Reference no: EM133444824

Case study

Bobby Holmes is a 56-year-old obese Caucasian male who was recently brought to the ED with chief complaints of blurred vision, fatigue, frequent urination, and difficulty walking. His medical history and co-morbidities include coronary artery disease, atherosclerosis, Type 2 DM, Hypertension, and diabetic neuropathy. He relies on his son for transportation and financial needs related to his medical health because he recently lost his medical insurance.

Upon assessment, Mr. Holmes was diagnosed with hyperglycemia and the nurse noted a macerated wound to his left foot. He was admitted for hyperglycemia management and possible ostomyelitis. His current medications include Humalog U-100 per sliding scale before meals, Lantus 20 units QHS, Atorvastatin 40mg BID, and Lisinopril 40mg BID.

VS as follows: BP 147/86, T: 100.2F, P 86, RR 20, O2 97% RA.

MD orders: UA, CBC with diff, random glucose check, wound culture for Left foot wounds

Questions:

1. What is the priority interventions for Mr. Holmes in his current medical status upon admission?

2. What are some questions that the nurse may ask to obtain relevant information regarding his situation to ensure an appropriate plan of care?

3. What are the anticipated lab results based on the given information?

4. What important facts can the nurse teach the patient about diabetes to promote positive health outcomes?

5. What interdisciplinary team members are appropriate to be involved in Mr. Holmes plan of care?

6. In what ways can the interdisciplinary team members be proactively involved?

7. What lab values would alert the nurse to report it immediately to the medical provider?

8. What is safe to assume the reason for Mr. Holmes episode of hyperglycemia?

9. How can we connect the patient's medical condition to the pathophysiology of his admitting diagnosis?

10. What are some discharge goals that the nurse can expect to share with the patient?