Questions about Managing a case

Is this your homework?

What are your thoughts on the issue?

No its not my homework.....its about 3 monthes till now no body can answer me..if you ahve an idea please i need

You don't offer enough information to help you. What are the labs? CBC/H&H, electrolytes? What other observations other than a hypertensive blood pressure and hyperglycemia? Is the patient on medications? Define severe bleeding? What is the source of the "severe bleeding"?

The labs would indicate if blood product might be ordered by physician. There are fluid replacement protocols adjusted for renal failure. When is the patient due for dialysis (presumably hemodialysis?)

Not all he not all hemorrhage require blood products.

If this is a friend/family member that falls under medical advice and we cannot assist.

Impossible to know if a blood transfusion is needed based on blood pressure and blood glucose levels. What is the hemoglobin? A BP of 190/90 doesn't scream hypovolemia to me...

1. We don't have enough information on the situation!

2. As nurses, we rely on the physician on "manage" this case and to write us an order for specific fluid replacement.

1. We don't have enough information on the situation!

2. As nurses, we rely on the physician on "manage" this case and to write us an order for specific fluid replacement.

Well, not exactly. As nurses, we cannot make medical diagnoses and we don't prescribe medical plans of care, which is what would be the case here.

If this is for a personal situation, you need to have the people involved speak to the physician, or another physician with expertise in diabetic renal failure management. If it's for a legal matter, somebody needs to talk to an attorney whose legal nurse consultant will be able to identify a physician expert for an opinion as to whether whatever management occurred was or was not appropriate.

If it's not just idle curiosity, why not tell us the circumstances?