Question

Mr. Jenaro is a 61-year-old Spanish-speaking man who presents to the emergency room with his wife Dolores. Mrs. Jenaro is also Spanish speaking, but understands some English. Mr. Jenaro complains of nausea and vomiting for two days and symptoms of confusion. His blood glucose is 796 mg/dL. Intravenous regular insulin (Novolin R) is prescribed and he is admitted for further evaluation. He will require teaching regarding his newly diagnosed diabetes. Mr. Jenaro is newly diagnosed with diabetes. His hemoglobin A1C is 10.3%. Mr. Jenaro is slightly overweight. He is 5 feet 10 inches tall and weighs 174 pounds (79 kg). He reports no form of regular exercise. He does not follow a special diet at home. He states, “I eat whatever Dolores puts in front of me. She is a good cook.” For the past few months, Mrs. Jenaro has noticed that her husband “has been very thirsty and has been up and down to the bathroom a hundred times a day.” Neither can recall how long it has been since these changes in Mr. Jenaro began. Dolores states, “It has been quite a while now. It just seems to be getting worse and worse.” BP- 133/89 HR – 88 RR- 20 O2 sat – 98% T- 98.7 His last blood sugar/FS – 450

can someone help me with a nursing assessment

Answer 1

DIABETES MELLITUS-It is a disease caused by Increased levels of glucose in blood. -due to Insufficiency of INSULIN HORMONE secreted by PANCREAS GLAND situated nearby the Stomach. -insulin helps to get the glucose into the body cell for energy. * TYPES OF DM-TYPE 1 and TYPE 2 TYPE 1_Body doesn't make Insulin TYPE 2_Decreased production of Insulin, onset is above 40 years. Obesity, age and hereditary, lacks of physical activity are the Risk Factor. *HOW WILL KNOW PRESENCE OF DM -Excessive THIRST, Excessive HUNGER, Excessive URINATION, NAUSEA, VOMITING and DEHYDRATION, CONFUSION, FATIGUE and BLURRED VISION *TESTS TO DETECT DM -HbA1c-to know Controllence of Sugar -Random blood sugar -Urine sugar, Oral glucose tolerance test( 8 hour starvation before test and then drink sugar fluid) fasting blood sugar (8 hour starvation before test) TREATMENT _DIETARY CHANGES, LIFESTYLE MODIFICATIONS, INSULIN INJECTION *COMPLICATIONS-Sudden decreased blood glucose level( at that time drink any fruit juice or eating candy, honey, and sugar), Skin damages, nerve damage, blurred vision Change diet plan(low fat, low salt, low sugar), alcohol intake cessation, stop cigarette smoking., Regular excercise, foot care, take medicine regularly, complete teeth care, NURSING ASSESSMENT *SUBJECTIVE DATA_History of current problem, family history of DM, Current medication, Knowledge regarding self care of DM OBJECTIVE DATA_VITAL SIGNS, LAB VALUES, SIGNS OF DEHYDRATION, FRUIT SMELL DURING BREATH, PRESENCE OF ANY COMPLICATIONS.