Reference no: EM133794522

Problem

Tula Stillwater Tula Stillwater is 36 years old and has had diabetes since age 26. Ms. Stillwater weighs 218 lb, is gravida 1 para 1, and delivered a 9 lb, 6 oz boy via cesarean section 3 days ago, resulting in a transverse abdominal incision with staples. She reports tenderness on the right side of the incision, but acute pain on the left side of the incision. Her 0800 vital signs are as follows: temperature, 101.6°F; pulse, 76 beats/min; respirations, 18 breaths/min; blood pressure, 134/78 mm Hg. Her blood glucose before breakfast is 185 mg/dL; her blood glucose on previous days had ranged from 90 to 124 mg/dL. On initial assessment, you note the dressing is intact on her incision. The staples are intact in the incision; the incision is well approximated and without erythema on the right side. However, the left side of the incision is pulling apart and is edematous and warm to the touch, with a scant amount of purulent drainage. Prescribed Interventions Vital signs q4h Fingerstick blood glucose before meals and at bedtime Regular insulin per sliding scale Prescribed interventions: Remove staples before discharge. Discharge on third day, if stable. Developing Clinical Reasoning and Clinical Judgment What is your interpretation of her vital signs? Who should be notified and when? How would you determine whether Ms. Stillwater meets the criteria for discharge? What is the relationship between Ms. Stillwater's diabetes and her postsurgical condition? What factors affect her staple removal? How should you respond to her fingerstick blood glucose level? What nursing interventions do you foresee performing? Describe the timing and the technique for administering her insulin.