Reference no: EM133297172

Case: Patient K is a 65 year old single male who has a 20 year history of type 2 diabetes. Both of his parents also had type 2 diabetes. He had a myocardial infarction at age 57 and states that he was told his cholesterol is high. He smokes 15 cigarettes per day for the past 40 years. WT 99.8 kg (220 lbs) HT 172 cm (5 feet 8 inches).

He has been in hospital for three days due to diabetes complications and poorly controlled blood glucose levels. His blood glucose on admission was 40 mmol/L. He reported blurred vision, polyuria, and severe polydipsia. Skin was warm and dry and temperature was 38.3 C. He was very lethargic.

He reports numbness on the soles of both feet and a small, round, well-demarcated ulcer was noted on the ball of his left foot. He notes that he has not taken his anti-hypertensive medication or anti-diabetic medications for the past few days as he is recently unemployed and is trying to ration his medication and he has been sick in bed with a cold.

Question 1. What are the risk factors for diabetes complications for this client?

Question 2. Using the assessment data provided to support your answer, identify and explain whether he was experiencing DKA or HHNK on admission.

Question 3. What interventions are anticipated based on the identified problem above?

Question 4. The client reports that he has never experienced angina and did not experience pain with his myocardial infarction. What patient teaching regarding diabetes and angina/MI pain is appropriate?

Question 5. Based on the client's history and presenting illness, he is now prescribed insulin. Explain the teaching required regarding:

Symptom recognition

Insulin administration
Glucose monitoring