CASE STUDY: THE PATIENT WITH DIABETES MELLITUS THE PATIENT IS A 48…
Question Answered step-by-step CASE STUDY: THE PATIENT WITH DIABETES MELLITUS THE PATIENT IS A 48… CASE STUDY: THE PATIENT WITH DIABETES MELLITUSTHE PATIENT IS A 48 YEAR OLD UNCONSCIOUS WOMAN ADMITTED TO THE ED. SHE HAS A KNOWN HISTORY OF TYPE I DIABETES MELLITUS. HER DAUGHTER ACCOMPANIES HER AND TELLS THE STAFF THAT HER MOTHER HAS HAD THE “FLU” AND HAS BEEN UNABLE TO EAT OR DRINK VERY MUCH. THE DAUGHTER IS UNCERTAIN WHETHER HER MOTHER HAS TAKEN HER INSULIN IN THE PAST 24 HOURS. THE PATIENT’S VITAL SIGNS ARE TEMPERATURE 101.8 F; PULSE 120, WEAK AND IRREGULAR; RESPIRATIONS 22, DEEP with FRUITY ODOR; and BLOOD PRESSURE 80/42 MM HG. BLOOD SPECIMENS AND ARTERIAL BLOOD GASES ARE DRAWN AND AN IV INFUSION BEGUN.1. Based on this patient’s history, give the probable changes in laboratory results for serum glucose, serum osmolarity, serum acetone, BUN, arterial pH, and arterial PCO2. What medical emergency do these data indicate?2. What type of IV solutions should the RN be prepared to administer to this patient? What drugs should the nurse be prepared to give? Explain your answers.3. The patient is placed on continuous cardiac monitoring. What is the rationale for this intervention?4. During the first 24 hours, what complications should the nurse monitor for in this patient?5. The patient eventually becomes normoglycemic, regains consciousness, and begins a 1500-calorie diabetic diet. Develop a teaching-learning plan for her about this diet.6. Before this emergency, this patient had been monitoring urine glucose and ketones for self-care and insulin administration. Her MD prescribes blood glucose monitoring instead of urine testing. What is the rationale for this change?7. Which aspect of diabetic self-care should the nurse discuss with this patient before her discharge?8. The patient is to be discharged on a mixed-dose regimen for insulin. She is to receive 10 units regular insulin and 18 units NPH insulin before breakfast and another 5 units regular insulin and 12 units NPH at dinnertime. Develop a teaching-learning plan for these medications.9. Considering the patient’s insulin protocol, the patient should keep in mind what principles about the actions of the insulins she is taking?10. What should the nurse discuss with this patient about diabetes, insulin and illness? What can this patient do to prevent future emergency episodes? Consider “Instructions for Sick Day” rules. Health Science Science Nursing NURSING NR160115 Share QuestionEmailCopy link Comments (0)
