spouse for changes in mental status from his baseline. The client's wife reports that he woke at 0600 to complete his morning routine. At approximately 1100 he became unaware of his surroundings and began sweating profusely and slurring his words. Breath sounds are clear but noted with a fruity citrus odor and deep rapid respirations. Sinus tachycardia per cardiac monitor. He is awake and alert, pupils equal and reactive to light. Vital Signs Time Temp P RR B/P Pulse oximeter 1200 99.5° F (37.5 °C) 118 32 97/66 89% on RA Medications Empagliflozin 10 mg PO daily Sitagliptin/ metformin 50-1000 mg PO daily Valsartan 160 mg PO daily Which 4 findings are most significant? Lung sounds History of type Il diabetes Respiratory status Circulation Pupils Temperature Mental status Medications
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- M.H. is an 80-year-old Caucasian female who is married and lives with her spouse. She presents to your office today with her spouse, feeling “coocoo, I just don’t feel right.” Currently she is taking rosuvastatin prescribed by her cardiologist for hyperlipidemia and a daily 325 mg aspirin. She drinks 3–6 hard liquor drinks a day, 3–4 times a week in the evening, and has a 65-year smoking habit, currently smoking two packs per day (ppd). She has no known allergies. Past surgical history includes hysterectomy for a benign fibroid. Family history of breast cancer in three sisters, Type 2 diabetes and CVA in one sister, cancer of unknown origin in one brother. All siblings and parents are deceased. Her husband reports that she is hard of hearing. He feels that it is due to cerumen build-up in her ears. She refuses to have the buildup removed. Her husband is also worried about her memory—states that she “just does not remember things like she used to. She keeps asking me the same questions…A 76-year-old patient states, “I have been experiencing com-plications of diabetes.” The nurse needs to direct the patient to gain more information. What is the most appropriate com-ment or question to elicit additional information? a. “Do you take two injections of insulin to decrease thecomplications?” b. “Most physicians recommend diet and exercise to regulateblood sugar.”c. “Most complications of diabetes are related to neuropathy.”d. “What specific complications have you experienced?”Formulate a Discharge Plan for a 3-year-old male child newly diagnosed with Diabetes Mellitus Type 1. Use the acronym METHODS (medication, exercise(activity /environment, treatment, health education, out-patient follow-up, diets, social/spiritual). His home medication is Regular Insulin 3 units SC TID 30 minutes before meals. The doctor also ordered monitoring of blood glucose TID before an insulin injection. The doctor advised them to return for a follow-up checkup after 2 weeks with the CBG monitoring log, and as needed. The parents are anxious about their child's condition and worried that they might not be able to take care of him. The mother asks for instruction on how to administer the insulin as this is the first time that they will do this. The mother verbalized concern that his child might need diet and activity restrictions. They have heard the word "hyperglycemia and hypoglycemia" from an adult neighbor and asks you if their child would also experience those episodes. The…
- John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Question: Preventing complications of surgery is an important part of all surgical patient care. What preoperative While Mr. Doe is in the Operating Room, what considerations will be taken to ensure Mr. Doe’s safety and positive outcome? Identify 2 IntraOp nursing diagnoses for Mr. Doe teaching does Mr. Doe require in order to prevent complications? Give 3-4 examples)A 58-year-old woman presents to the emergency department with progressive fatigueand weakness for the past 6 months. She is short of breath after walking several blocks.On review of systems, she mentions mild diarrhea. She has noted intermittent numbnessand tingling of her lower extremities and a loss of balance while walking. She denies otherneurologic or cardiac symptoms and has no history of black or bloody stools or otherblood loss. On physical examination, she is tachycardic to 110 bpm; other vital signs arewithin normal limits. The head-and-neck examination is notable for pale conjunctivas anda beefy red tongue with loss of papillae. Cardiac examination shows a rapid, regularrhythm with a grade 2/6 systolic murmur at the left sternal border. Neurologicexamination reveals decreased sensation to light touch and vibration in the lowerextremities; no depression noted. The hematology consultant on call is asked to see thispatient because of a low hematocrit level. Megaloblastic anemia…Presentation on type 2 diabetes 1 introduction and cause 2. Causes and diagnosis 3. Nursing intervention and conclusions
- Scenario: Frank Fellow, a 72-year-old is recently discharged after beingdiagnosed with early onset dementia. He lives in a two-story housewith his wife Amelia. The doctor requested PSW visit twice a week. Thedischarge note reported: moderate-sized red discoloration located onFrank’s inner thigh. Medical history includes hypertension, diabetesmellitus type 2 on insulin injection, rheumatoid arthritis, and GERD.Frank has been doing the insulin injection himself since he wasdiagnosed.You are the PSW assigned for Frank. This is the first initial visit.A. Create a care plan based on 2 identified care needs Assessment Diagnosis Planning Intervention EvaluationRON is suspected of DKA. Formulate a plan of education for Ron's wife, so she will better understand his condition and be able to assist him to manage those days when is unwell. What areas would you cover? How would you ascertain her understanding?How many days will the following prescription last?Microgestin#211 po qd x 21 d off 7d.What is the estimated days supply for this medication? [____] days. Hint: Look up what this medication is used for.
- Situation: Mrs. Corona was diagnosed of Diabetes Mellitus Type II. She was admitted to the Emergency due to dizziness, headache frequency of urination at night and complained of very hungry. Her weight suddenly decreases for the past months from 140 lbs to 110 lbs also feeling tired and having dry skin. She sought admission due to the following signs and symptoms. Her hemogluco test (blood sugar) level is from 180 - 200mg / dl 2 hours after eating. The best and correct ecologic model for Mrs. Corona? a. Web Model b. Triangle model c. Wheel model d. All the choicesRecommendations an individual can take to reduce the risk of developing type 2 diabetesA 75-year-old man with terminal small cell carcinoma of the lung presents to the emergency department with altered mental status. The patient’s wife, who cares for him at home, states that he is quite weak at baseline, requiring assistance with all activities of daily living. Over the past few days, he has become progressively more lethargic. She has been careful to adequately hydrate him, waking him every 2 hours to give him water to drink. His appetite has been poor, but he willingly ingests the water, consuming 2–3 quarts per day. He is taking morphine for pain and dyspnea. On examination, the patient is a cachectic white man in mild respiratory distress. He is lethargic but arousable. He is oriented to person only. Vital signs reveal a temperature of 38 °C, blood pressure of 110/60 mm Hg, heart rate of 88 bpm, respiratory rate of 18/min, and oxygen saturation of 96% on 3 L of oxygen. On head-neck examination, pupils are 3 mm and reactive, scleras are anicteric, and conjunctivas are…