CHARISSA M.

DE LEON MS CASE ANA CA1 LEGARDA

FOR CASE DISCUSSION:

• A 45-year old female patient is brought to the ER, unconscious. Laboratory work
up was done and results reveal that she is diabetic. Her blood glucose is 360
mg/dL and Hgb a1c (glycosylated Hgb) is 23%.

Questions :
• What medical condition is your initial impression in this client?
-Diabetes Mellitus Type II
• Give 2 pharmacologic drugs will you anticipate to administer in this client?
-metformin
-insulin
• What is your priority nursing diagnosis for this client?
-risk for unstable blood glucose level r/t to insuli resistance, impared insulin secretion and
destruction of beta cells.
• Give at least 4 appropriate nursing interventions for the client’s nursing diagnosis.
- assist the patient in identifying eating patterns that needs to be modified.
-administer insulin medication as ordered.
-provide food or other sources of glucose as directed for hypoglycemia
-educate patient about proper way of taking prescribed medication
-educate patient about teh importance of following a prescribed meal plan.

• What should be the client’s therapeutic position or desired activity for appropriate his/her
medical condition?
-avoid sitting still for long periods.try to get up every 3o mins and move around for atleast a few
minutes.
-get active. Take a brisk daily walk, ride a bike, swim laps.

• A 20-year old male patient has a history of long term use of NSAIDS. He was
brought to the hospital for chief complaints of oliguria and edema in his lower
extremities. BUN shows 35 mg/dL and serum creatinine is 2 mg/dL.

Questions :
• What medical condition is your initial impression in this client?
- Nephrotic syndrome
• Give 2 pharmacologic drugs will you anticipate to administer in this client?
-Diuretics (lasix)
- Plasma expanders
• What is your priority nursing diagnosis for this client?
-Fluid volume Excess
• Give at least 4 appropriate nursing interventions for the client’s nursing diagnosis.
-assess vs
-monitor input and output
 -monitor weigt
-wof ascites
• What should be the client’s therapeutic position or desired activity for appropriate
his/her medical condition.
-upright position
-reduce the amount of liquid in diet

• A 55-year old male client vomits blood and hence was brought by his family to the
nearby ER. He has a history of chronic alcoholism and cigarette smoking and
intake of aspirin for prevention of stroke.

Questions :
• What medical condition is your initial impression in this client?
-liver cirrhosis
• Give 2 pharmacologic drugs will you anticipate to administer in this client?
-LACTULOSE
-VIT. K
• What is your priority nursing diagnosis for this client?
-DISTURBED THOUGHT PROCESS
• Give at least 4 appropriate nursing interventions for the client’s nursing diagnosis.
- ASSESS LOC, GCS,
-DISCUSS CURRENT SITUATION, FUTURE EXPECTATION.
-RECOMMEND AVOIDANCE OF NARCOTICS OR SEDATIVES, ANTI ANXIETY AGENTS AND
LIMITING OR RESTRICTING USE OF MEDICATIONS METABOLIZED BY THE LIVER
-.ADMINISTER LACTULOSE AS PRESCRIBED
• What should be the client’s therapeutic position or desired activity for appropriate
his/her medical condition.
-MAINTAIN BEDREST