The patient is a 48-year-old unconscious woman admitted to the…
The patient is a 48-year-old unconscious woman admitted to the ED. She has a known history of type 1 diabetes mellitus. Her daughter accompanies her and tells the staff that her mother has had the “flu” and has been unable to eat or drink very much. The daughter is uncertain whether her mother has taken her insulin in the past 24 hours.
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The patient’s vital signs are temperature 101.8° F; pulse 120, weak and irregular; respiration 22, deep, and fruity odor; and blood pressure 80/42 mm Hg. Blood specimens and arterial blood gases are drawn and an IV infusion begun.
- During the first 24 hours, what complications should the nurse monitor for in this patient? Explain.
- What should the nurse discuss with this patient about diabetes, insulin, and illness?
The patient is to be discharged on a mixed-dose regimen for insulin. She is to receive 10 units regular insulin and 18 units NPH insulin before breakfast and another 5 units regular insulin and 12 units NPH at dinnertime.
- Which aspect of diabetic self-care should the nurse discuss with this patient before her discharge?
- What can this patient do to prevent future emergency episodes?
Reference:
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2021). Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (10th ed., Vol. 1). Elsevier.
Silvestri, L. A., & Silvestri, A. E. (2020). Saunders comprehensive
review for the NCLEX-RN® examination (8th ed.). Elsevier.
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