During Intensive 2, Practical A, you will be assessing and implementing care for two patients (Louca & Sue) experiencing complications of diabetes. You will be randomly allocated one of these patients and you will need to complete a CRC Nursing Care Plan. Click on the Groups tab to find out which scenario you have randomly been assigned. The care plan is based on the information that is provided on MyLO only (Sue- page 2.5 on MyLO; Louca- page 2.7 on MyLO), not on the additional cues that you obtain in the Practical session. Case Study: 69-year-old Louca Louca is a 69-year-old man who has had Type 2 diabetes for 15 years. He also has hypertension. He is a retired librarian who lives with his wife and dog. He has been overweight for most of his life and is currently classified as obese with a BMI of 38. His father was a Type 2 diabetic and died from a stroke at the age of 70. To manage his diabetes, Louca’s GP has referred him to a Diabetes Education Centre to help manage his condition and to receive guidance from the multidisciplinary team. His GP has prescribed the following medications to help manage his diabetes and hypertension: 500mg metformin BD 120mg SR gliclazide mane 50mg metoprolol BD Louca has been encouraged to take his BGLs twice daily, but he often forgets. He has found it difficult to manage his diabetes as he works long hours, often resulting in him eating lots of ‘fast food’. A month or so ago he noticed a wound on the base of his right foot. Today he has decided that he would go to his local Diabetes Education Centre to inform them about his wound. Upon getting ready he started experiencing abdominal pain, nausea & diarrhoea. He has decided to postpone going to the Diabetes Education Centre until he feels better. Despite feeling unwell, Louca still took his medications as prescribed (above). Louca remained in bed for the rest of the morning. By 1700 Louca’s wife became concerned as he had not eaten or drunk anything all day, he had been vomiting and he was becoming increasingly drowsy. His wife decided to call the ambulance. 1730 hours: Louca has arrived in the Emergency Department. The paramedics explain that he is confused, drowsy and has slurred speech, that he wakes with stimulus, is pale, cold and clammy. The most recent vital signs obtained by the paramedics are as follows: HR 118bpm, BP 104/58, RR 24, SpO2 100%, Temp 36.5, and his BGL was 3.2mmol/L 5 minutes ago. His wife is present, and she is very distressed. You will need to consider the patient situation, identify normal and abnormal cues and identify the two highest priority nursing problem. For the nursing problem of highest priority you will need to: Develop SMART goals. Devise holistic nursing actions (at least 6) in order of priority and specify if it is a dependent or independent nursing action. You must consider the medical, pharmacological, social and psychological requirements of the patient. Provide a comprehensive rationale for each action (this section needs to be supported by contemporary literature and/or clinical guidelines). Provide relevant evaluate outcomes for each action (this section needs to be supported by contemporary literature and/or clinical guidelines).
During Intensive 2, Practical A, you will be assessing and implementing care for two patients (Louca & Sue) experiencing complications of diabetes. You will be randomly allocated one of these patients and you will need to complete a CRC Nursing Care Plan.
Click on the Groups tab to find out which scenario you have randomly been assigned. The care plan is based on the information that is provided on MyLO only (Sue- page 2.5 on MyLO; Louca- page 2.7 on MyLO), not on the additional cues that you obtain in the Practical session.
Case Study: 69-year-old Louca
Louca is a 69-year-old man who has had Type 2 diabetes for 15 years. He also has hypertension. He is a retired librarian who lives with his wife and dog. He has been overweight for most of his life and is currently classified as obese with a BMI of 38. His father was a Type 2 diabetic and died from a stroke at the age of 70.
To manage his diabetes, Louca’s GP has referred him to a Diabetes Education Centre to help manage his condition and to receive guidance from the multidisciplinary team.
His GP has prescribed the following medications to help manage his diabetes and hypertension:
500mg metformin BD
120mg SR gliclazide mane
50mg metoprolol BD
Louca has been encouraged to take his BGLs twice daily, but he often forgets. He has found it difficult to manage his diabetes as he works long hours, often resulting in him eating lots of ‘fast food’. A month or so ago he noticed a wound on the base of his right foot.
Today he has decided that he would go to his local Diabetes Education Centre to inform them about his wound. Upon getting ready he started experiencing abdominal pain, nausea & diarrhoea. He has decided to postpone going to the Diabetes Education Centre until he feels better. Despite feeling unwell, Louca still took his medications as prescribed (above). Louca remained in bed for the rest of the morning. By 1700 Louca’s wife became concerned as he had not eaten or drunk anything all day, he had been vomiting and he was becoming increasingly drowsy. His wife decided to call the ambulance.
1730 hours: Louca has arrived in the Emergency Department. The paramedics explain that he is confused, drowsy and has slurred speech, that he wakes with stimulus, is pale, cold and clammy. The most recent vital signs obtained by the paramedics are as follows: HR 118bpm, BP 104/58, RR 24, SpO2 100%, Temp 36.5, and his BGL was 3.2mmol/L 5 minutes ago. His wife is present, and she is very distressed.
You will need to consider the patient situation, identify normal and abnormal cues and identify the two highest priority nursing problem. For the nursing problem of highest priority you will need to:
- Develop SMART goals.
- Devise holistic nursing actions (at least 6) in order of priority and specify if it is a dependent or independent nursing action. You must consider the medical, pharmacological, social and psychological requirements of the patient.
- Provide a comprehensive rationale for each action (this section needs to be supported by contemporary literature and/or clinical guidelines).
- Provide relevant evaluate outcomes for each action (this section needs to be supported by contemporary literature and/or clinical guidelines).
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