Keld401

In an H&P dr charted "pt's o2 sats 120's on non-rebreather but quicky drop to the 00's without it." Haven't quite figured out how an o2 sat can be more than 100%, or 0%. Hopefully it was a transcription error!

My next thing to try is setting an alarm clock or maybe his cell phone to remind him. I have been prefilling his needles w the right dosage but he forgets to use them! Or he takes what he thinks he needs. Either way its not effective enough. I also considered a big dry erase board that's easy to see. I have heard of med planners that come w an alarm, anyone know where to get one?The home care assistants would be good, but they can't afford it. :-( the social worker is going out next week to see if she can do anything. Making him daily isn't a long term solution since he takes insulin bid, and i don't think indefinite daily visits to administer insulin is covered by Medicare.Thanks guys!

I have elderly pt (70's) that I have been working on diabetes education with. He is really sweet, wants to be compliant and tries very hard, but is very forgetful. He rarely remembers to take his insulin (70/30 30units bid) and when he does he may take 2 or 8 or 20 units. Has cataracts and poor vision, had him draw up 30 units and he had a lot of difficulty and only drew up 21 units, so I prefilled a week's worth of insulin syringes, last week he only used 3 of them, this week only 1. He has gotten better about checking his cbg and cutting down on sweets, ranges have went from 30's-600+ to 50's-300's, over the past month. I have tried several different kinds of charts and signs with spots for am and pm cbg, when insulin given, and when meds taken, taped them to his fridge, but between his eyesight and forgetfulness they don't do much good. His wife isn't in great shape and isn't much help w/ reminding him to take insulin. He is very receptive to education and really wants to get is sugar under control, as his kidneys are already showing damage. I just don't know what else to do to get him to remember how/ why/ when to take the insulin. He is also forgetful w/ taking his po meds but has improved w/ using the chart and BP has been better controlled, at least until today when he forgot his meds again and BP was 210/88. Any ideas on charts, signs, different types of glucometers, etc that I can use to help him remember to check cbg before meals, take insulin as ordered, and take meds? Thanks a bunch!! Kelly

Do you have a Coagucheck machine available? Its like a glucometer, and gives you instant readings with a fingerstick. Alot of agencies are using them now. If you have to do a blood draw, I use a 23 g butterfly, waste a small amount into a red tube, then fill the blue. It has to be all the way to the line or the sample won't be usable. If you dont waste into the red tube the air in the butterfly tubing takes up space in the blue tube and it won't fill. Good luck, enjoy your first day!