Mr. Gregg is a 65-year-old African-American male who was admitted with complaints of increased fatigue, shortness of breath, and headache. He states that he retired 9 months ago after 45 years as a construction worker. He now leads a sedentary lifestyle, and doesn't have as much energy as he used to have. He has gained 50 pounds since retirement. Upon assessment, Mr. Gregg weighs 255 pounds and is 5' 11" tall. Vital signs are temperature 98.8°F, pulse 88 beats per minute, respirations 20 breaths per minute, and blood pressure 150/90. Assessment findings are documented in the patient's record and reported to the physician. The following laboratory studies are ordered to determine the diagnosis of HHS. Serum electrolytes, Na+ 128, K+ 5.8, chloride 98, glucose 940, BUN 62, CREAT 2.4, and HCO3 21. Hemoglobin A1C 12.2.
Mr. Gregg’s last blood glucose measurement was 260 mg/dL. What nursing actions should be taken?
As his blood glucose level is very high it is important to manage his blood glucose level and he is now have the complication of diabetes is called hyperosmolar hyperglycemic state.
Inform health practioner immediately.Assessing patients vitals signs including kussmaul respirations.administation of intravenous fluid according to the electrolyte value and it should be monitored contineously.
Start intravenous insulin according to the doctors order.always carry aseptic technique while doing invasive procedures to tackle infections.Intake out put monitoring is vital and encourage the patient to increase hydration.
It is vital to manage glucose level to prevent other hyperglycemic complications like stroke and heart disease.
Mr. Gregg is a 65-year-old African-American male who was admitted with complaints of increased fatigue, shortness of bre...
Mr. Gregg is a 65-year-old African-American male who was admitted with complaints of increased fatigue, shortness of breath, and headache. He states that he retired 9 months ago after 45 years as a construction worker. He now leads a sedentary lifestyle, and doesn't have as much energy as he used to have. He has gained 50 pounds since retirement. Upon assessment, Mr. Gregg weighs 255 pounds and is 5' 11" tall. Vital signs are temperature 98.8°F, pulse 88 beats per...
Case #2: Diabetes Mellitus Case Study A Case Scenario: JC is a 72-year-old African American male living alone in his own home. JC was found unconscious by his neighbor who went next door to check on him because “he had not seen him for a while.” The neighbor stated JC has a history of diabetes and has been spending more time alone since his wife passed away last year. JC is lethargic and slow to respond to questions. While taking...
Case #2: Diabetes Mellitus Case Study A Case Scenario: JC is a 72-year-old African American male living alone in his own home. JC was found unconscious by his neighbor who went next door to check on him because “he had not seen him for a while.” The neighbor stated JC has a history of diabetes and has been spending more time alone since his wife passed away last year. JC is lethargic and slow to respond to questions. While taking...
Mr. A is an 18-year-old 80-kg African American man admitted to the intensive care unit after emergency surgery for gunshot wounds to the abdomen. The surgical procedure was extensive and involved repair of a perforated bowel, splenectomy, and hemostasis. Mr. A’s mean arterial pressure (MAP) dropped below 65 mm Hg during resuscitation, and he received 9 units of packed red blood cells and 4 L of lactated Ringer solution intravenously (IV) to achieve hemodynamic stability. Clinical Assessment Within 24 hours...
Brief Patient History Mr. A is an 18-year-old 80-kg African American man admitted to the intensive care unit after emergency surgery for gunshot wounds to the abdomen. The surgical procedure was extensive and involved repair of a perforated bowel, splenectomy, and hemostasis. Mr. A’s mean arterial pressure (MAP) dropped below 65 mm Hg during resuscitation, and he received 9 units of packed red blood cells and 4 L of lactated Ringer solution intravenously (IV) to achieve hemodynamic stability. Clinical Assessment...
Brief Patient History Mr. A is an 18-year-old 80-kg African American man admitted to the intensive care unit after emergency surgery for gunshot wounds to the abdomen. The surgical procedure was extensive and involved repair of a perforated bowel, splenectomy, and hemostasis. Mr. A’s mean arterial pressure (MAP) dropped below 65 mm Hg during resuscitation, and he received 9 units of packed red blood cells and 4 L of lactated Ringer solution intravenously (IV) to achieve hemodynamic stability. Clinical Assessment...
Brief Patient History Mr. A is an 18-year-old 80-kg African American man admitted to the intensive care unit after emergency surgery for gunshot wounds to the abdomen. The surgical procedure was extensive and involved repair of a perforated bowel, splenectomy, and hemostasis. Mr. A’s mean arterial pressure (MAP) dropped below 65 mm Hg during resuscitation, and he received 9 units of packed red blood cells and 4 L of lactated Ringer solution intravenously (IV) to achieve hemodynamic stability. Clinical Assessment...
History: Mr. Dan Griffith is a 65 year old male who presented to the emergency department with shortness of breath and chest tightness of recent onset. He has a 7 year history of COPD and is on oxygen at home. Physical assessment reveals a respiratory rate of 32 and slightly labored, temperature of 98.9, and SpO2 of 86% while on oxygen via nasal cannula at 2 L/min. Question: Mr. Griffith is admitted to the pulmonary unit with acute exacerbation of...
Brief Patient History: Mr. X is a 64-year-old male admitted to the unit with acute myocardial infarction (AMI) after emergent left (L)- sided heart catheterization/percutaneous coronary intervention (PCI). Past history includes diabetes mellitus type 2, heart failure, hypertension, and osteoarthritis. Home medications include furosemide Lasix), digoxin (Lanoxin), captopril (Capoten), carvedilol (Coreg), Byetta (exenatide), Glucophage (metformin), and Motrin (ibuprofen). Clinical Assessment: Twenty-four hours after admission to the unit, Mr. X is alert; oriented to person, place, and time; and pain free....
Mr. Charles Lamont is a 64-year-old patient who is visiting his primary care physician with complaints of vomiting x 3 days and inability to keep anything down. His wife is waiting for him in the lobby. She is hoping that Mr. Lamont will tell the physician about his recent bout of coughing and shortness of breath. He smokes 1½ packs of cigarettes per day. His wife has been encouraging him to stop, but he has not shown any interest in...