Anti Hyperglycemic Drug, And By Ordering Inadequate Monitoring Of Ms. Green 's Glucose Levels

H, who had come into the emergency department two days prior for diabetic ketoacidosis (DKA) and was diagnosed with type 1 diabetes. The Mayo Clinic explains that diabetic ketoacidosis occurs when the body cannot produce insulin. Insulin is the key that allows glucose to enter cells, and provide the cells with energy. Without glucose for energy, the body begins to breakdown fats that produce harmful substances known as ketones. DKA is characterized by hyperglycemia, metabolic acidosis and ketones in the urine, (2017). That had since resolved, so for the most part of the day me and the secondary nurse were providing diabetic education. She was educated on the use of the glucometer, how to give insulin injections, and symptoms of hypoglycemia, I felt confident in this education and was surprised by how much I remembered from previous lectures. I did not have time to provide teaching on diet, exercise induced hypoglycemia, or patient specific teaching based upon her report, because we switched our roles. I can see how education can get swept under the rug in practice when you are so busy throughout the day. Instead of saving education until the end of the day, when I become a new nurse I will make sure I am taking advantage of every patient encounter as an opportunity to educate. Later in the simulation, when I had transitioned roles, Ms. H experienced a hypoglycemic episode after receiving a dose of insulin and not consuming any of her breakfast. According to Silvestri, hypoglycemia is often caused by the following, too much insulin, too little food, or excessive activity (2014, p. 653). In Dr. Johanson’s lectures I learned that carbohydrates are the main source of energy for the body and are metabolized to form glucose for the body to use. When there is no consumption of carbohydrates, there is no glucose and this results in low blood glucose known as hypoglycemia. A type 1 diabetic lacks the ability to make insulin, which is the key that

eflective Account 3 : Blood glucose monitoring Description During my placement I was asked by my mentor to perform a blood glucose reading . The patient was a 78 year old gentleman Mr P with diabetes type 2. I have introduced myself , checked the patient's identity and asked for permission to perform the blood glucose reading and explained the procedure prior to insulin administration and obtained a valid consent. I washed my hands and put on gloves ; Mr P refused to washed his hands saying that he washed them before my arrival.

This duty was then breached. Either care was not administered, or it was ministered improperly. The quality of the care is established through the testimony of expert testimony from other doctors.

As noted, on February 29, 2016, the patient was nonetheless admitted to the UCR hospitalist. This was a senior member of the UCR hospitalist team who knew or should have known all of the policies and procedures for admission, and should never have admitted the patient as an attending to the hospital. In so doing, he was directly and deliberately interfering with the doctor patient relationship.

If testing results support the suspicions of impairment, then management is mandated to report the incident to the North Carolina Board of Nursing (NCBON, 2011). With increased medication errors, Beverly failed to provide a safe and effective nursing care to the patient, therefore violating the laws of the Nurse Practice Act (NCBON, 2009).

A person with type 2 diabetes may be treated with insulin as well as an oral hyperglycaemic drug. Discuss why this combination may be prescribed.

Over this last week, I have received a patient named Sherman “Red” Yoder. He is an 80-year-old male farmer, who lives alone in the farmhouse that he had grown up in. Red was married for 50 years and has been a widow now for 10 years. Red has one son, Jon, who takes care of the farmhouse and the land. He has one daughter-in-law, Judy, who is in involved with his care. Red was diagnosed with diabetes six months ago. Diabetes mellitus is a chronic condition that affects your body 's ability to use the energy found in food. As of only a few weeks ago, Red has been managing his diabetes with insulin. Insulin is a hormone that controls blood sugar. Before he began using insulin, he managed his diabetes with oral medication. After carefully assessing Red’s chronic illness, diabetes, many red flags were presented that could interfere with his management. In turn, this would cause further complications.

Further, Mrs. Freel has Type 2 Diabetes, however, she has not taken her medicine within the past 24 hours. This has affected her endocrine system, leading to her experiencing elevated blood sugar

During one of my rotations, I was assigned a young adult patient who had run out of insulin and had been admitted to the hospital following a Diabetes Ketoacidosis (DKA) episode. I realized that my patient was probably torn between buying insulin and buying healthy food because her chart showed several admissions in the

Mrs. Blake should continue to take her insulin even if she is not eating. She should have a sick plan in place that she follows when she is sick. Even though she is not eating, because of her sickness her body may even require more insulin than usually. She should check her blood sugar more frequent maybe every hour, and try to keep it below 200 mg/dL (MedlinePlus, 2016). If Mrs. Blake is dehydrated she can replace her fluids with water, chicken broth, diet caffeine-free soda, club soda and tomato juice (MedlinePlus, 2016). It is important that she check urinate for ketones with each void (MedlinePlus,

Patient G.M. is a four-year-old female from a middle class family living in San Diego. She originally presented with her mother and father to her general practitioner with lethargy and several vomiting episodes in the past few days. Her father stated concern after realizing her frequent urination in the past week. Her vital signs upon initial assessment were HR 140 RR 22 Temperature 102.7 degrees Fahrenheit, BP 70/62, O2 saturation 97%, 32 pounds, and 40 inches tall. Her General practitioner was concerned about type I diabetes and performed a blood sugar check. Upon assessment the monitor read HI, indicating that the level was above 500 and too high for the monitor to read. The doctor informed them she needed immediate treated in the closest pediatric ER due to the potential for diabetic ketoacidosis.

C.S. is a morbidly obese 32-year-old female admitted to the hospital on 8/26/05 with an admitting diagnosis of poly-drug overdose. According to the patient, the last thing she remembers is going to bed and then waking up in the hospital 2 days later without any recollection of what had happened. She has a history of suicide twice in the past, but denies suicidal ideations this time. C.S. also has a history of Diabetes type II that is normally controlled with oral medications. She states that she checks her blood glucose at home and it has been in the 200mg/dl range for the past month. Current blood glucose is 256mg/dl. C.S. is to be discharged tomorrow with a new prescription for insulin.

There is growing concern that intense glucose lowering or the use of certain agents may be associated with adverse cardiovascular outcomes.

Because steroids cause the blood sugars to rise in some patients, insulin is a medication is to bring down the glucose. There are short and long acting insulins that a patient is prescribed. A glucometer, a device used to measure blood sugar is also prescribed for these patients. A provider prescribes for the patient at discharge a diabetic diet, short acting insulin, sliding scale to use with the short acting insulin, long acting insulin, glucometer, and testing supplies. Patients become overwhelmed and confused very easily and some are just in denial.

It was two o’clock in the morning. I heard my brother screaming my name and I knew it was happening again. We had begun taking turns spending the night in my mother’s room to keep an eye on her. Nights like this had occurred so many times before that I no longer panicked. My mother was on the floor seizing because the doctors were still trying to get her insulin dosage correct. My brother immediately called 911 and we waited for them to arrive. What I did not know was that this time was not like before. My mother went into a coma for eight days and when she finally woke up her short term memory was gone. She did not remember her kids or anything about her adulthood. We had to reteach her her entire life after her childhood including the death of my father and her youngest son. She could no longer work because she could not remember how to do her job or anything related to accounting. Doctors were not sure if her short term would ever return and it did not. Even though brain trauma due to hypoglycemia is a rare occurrence, it can occur. Hypoglycemia seizures are also considered a medical emergency. However, they can be prevented. I often replay this night in my mind trying to figure out what my brother and I could have done differently. Current literature suggest that the gold standard, glucagon, is not being used as often due to lack of patient teaching and education. From personal experience, I know that diabetic educators and physicians did not teach my family members