Hello and thank you for taking the time to read my question. I am in my 2nd semester and need a little guidance. I really appreciate your help!
I have a case study on a patient with diabetes.
She is a 45 yoa female with Type II DM. She injured her toe while walking out to her car over a month ago. The wound got worse, turning dark in color and with her losing sensation in the toe. She has a history of PVD and DM, so decision was made to amputate the toe. Before being hospitalized, she was taking an oral hypoglycemic for control of her DM. While in the hospital she is placed on a sliding scale of regular insulin AC and HS based on accu check results. Two days after surgery, she goes to an extended care facility.
Drugs ordered: Glucophage 500mg PO BID
Humulin R SC 30 min AC and HS sliding scale base.
Fasting blood glucose levels BID
2000 calorie diet
Shift change at 11pm, report says her blood sugar was 165 and received 2 units of insulin. The night before she didn't sleep well and is now wondering hall. Based on events above my first action would be...?
I was thinking the first thing I should is assess her for pain, which may be keeping her from sleeping.
Then if need be, call doctor for Rx for sleep aid?
I would maybe make my additional diagnosis of sleep pattern disturbance?
And to determine her night awakenings, I would check her ABG labs to see if she is not getting adequate O2; sleep apnea.
I would appreciate any advise!!! THANK YOU!!