Diabetes Mellitus Case Study (45 min)
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Outline
Miss Matthews is a 16-year-old female who is brought to the emergency department after collapsing at school. She is currently alert, but pale and weak. A blood glucose performed by the paramedics read meter Max or high. Upon further questioning, the parents report that their daughter has been weak a lot lately. Miss Matthews reports but she’s always hot and exhausted. She reports a 10-pound weight loss over the last 2 months despite eating all the time and agrees that she has been thirsty and peeing a lot. The nurse notes Kussmaul respirations and fruity breath. A serum glucose revealed that Miss Matthews’ blood glucose is 523 mg/dL, and her urine was positive for ketones. The provider explains that she is likely a diabetic. Her parents are shocked as she has always been a healthy and athletic child. The parents ask the nurse “ How can she be diabetic when she is so skinny and exercises all the time? Miss Matthews is treated for diabetic ketoacidosis over the next 2 days and is now feeling much better. The diabetic nurse educator comes by to teach Miss Matthews how to self-administer SubQ insulin using an insulin pen. Miss Matthews says “I can’t stand needles, isn’t there a pill I can take instead?” Miss Matthews is able to demonstrate proper technique for glucose monitoring and self-administration of insulin with the insulin pen. Her blood glucose levels are stable between 140 and 180 mg/dL, and the provider has said that she could go home today. 200% NCLEX Pass Guarantee.
What additional nursing assessments should be performed at this time?
What history questions would you like to ask of the patient and/or her parents?
What diagnostic tests should be run for Miss Matthews?
What is an appropriate response by the nurse?
What treatments do you expect to be ordered for Miss Matthews at this time?
What is the most appropriate response by the nurse?
What options does Miss Matthews have for insulin administration?
In addition to the insulin education, she has already received, what other education topics should be included in discharge teaching for Miss Matthews?
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Med-Surge 3
Concepts Covered:
- Gastrointestinal
- Liver & Gallbladder Disorders
- Disorders of Pancreas
- Oncology Disorders
- Central Nervous System Disorders – Brain
- Upper GI Disorders
- Medication Administration
- Lower GI Disorders
- Disorders of the Adrenal Gland
- Disorders of the Thyroid & Parathyroid Glands
- Hematologic Disorders
- Studying
- Substance Abuse Disorders
- Anxiety Disorders
- Cognitive Disorders
- Eating Disorders
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Bipolar Disorders
- Developmental Considerations
- Concepts of Mental Health
- Health & Stress
- Psychological Emergencies
- Somatoform Disorders
- Communication
- Test Taking Strategies
- Adult
- Emergency Care of the Cardiac Patient
- Intraoperative Nursing
- Microbiology
- Cardiac Disorders
- Vascular Disorders
- Nervous System
- Gastrointestinal Disorders
- Immunological Disorders
- Fundamentals of Emergency Nursing
- Dosage Calculations
- Understanding Society
- Circulatory System
- Concepts of Pharmacology
- Newborn Care
- Adulthood Growth and Development
- Respiratory Disorders
- Postoperative Nursing
- Pregnancy Risks
- Neurological
- Postpartum Complications
- Noninfectious Respiratory Disorder
- Peripheral Nervous System Disorders
- Learning Pharmacology
- Prenatal Concepts
- Tissues and Glands
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Renal Disorders
- Disorders of Thermoregulation
- Female Reproductive Disorders
- Sexually Transmitted Infections
- Acute & Chronic Renal Disorders
- Shock