Why do you think Mr. Robbins was switched from Metformin to novolog coverage for his type 2 dm?
Mr. James Robbins, 75 year old male with a history of COPD, DM2 is admitted to the ED with the following symptoms: cough, increasing shortness of breath, temp 100.4, increasing need to use his inhaler (albuterol) – instead of 2 x a day he has been using in 4-5x day.
Current Medications at home include: albuterol 2 puffs 4-5x day, serevent 2 puffs bid (q 12 hours), fluticasone 2 puffs bid, metformin 500 mg bid, multivitamin 1 tab qd, calcium with vitamin d 500mg/600mg 2 tablets 2x a day
Health care provider orders: Oxygen 2 liters to maintain sat 92%, IVF D51/2 NS at 50 cc/hour, CBC, BMP, Albuterol/Atrovent UD treatments q 4 hours ATC while awake, Solumedrol 40 mg IVP q 8 hours, Serevent 2 puffs q 12 hours, NCS diet, blood glucose checks ac and hs with a sliding scale coverage
0-150 blood glucose – no coverage
151-200 – give 2 units novolog insulin
201-250 – give 4 units novolog insulin
251-300- give 6 units novolog insulin
301-350- give 8 units novolog insulin
Greater than 350 call provider
Continue with MVI qd and Calcium with vitamin d 500/600 2 tabs bid, fluticasone 2 puffs bid
Incentive spirometry at bedside and encourage q 1 hour w/a
The medication used to treat the symptoms of COPD like Solumedrol,IVF Dextrose 5% has the potential to increase the blood glucose levels and it cannot be effectively controlled with oral supplements like metformin so a fast acting medication which can be given subcutaneously works efficiently in controlling the high blood sugar levels in type 2 diabetic patients.
Why do you think Mr. Robbins was switched from Metformin to novolog coverage for his type...
As a RN, what will you teach this patient? What will your teaching session be like? Consider the patient's dx, medications, treatments, treatment options, consults, and spiritual needs, and care & incorporate these in your teaching plan. Mr. James Robbins, 75 year old male with a history of COPD, DM2 is admitted to the ED with the following symptoms: cough, increasing shortness of breath, temp 100.4, increasing need to use his inhaler (albuterol) - instead of 2 x a day...
Patient: Mr. Rogers. Gender: Male Age: 79 4/4/2040 Setting: Medical Surgical Unit in Hospital. Pre-existing Conditions: Diabetic Type II, Chronic Leg Ulcers, Peripheral Vascular Disease, Stroke, and Aphasia. Mr. Rogers is 79-year old male that came into the ER with complaints of Right lower leg pain. He was found to have cellulitis of his right calf. Patient states, “I know my leg wounds have been draining a lot lately, but for the last 2 days my leg feels inflamed and...
Created by Raney Linck pg. 1 of 5 To complete this exercise, you will need: Success Packet: D (Drugs to Know), Clinical Tools: 3a-3c (Clinical Reminders), and a Drug Book. You may also find the search engine at this website useful: MEDLINEPLUS.GOV (also WEBMD.COM). ***** This assignment is due at 6:30 AM on your very first clinical (orientation) day. ***** CRITICAL THINKING EXERCISE INDU MOHAN INDU MOHAN, age 68, and her husband Pulin have come from India to visit her...