cause of diaphoresis

[Ms.RN]

hello everyone

i have a question about one of my patient i had the other day. this patient is a brittle diabetic patient. when i took care of her, she was diaphoretic and her gown was wet. i checked her blood sugar and it was over 400 and i gave her coverage with short acting. i rechecked her blood sugar and it went down. to 120. but she was still very diaphoretic. her face was wet with sweat, her gown was also wet. i checked her vitals, her blood pressure was little elevated to 150/80. pulse 80, and temp was normal, 98.7, pulse ox 97% in ra. she just complained that she is not feeling well. so waht do you think is causing this?

[zahryia, LPN]

I have a question. (Keep in mind, I'm still in school)

As a nurse, how far are we supposed to go as far as figuring out WHY she has diaphoresis.

Isn't it our job to report the symptom to the doctor and have them figure it out?

[Scrabbler]

I have a question. (Keep in mind, I'm still in school)

As a nurse, how far are we supposed to go as far as figuring out WHY she has diaphoresis.

Isn't it our job to report the symptom to the doctor and have them figure it out?

Yes it's the doc's job to make a medical diagnosis, but it's our job to think critically about what's going on with the patient and possible diagnoses so we can better anticipate treatment and plan our care. We spend far more time directly involved with the patients and should put the knowledge aquired therein to best use. Plus, we should do what we can to make patients comfortable and that takes critical thinking and problem-solving. It might be as simple as adjusting the heat when someone's sweating or taking off a woman's bra when she has chest pain, or it could be tricky as is the case with this patient and her diaphoresis...I could get wordier, so I'll leave it at that!

[leslie :-D]

found out this patient had infection in her stool and in her wound. but when i assessed her, she did not have a fever.

i have learned through many experiences, that many pts do not present with fever when being dx'd with infection.

my dtr has had strep throat sev'l times, and once, scarlet fever.

never had a temp w/strep, and a very low grade with scarlet.

and most elderly will not have a fever...

until the infectious process has advanced to late stage.

do not look at fever, or lack thereof, as an indicator of any given process.

conversely, many pts do present with subtemps, when approaching sepsis...96, 97.

diaphoresis was alone, enough to suspect something was cooking.

being afebrile, meant nothing to me.

leslie