What complications would be of concern to the nurse

Assignment Help Biology

Reference no: EM133796094

Assignment: Metabolism

Case Study: The client is Jack, a 64 yr old male. He has type 2 diabetes mellitus. He was brought to the emergency department by his wife because he has been sick for several days She also reports that the client has been sleeping a lot for the last week. He has also been nauseous and vomiting for 2 days and unable to keep any of his medications down. He reports urinating frequently and feeling dizzy when he gets up.

1) Admission vital signs: Temperature of 98.2°F, HR 110 bpm, RR 32, BP 100/68 mmHg, Pulse Ox 96% on room air

2) Admission assessment findings: Height 5 ft. 11 inches, weight 224 lbs., breath sounds clear, hyperactive bowel sounds, lethargic but arousable, requested urinal when he arrived on the unit and voided 680 ml of pale yellow urine, a small blister noted on the heel of the left foot - wife stated that the client had an old pair of shoes that caused the blister.

3) Medical history: Diagnosed with Type 2 Diabetes Mellitus about 15 yrs ago, does not follow prescribed therapeutic diet, social drinker - more on weekends, married 40 yrs, takes oral DM meds, checks blood glucose 2 times daily when he remembers, history of hypertension

4) Laboratory values / Diagnostic tests: pH 7.34, PaCO2 34 mmHg, Pa02 93 mmHg, HCO3- 24 mEq/L, blood glucose 620 mg/dL, potassium 5.1, BUN 60mg/dL , creatinine 1.8, serum osmolality 324, chest x-ray and ECG were unremarkable

5) Physician orders: Admit to Medical-Surgical Unit, monitor vital signs every 4 his, NPO, activity - bed rest, monitor blood glucose every 4 hr, IV therapy: 0.9 normal saline solution at 150 ml/hr

6) Medications: glyburide 2.5 mg orally daily, metoprolol 25 mg orally 2 times a day, hold for HR under 60 and/or systolic BP less than or equal to 100 mmHg

Sliding Scale:

Novolog before meals & before bed: 150-199 2units 200-249 4units
250-299 6units 300-349 8units
350-400 lOunits & call MD

Task

I. What assessment and history data should the nurse focus on related to Diabetes Mellitus Type 2?

II. What additional tests would be used to evaluate the client's current status and response to treatment? What do the current labs indicate?

III. What do the ABG results indicate?

IV. What initial interventions / treatments would you recommend for this client?

V. What complications would be of concern to the nurse?

VI. What discharge planning and teaching would be indicated?

Reference no: EM133796094

Questions Cloud

Antibiotics and their tunneled catheter : The patient completed their course of IV antibiotics and their tunneled catheter into the superior vena cava was no longer needed.

What messages will you ask your influencers to promote? : What percentage of your posts will be promotional, if any? What messages will you ask your influencers to promote?

Consumer health informatics is still relatively : Consumer health informatics (CHI) is still a relatively new field, but it is rapidly evolving and has the potential to revolutionize

Received renal transplant is on ciclosporin therapy : A patient who has received a renal transplant is on ciclosporin therapy. He says he has been feeling down recently and is therefore taking

What complications would be of concern to the nurse : What initial interventions / treatments would you recommend for this client? What complications would be of concern to the nurse?

Daily for hypercholesterolemia management : 45-year-old man takes atorvastatin 40 mg once daily for hypercholesterolemia management. His medical history also includes plaque psoriasis,

Newly hired provider routinely individualizes therapy : A physician is involved in direct patient care at an outpatient clinic where a newly hired provider routinely individualizes therapy

Significant only for acute coronary syndrome and diabetes : A physician providing transition of care services reviews a patient whose medical history is significant only for acute coronary syndrome and diabetes

What does archaeopteryx fossil tell us : Who forced Darwin to publish his works? What does Archaeopteryx fossil tell us? How did species get to other continents and become disturbed?

User Account

All Pages