Vsim Skylar Hansen; Hyperglycemia

DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS) PATIENT INFORMATION ANTICIPATED PHYSICAL FINDINGS ANTICIPATED NURSING INTERVENTIONS Insulin is a hormone secreted by beta cells, which are one of four types of cells in the islets of Langerhans in the pancreas. Insulin is an anabolic, or storage, hormone. When a person eats a meal, insulin secretion increases and moves glucose from the blood into muscle, liver, and fat cells. In those cells, insulin transports and metabolizes glucose for energy stimulates storage of glucose in the liver and muscle signals the liver to stop the release of glucose, enhances storage of dietary fat in adipose tissue, accelerates transport of amino acids into cells, inhibits the breakdown of stored glucose, protein, and fat. Diabetes Type 1: It is characterized by the destruction of the pancreatic beta cells. Diabetes Type 2: It is insulin resistance and impaired insulin secretion. Insulin resistance refers to a decreased tissue sensitivity to insulin. Fatigue and weakness, sudden vision changes, tingling or numbness in hands or feet, dry skin, skin lesions or wounds that are slow to heal, and recurrent infections. The onset of type 1 diabetes may also be associated with sudden weight loss or nausea, vomiting, or abdominal pains, if DKA has developed. Skyler Hansen is an 18- year-old male, diagnosed with Type 1 Diabetes 6 months ago. He was brought to the ER by his friends, the patient has not eaten over 5 hours and is drowsy, wakes with stimulus, has slurred speech, is diaphoretic, and is acting irrationally. Fasting Blood Glucose (blood glucose determination obtained in the laboratory after fasting for at least 8 hours), random plasma glucose, and glucose level 2 hours after receiving glucose (2-hour post load) may be used. HgbA1C (A1C), Fasting lipid profile, Test for microalbuminuria, Serum, creatinine level, Urinalysis, Electrocardiogram. An abnormally high blood glucose level is the basic criterion for the diagnosis of diabetes. - Administer prescribed medications on time - Provide glucose checks before meals - Offer a snack to patient after administering insulin to avoid hypoglycemia - Asses patient LOC to make sure they don’t go into DKA vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Vanessa Forrest, RN, Emergency Department Your name, position (RN), unit you are working on SITUATION Skyler Hansen, 18 year-old-male, was brought to the Emergency Department by his friends because he started acting “weird” while they were playing basketball, they also stated he had not eaten anything for 5 hours. Patient’s name, age, specific reason for visit BACKGROUND Primary: Type 1 Diabetes (diagnosed 6 months ago) Date of Admission: 4/16/2020 Current Orders: -The patient has 1-amp (50ml) Dextrose 50% in water IV push slowly. -For BS less than 70 after given then another dose can be repeated. -A BMP was ordered, and fingerstick glucose monitoring PRN. Patient’s primary diagnosis, date of admission, current orders for patient ASSESSMENT The patient is drowsy, wakes with stimulus, has slurred speech, is diaphoretic, and is acting irrationally. The patients’ blood sugar is 58mg/dL. The patient is not AAO x 3, he is very unoriented. Vital signs BP: 128/76, HR:93, RR: 19, O2: 96%, T: 99F, his skin is clean and intact but very sweaty to touch Current pertinent assessment data using head to toe approach, pertinent diagnostics, vital signs RECOMMENDATION The patient should be under continuous observation, to continue to monitor his blood glucose level to avoid hyper or hypoglycemia. Avoid the patient having to experience rebound hypertension if too much dextrose is given to him.