You are working in the MD now clinic when a mother brings in her...

Question Answered step-by-step You are working in the MD now clinic when a mother brings in her… You are working in the MD now clinic when a mother brings in her 19-year-old-daughter, Ms. H. Gamboa who has type 1 DM and has just returned from a trip to Mexico. She’s had a 3-day fever and diarrhea with nausea and vomiting (N/V). She has been unable to eat and has tolerated only sips of fluid. Because she has been unable to eat, she has not taken her insulin. Because Helen (as Ms. Gamboa is known to her friends) is unsteady, you bring her to the examining room in a wheelchair. While assisting her onto the examining table, you note that her skin is very warm and flushed. Her respirations are deep and rapid, and her breath is fruity smelling. Ms. Gamboa is drowsy and unable to answer your questions. Her mother states, “She keeps telling me she’s so thirsty, but she can’t keep anything down.”1. List four pieces of additional information you need to elicit from Ms. Gamboa’s mother. (10 points)Answer:2. Describe the pathophysiology of DKA (diabetic ketoacidosis). (10 points)Answer: 3. Explain the patient’s presenting S/S. (List three.) (10 points)Answer: 4. Her current VS are temperature 101.3° F (tympanic), 90/50, 124, 36 and deep, 90/50. Are these VS appropriate for a woman of Ms. Gamboa’s age? Why or why not? Discuss your rationale. (10 points)Answer: A decision has been made to transport Ms. Gamboa by ambulance to the local ED. After evaluating Ms. Gamboa, the ED physician writes the following orders.5. Carefully review each order. Mark with an “A” if the order is appropriate; mark with an “I” if inappropriate. For each order you mark as “I,” explain why it is inappropriate and correct the order. (10 points)___ 1000 ml LR IV STAT.___ Give 36 units lente insulin and 20 units regular insulin SC (subcutaneously) now.___ CBC with differential; CMP, blood cultures × two sites; clean-catch urine for UA and culture and sensitivity (C&S); stool for ova and parasites, Clostridium difficile toxin, and C&S; serum lactate, ketone, and osmolality; ABGs on room air___ 1800-calorie American Diabetes Association (ADA) diet___ Ambulate q.i.d.___ Acetaminophen (Tylenol) 650 mg (10 gr) PO___ Furosemide (Lasix) 60 mg IVP now___ Urine output every hour___ VS every shiftAnswer: All orders have been corrected and initiated. Ms. Gamboa has received fluid resuscitation and is on a sliding scale insulin drip via infusion pump. Her latest glucose was 347 mg/dl.6. What is the rationale behind using an infusion pump for the insulin drip? (10 points)Answer: Helen is ready for transport to the medical ICU. Her mother is beginning to realize that Ms. Gamboa is more acutely ill than she thought. She leaves the room and begins to cry. Reassure her that Ms. Gamboa will be okay. 7. How would you handle this situation? (10 points)Answer:8. Ms. Gamboa’s mother asks where she can get more information on how Helen can control her diabetes. What are some resources she may find useful? (10 points)Answer: Ms. Gamboa is transported to the MICU in slightly improved condition. She continues to improve and is discharged from the hospital 3 days later. Health Science Science Nursing NUR 1211C Share QuestionEmailCopy link Comments (0)