patient

Question 2

What are the normal glucose ranges for:

Preprandial glucose

Postprandial glucose

HbA1C

Answer 2

Preprandial - <100

Postprandial - <140

HbA1C - 4-6%

Question 3

In general, a Type 2 diabetic should check capillary sugar ____ daily and blood sugar upon ____

Answer 3

In general, a Type 2 diabetic should check capillary sugar once daily and blood sugar upon waking

Question 4

Steps to using a glucometer (8)

Answer 4

1. Wash hands with soap and water, dry completely
2. Insert lancet into device and set depth correctly
3. Verify test strips are w/in expiration period and insert into monitor
4. Stick side of finger
5. Allow blood to wick into the strip without touching
6. Apply pressure with cotton ball or gauze at site to stop bleeding
7. Record reading with date and time to take to doctor
8. Dispose of lancets in the proper container, not in the trash directly

Question 5

Why should lancets be stuck in the side of a diabetic’s finger?

Answer 5

Fewer nerve endings on the side, may help decrease pain sensation

Question 6

How often should diabetics examine their feet?

Answer 6

Once daily

Question 7

It’s in important to make sure your diabetic patients always wear ___

Answer 7

Shoes

Make sure they fit properly, don’t pinch or rub when they walk

Question 8

What should you tell your patients to examine when doing a daily foot exam? (5)

Answer 8

1. Nails trimmed neatly
2. Look at all skin areas
3. Monitor for calluses and corns, signs of thickening
4. Feet should feel warm to touch
5. Hair over joints is a sign of good circulaton

Question 9

What are the required components of a physician’s diabetic foot exam?

Answer 9

Inspection (all surfaces)

Pulse

Protective sensations (monofilament and vibration)

Reflexes at the ankle

Question 10

What are the 3 main types of carbs?

Answer 10

Starch

Sugar

Fiber

Question 11

What should you educate your diabetic patient on for eating a healthy diet?

Answer 11

Educate on types of carbs

Get enough protein while limiting red meat, cholesterol

Healthy fats

1/2 of plate w/ non-starchy veggies

Eat regularly