Nurse’s Directions for Collecting and Testing the Urine in Diabetes Mellitus.—The first urine voided in the morning at 7 A.M. should be thrown away, after which the entire quantity during the ensuing twenty-four hours, including that at 7 A.M. the following morning, should be collected in a thoroughly clean, wide-mouth bottle sufficiently large to contain the entire quantity. This should be kept in a cool place to prevent decomposition. After the urine has been measured, four or five ounces are removed for testing purposes. There is no necessity for having an elaborately equipped laboratory for making the simple tests of the diabetic urine. The nurse is only required to make the simple tests, leaving the more elaborate one for the physician. The articles necessary for these tests must be kept perfectly clean in order to make the tests accurate. The bottle in which the urine is collected must be washed and sterilized daily before the collection begins. One small three-inch white enameled or porcelain dish, one 10 c.c. graduated pipette, 6 test tubes, 1 small alcohol lamp or Bunsen burner, 1 box of sodium carbonate, 1 box talcum, and the reagents necessary for making the test, namely, Benedict’s solution, Fehling’s solution, and Haines’s solution.
SUMMARY
Diabetes Mellitus is a disease in which the body becomes more or less unable to utilize the sugars and starches, consequently there is an abnormal amount of glucose in the urine.
Manufacture of Sugar in the body from other food constituents besides carbohydrates has been proved with regard to proteins, hence the intake of nitrogenous substances must be restricted in diabetes—to a less extent, however, than the sugars and starches.
Acetone Bodies.—Diacetic acid, oxybutyric acid, and acetone develop in diabetes as a result of the breaking down of the fats and the lack of certain neutralizing agents found chiefly in carbohydrate foods.
Acidosis is a form of intoxication due to the retention of these toxic acids in the body. If not combated and overcome, it will result in the diabetic coma which is fatal in so many cases.
Diet Treatments.—The best known treatments are those devised and used by Drs. Allen and Joslin “The Starvation Treatment for Diabetes Mellitus,” and the “High Fat Diet” formulated by Drs. Newburg and Marsh. All cases cannot be handled alike and it is for the physician to determine the treatment calculated to give the best results in the definite case.
Training for Diabetic Nursing.—So much depends upon the administration of the treatment in this pathological condition that in many hospitals special training is being given to the nurses in the care of diabetic patients that they may be able intelligently to carry out the necessary régime, both in the hospital and in private practice.
Symptoms.—She must be able to recognize symptoms both from the findings resulting from the urinalysis and from those manifested otherwise by the patient.
The Record.—She must keep an absolute record of all that occurs during the course of treatment and instantly report any unusual happening.