Published Sep 28, 2010
donnak3756
5 Posts
scenario
51 year old male., Past history: Type 1 diabetes, Hypertension, Allergies: Penicillin.
Current medications: HumalogMix 25: 26 units mane and 16 units nocte.
Perindopril: 4 mg mane, Asprin: 100 mg daily.
Social History: does not drink alcohol, and smokes 1 pack of cigarettes a
day. He lives in a single bed unit by himself.
Weight :70kg. Height: 190cm
Presenting complaint: admitted with confusion for investigation after found with confused and disorientated at home. His Glasgow coma score was 14/15 inemergency.
Current situation:
speech is slurred. unable to remain still in the bed and he complains of feeling weak with no energy.
GCS score of 13/15 -opens his eyes in response to your voice,continues to obey commands. However he does not know where he is or what year it is.
Further investigation reveals has had the full dose of his insulin this morning. 26 units of HumalogMix but he has had nothing to eat for breakfast. You complete a blood sugar reading which reveals a level of 2.1 mmols.
You implement the ward protocol for managing hypoglycaemia.You inform the medical officer of the current situation and he requests that the BSL e repeated in 30 minutes after administration of the carbohydrates.You administer 15-20 gram of simple carbohydrate in 125 mls of orange soft drink ater 30 minutes further assessment reveals BSL is now 4.7 mmol/L.
vital signs are HR 72 bpm, BP 105/65 mmHg, RR 16, SpO2 99%. His GCS is
now 15.
NEED TO DO
prioritise the patient problems in order of highest need first, then Select the three most important problems that are present for the patient in the next two hours and Using evidenced practice discuss the nursing interventions required to eet the identified care needs for the patient.. short term goals only.
so far i have got for my nursing diagnosis
Imbalanced nutrition : less than body requirements related to ?
Risk for injury related to altered consciousness secondary to hypoglacemia
Risk for hyperglacemia related to altered nutrition secondary to hypoglacemia
Risk for unstable blood glucose related to simple carbohydrates administered secondary to hypoglacemia
im stuck. im hoping the above is correct. and not sure which order to put them in. if any one can shred some light it would be greatly appreciated as i have spent hours on this and still coming up blank. i know theres more out there but not sure what.
thanks
Sunny3766
2 Posts
Hi did you finish this assignment? I have exactly same scenario and work to do, but I am stuck too. *^^*
Esme12, ASN, BSN, RN
20,908 Posts
Welcome to AN! We are happy to help but we won't do it for you. What semester are you? It helps me know better how to start you on your path. Are you in Canada?
For our American friends
2.1 mmol/L (38 mg/dL)
85 mg/dl (4.7 mmol)
What do you have so far and I will help you.