ADULT DIABETES MELLITUS You are an RN, working 7 AM to 3 PM on a 30...

Question Answered step-by-step ADULT DIABETES MELLITUS You are an RN, working 7 AM to 3 PM on a 30… ADULT DIABETES MELLITUS You are an RN, working 7 AM to 3 PM on a 30 bed medical unit in a community teaching hospital. The day staff consists of a nurse manager, 5 RNs, 4 PCTs (Patient Care Technicians), and a unit clerk. Patient rounds with the hospitalist, nurse practitioner, physician specialists and charge nurse occur at 8 AM. A Hospitalist and Nurse Practitioner coordinate the medical care of patients admitted to this unit. A Registered Dietician (RD), Pharmacist, Case Manager, and Social Worker are assigned to this unit. You arrive and receive report for your assignment as follows: Sharon Haskins Age: 56 years Weight: 84 Kg Admitting Diagnosis: Uncontrolled Diabetes Mellitus, Renal Insufficiency Past Hx: Hypertension, Peripheral Arterial Disease Diet: 1800 cal 2 Gm Na ADA diet Medications: Metformin 1000 mg PO BID Glipizide XL 10 mg PO daily Lisinopril 10 mg PO daily Cilostazol 100 mg PO BID Morphine sulfate 3 mg IV q3h PRN pain left leg Received Morphine x 2 during night with moderate relief Fingerstick blood sugar 0600: 328 Labs: HgA1c: 11.2 Hg 10.1 Hct 34.2 K 5.2 BUN 86 Cr 2.1 Diagnostics: Ankle brachial index: Left: 0.54 Right: 1.1 Consults: Vascular surgeon to discuss possible AV shunt placement, angioplasty left lower extremity Endocrinologist re: insulin therapy Rev 9/12 Sophia Vergara Age: 86 years Weight: 46 Kg Admitting Diagnosis: Hyperglycemic-hyperosmolar state (HHS) Admitted to ICU two days ago. Transferred to the Metabolic Unit last evening PMH: Hypertension, Type 2 DM Recently migrated from Guatemala Unknown medications prior to admission Lethargic, confused Lives alone, no next of kin on chart Restless most of the night Continent of urine and stool Hg 10.7 Hct 31.2 BUN 44 Creatinine 1.6 Fasting glucose this AM 122 Discharge planning for placement Duane Reed Age: 58 years Weight: 59 Kg Admitting Diagnosis: Hypoglycemia Came to the floor during night shift HPI: Found minimally responsive by wife at 0200. Brought to ED by paramedics. Blood sugar in field was 48mg/dL. Administered D50W bolus and was alert & responsive on arrival to ED. Recently started on Lantus for better blood sugar control. Past Medical History: Type 2 DM x 20 years, hypertension Labs: HgA1c 6.5, Hg 14, Hct 44.5, BS at 3am 88 Medications: Lantus 10 units subq daily Glyburide 5mg PO daily Lisinopril 20 mg PO daily Supportive wife, has insurance Haseya Smith Age 65 years Weight: 67 Kg Admitting Diagnosis: Diabetic Foot Ulcer left lower extremity Past Medical History: Type 2 DM, Venous Insufficiency, Heart Failure Patient comes from the Navajo tribe reservation Scheduled for OR today at 09:00 am for debridement and Vacuum-assisted wound closure (VAC) therapy NPO since midnight Medications: Metformin 850 mg PO BID Glyburide 5 mg PO daily Digoxin 0.125 mg PO daily Rev 9/12 Zestoretic 20/25 PO daily Ancef 2 Gms IV on call (send to OR with Patient) Social Worker to arrange subacute care for probable discharge tomorrowPart B1 Template – Prioritization of Care & Discharge Planning Part B.1 – Audience groups will discuss prioritization and corresponding rationale; identify needs of each patient and develop a staffing plan to provide care based on the patient and staffing data presented in each week’s seminar. Arrange patients on grid in priority order with rationale. Identify initial assessment priorities for each patient (5 minimum) in priority order including referenced rationale. See grid Identify planned activities for the day (5 minimum) for each patient including referenced rationale. Delegate tasks to the appropriate staff Organization, Grammar, Spelling, References (APA format) Total Points 100%____ In the grid below list patients in priority order across the top. Under each patient indicate the five priority interventions. Place an asterisk (*) next to items that only a nurse should do and (**) next to items delegated to the UAP; (***) next to the items delegated to the NUS; (****) next to the items delegated to all others (please specify). Patient 1Patient 2Patient 3Patient 4Pt. & Data AssessmentsPatient: Rationale: Pt. & Data AssessmentsPatient: Rationale: Pt. & Data AssessmentsPatient: Rationale: Pt. & Data AssessmentsPatient: Rationale:Priority Assessments:1. 2. 3. 4. 5.Priority Assessments:1. 2. 3. 4. 5.Priority Assessments:1. 2. 3. 4. 5. Priority Assessments:1. 2. 3. 4. 5.Patient Planned Activities: 1. 2. 3. 4. 5. Patient Planned Activities1. 2. 3. 4. 5.Patient Planned Activities 1. 2. 3. 4. 5.Patient Planned Activities1. 2. 3. 4. 5.Staffing: Staffing: Staffing: Staffing: References Health Science Science Nursing NUR 4307 Share QuestionEmailCopy link Comments (0)