Reflection

Just last month, Zamboanga city was on the verge of crisis, some of its barangays were affected due to
low fewer elements that have come to the city. It was
Nursing Care Plan for: Diabetes, High Blood Sugar,
Hyperglycemia, DKA, Diabetic Ketoacidosis, Fluid and
Electrolytes Imbalance.
Scenario:
A 38 year old male presents to the ER. He states he has been having
blurry vision, extreme thirst, and frequent urination since last Sunday night
after he attended a Super Bowl Party. It is now Tuesday. He stated that
since yesterday morning he has been vomiting. Pt states he has been a
type 1 diabetic since he was 5 years old. He states he finds being a
diabetic an inconvenience and hardly ever checks his sugar and only
occasionally will he give himself insulin injections. Pt VS: HR 106, BP
108/68, O2 Sat 97% on RA 25, On assessment, pt eyes look sunken, skin
turgor greater than 3 seconds, breath smells fruity, and pt skin looks dry
and flushed. Pt takes the following medications: Neurontin 300mg PO
BID, Lortab 10-325mg 1-2 Tabs every 6 hours as needed for pain,
Metformin 1000 mg PO BID, Regular Insulin per sliding scale with meals
(pt states he only does this occasionally), Levemir 35 units subq at night
(pt states he hasnt taken this in over 2 months). Lab work: Glucose 636,
K+ 2.9.

Nursing Diagnosis:
Fluid and Electrolyte Imbalance related to diabetes as evidence by
Glucose 636 and K+ 2.9.

Subjective Data:
He states he has been having blurry vision, extreme thirst, and frequent
urination since last Sunday night after he attended a Super Bowl Party.
He stated that since yesterday morning he has been vomiting. Pt states
he has been a type 1 diabetic since he was 5 years old. He states he
finds being a diabetic an inconvenience and hardly ever checks his sugar
and only occasionally will he give himself insulin injections. Regular
Insulin per sliding scale with meals (pt states he only does this
occasionally), Levemir 35 units subq at night (pt states he hasnt taken
this in over 2 months).
Objective Data:
VS: HR 106, BP 108/68, O2 Sat 97% on RA 25, On assessment, pt eyes
look sunken, skin turgor greater than 3 seconds, breath smells fruity,
and pt skin looks dry and flushed. Pt takes the following
medications: Neurontin 300mg PO BID, Lortab 10-325mg 1-2 Tabs every
6 hours as needed for pain, Metformin 1000 mg PO BID. Lab work:
Glucose 636, K+ 2.9.
Nursing Outcomes:
-Pts Blood Glucose will be 80-150 within 24 hours.-Pt K+ Level will be
3.5-5.0 within 12 hours.-Pt will verbalize 4 long-term side effects of
unmanaged diabetes by discharge.-Pt will demonstrated to the RN how to
take his blood sugar and how to get himself insulin injections by
discharge.
Nursing Interventions:
-Pt will be started on an Insulin gtt and blood sugars will be check every
hour per md order until pts blood sugars are 80-150. -Pt will be given
potassium supplementation per md order and a BMP will be drawn 1 hour
after potassium supplementation is given to check K+.-The nurse will
verbalize and provide printed material to pt on the side effects of
unmanaged diabetes.- The nurse will demonstrate to the pt how to check
blood sugars and give insulin injections properly and will ask the patient to
reciprocate.
- See more at: http://www.registerednursern.com/nursing-care-plan-and-diagnosis-for-diabetes-high-
blood-sugar-hyperglycemia-dka-and-diabetic-ketoacidosis-fluid-electrolytes-
imbalance/#sthash.H1XNAQl6.dpuf