Wednesday, July 4, 2012

Does anyone think that i am on the right track with this case study


Does anyone think that i am on the right track with this case study?
Mrs. Grace Pallance is a 42 year old woman who is admitted to your ward through the emergency department, having been referred by her local doctor. She has a week long history of fatigue, headache, poor appetite, thirst and frequency. On admission the following data is recorded: • weight is 90kg = morbidly obese. • height is 164cm • temperature: 37.2 degrees Celsius = normal • pulse: 120 beats/minute = increase higher than normal • respiration's: 20 breaths/minute = high side of normal • BP: 160/95 mmHg = high Urinalysis: • large amounts of glucose = high indicating metabolic imbalance • trace albumin • nil ketones = indicating that this episode is still reversable. • SG1.016 = normal range Plasma glucose level: • 16mmollL = high indicating metabolic imbalance Provisional diagnosis Type 2 Diabetes Mellitus Mrs Pallance is to be transferred to the ward and an electrocardiograph (ECG) is to be taken on arrival in the ward. 1. Upon her arrival in the ward you assess Mrs Pallance. Based on your knowledge of T2DM and your assessment; discuss the nursing interventions required and explain the rationale for each intervention. 1/Upon admission to ward I would do a set of observations- to establish our baseline. 2/ Administer iv fluids. 3/ Catheretize to monitor fluid output. 4/Monitor electrolytes. 5/ Administer iv insulin and Dextrose to stablize pt 2. Using the information from the case study, explain Mrs. Pallance's symptoms to her as they relate to the provisional diagnosis. In your answer identify her risk factors for developing type 2 diabetes
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Administering insulin via iv and putting in a catheter seems like over kill on a patient with a BG of 288 without knowing when the last meal was and was the level going up or down. A simple injection of a fast acting insulin may be in order but without ketones in the urine I would be looking at heart/lung issues and monitor the diabetes issues. She has diabetes, she does not have risk factors for developing type 2 diabetes, she IS diabetic.




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Posted by Diabetes Melitus at 9:17 AM