MedicalCase05_SkylerHansen_GRQ_UPDATED
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Louisiana State University *
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Medicine
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Apr 3, 2024
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Medical Case 5: Skyler Hansen
Guided Reflection Questions
1.
How did the scenario make you feel? I felt very confident performing this scenario after watching the tutorial. I made sure I did my hand wash and identified the patient having read my patient’s condition. With my diabetes skills and interventions, I started my assessment. I had to move quickly because the patient needed quick interventions to prevent hypoglycemia. It helped me improve my skills in managing diabetes which will help me in real life situations. 2.
What management options would have been appropriate if Skyler Hansen had been alert and could swallow?
If Skyler Hansen had been alert, and could swallow, giving him 4 oz of orange juice, some carbohydrates like banana or crackers would have been appropriate and protein
by mouth to improve his blood sugar levels.
3.
If Skyler Hansen’s acute hypoglycemic episode had not have been treated immediately, what could have happened? If Skyler Hansen’s acute hypoglycemic episode had not have been treated immediately, his blood pressure would have drop drastically, he would have been unconscious and lethargic, his brain would not get enough energy or glucose, and Skyler could have ended up having seizures. This could lead to death. 4.
If too much glucose were administered to Skyler Hansen while the health care team was
trying to correct his blood glucose level, what could occur? Too much glucose could lead to diabetic ketoacidosis which is common in Type 1 diabetes. This is a condition where the blood glucose level is too high and there is not enough insulin to help regulate it back to the cells. This leads to the body breaking down fat as a source for energy which produces ketones that makes the blood acidic causing diabetic ketoacidosis. Too much insulin can also cause irritation and bruises at the site of administration. Skyler could experience polyuria, polydipsia, blurred vision, confusion, and a headache
.
5.
What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format. S: Skyler Hansen, an 18-year-old male diagnosed with type 1 diabetes 6 months ago was brough to the Emergency Department by his friends. His friends reported that he started acting weird and lied down on the cement while they were playing basketball.
B: He was lightheaded, drowsy, only woke up to stimulus, had slurred speech, was diaphoretic and acting irrationally. He had an episode of hypoglycemia because of having a long period without food and increased activity while playing basketball.
A: He was given 50 mL of 50% dextrose in water IV to increase his glucose levels. Later when he was alert and oriented, he was provided with some carbohydrates and © Wolters Kluwer Health | Lippincott Williams & Wilkins
proteins. Patient is on fingerstick glucose prn. He states he feels much better now and is still hungry. His oxygen levels are at 95% on room air, blood pressure is 122/76, pulse rate is 85bpm, respirations are 19bmp and temperature is 98F.
R: Patient is stable now. Patient vital signs should be checked frequently as well as his blood glucose levels. Watch closely for signs and symptoms of hypoglycemia or hyperglycemia. Follow doctors order and administer 1 amp (50 mL) of 50% dextrose in water slow IV push if glucose is less than 70 mg/dL.
6.
Describe age-appropriate patient teaching for Skyler Hansen and resources that may be helpful to him. The patient is an 18year old newly diagnosed 6 months ago and is still struggling to cope with his diagnosing. I would provide the patient with teachings about diabetes type 1 which happen when the cells in the pancreas does not produce enough or completely stop producing insulin. I would teach him about insulin and how to monitor his blood sugar. I would tell him that his low blood sugar was caused by a long period without food and increased activity while he was playing basketball. 7.
Discuss confidentiality and legal empowerment of 18-year-old patients such as in Skyler Hansen’s case.
Hansen is 18 years old and is considered an adult. He can make his own decisions and receive any care that he desires without his parents’ consent. Hansen did not have his parents with him and if he did, release of information to the parents would require Hansen to consent. 8.
What would you do differently if you were to repeat this scenario? How would your patient care change?
I would have checked Hansen’s allergies to medication even though his condition deteriorated so quick. I would have done a quick vital check on needed assessment and called the doctor immediately because I was worried after I started seeing his oxygen saturation dropping. © Wolters Kluwer Health | Lippincott Williams & Wilkins
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