Meghan is a 33-year-old Filipina at her 28th week of 2nd pregnancy. She called for her obstetrician’s visit due to “flu” symptoms. Records for this visit showed that she stood at 4 feet 11 inches tall and weighed 145 lb. She had a routine glucose challenge test performed and it was noted at 662 mg/dL. A random glucose completed 1–2 days later showed to be at 500 mg/dL. A follow-up HbA1c was at 11.6%. Meghan presented to her obstetrician 3 days after the HbA1c was drawn for ongoing evaluation of hyperglycemia and was advised to rest and take fluids. With the persistent “on-and-off flu-like” symptoms for 3-4 weeks which now included nausea, polyuria, and polydipsia, Meghan presented herself at the Emergency Department. She also added she needs to catch her breath most of the time. Additional symptoms included a 23-lb weight loss over the past 3–4 weeks. Here, she was ordered for CBG and urinalysis. Serum potassium level of 3.35mEq/L. Meghan was immediately started on an insulin drip at 0.1 unit/kg/hr. Further assessment and evaluation led to the decision of her hospital admission. Meghan had no family history of diabetes with the exception of one sister who had been diagnosed with gestational diabetes. Her medical history was significant for Crohn’s disease diagnosed in 2018 with no reoccurrence. Her pre-pregnancy weight was usually in between 114–120 lb. She had gained 25 lb during this pregnancy and lost 23 lb just before diagnosis. Meghan’s blood glucose monitoring indicated that values were ranging from 200–300 mg/dl range. A repeat HbA1c was 8.7%. TASKS: Complete the following activities to provide high quality, individualized care for the patient. Comprehensive Assessment (15 mins) – Collect, organize and document information about the patient. Data will be used to: Complete the client’s health record. Perform a quick and comprehensive assessment of the client’s hospital admission. Implement the relevant and appropriate assessment methods. Implementing Care (20 minutes) Obtain the CBG and urine specimen for Meghan. Prepare, administer, and document the ordered medications. (Recall correct procedure in medication administration.) Ongoing Care (15 minutes) - document the care that has been provided as follows: Using the FDAR format – so that this is communicated with the healthcare team. Discharge instructions (METHODS)

Meghan is a 33-year-old Filipina at her 28th week of 2nd pregnancy. She called for her obstetrician’s visit due to “flu” symptoms. Records for this visit showed that she stood at 4 feet 11 inches tall and weighed 145 lb. She had a routine glucose challenge test performed and it was noted at 662 mg/dL. A random glucose completed 1–2 days later showed to be at 500 mg/dL. A follow-up HbA1c was at 11.6%. Meghan presented to her obstetrician 3 days after the HbA1c was drawn for ongoing evaluation of hyperglycemia and was advised to rest and take fluids. With the persistent “on-and-off flu-like” symptoms for 3-4 weeks which now included nausea, polyuria, and polydipsia, Meghan presented herself at the Emergency Department. She also added she needs to catch her breath most of the time. Additional symptoms included a 23-lb weight loss over the past 3–4 weeks. Here, she was ordered for CBG and urinalysis. Serum potassium level of 3.35mEq/L. Meghan was immediately started on an insulin drip at 0.1 unit/kg/hr. Further assessment and evaluation led to the decision of her hospital admission. Meghan had no family history of diabetes with the exception of one sister who had been diagnosed with gestational diabetes. Her medical history was significant for Crohn’s disease diagnosed in 2018 with no reoccurrence. Her pre-pregnancy weight was usually in between 114–120 lb. She had gained 25 lb during this pregnancy and lost 23 lb just before diagnosis. Meghan’s blood glucose monitoring indicated that values were ranging from 200–300 mg/dl range. A repeat HbA1c was 8.7%. TASKS: Complete the following activities to provide high quality, individualized care for the patient. Comprehensive Assessment (15 mins) – Collect, organize and document information about the patient. Data will be used to: Complete the client’s health record. Perform a quick and comprehensive assessment of the client’s hospital admission. Implement the relevant and appropriate assessment methods. Implementing Care (20 minutes) Obtain the CBG and urine specimen for Meghan. Prepare, administer, and document the ordered medications. (Recall correct procedure in medication administration.) Ongoing Care (15 minutes) - document the care that has been provided as follows: Using the FDAR format – so that this is communicated with the healthcare team. Discharge instructions (METHODS)

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Question

Meghan is a 33-year-old Filipina at her 28^th week of 2^nd pregnancy. She called for her obstetrician’s visit due to “flu” symptoms. Records for this visit showed that she stood at 4 feet 11 inches tall and weighed 145 lb. She had a routine glucose challenge test performed and it was noted at 662 mg/dL. A random glucose completed 1–2 days later showed to be at 500 mg/dL. A follow-up HbA1c was at 11.6%. Meghan presented to her obstetrician 3 days after the HbA1c was drawn for ongoing evaluation of hyperglycemia and was advised to rest and take fluids.

With the persistent “on-and-off flu-like” symptoms for 3-4 weeks which now included nausea, polyuria, and polydipsia, Meghan presented herself at the Emergency Department. She also added she needs to catch her breath most of the time. Additional symptoms included a 23-lb weight loss over the past 3–4 weeks. Here, she was ordered for CBG and urinalysis. Serum potassium level of 3.35mEq/L. Meghan was immediately started on an insulin drip at 0.1 unit/kg/hr. Further assessment and evaluation led to the decision of her hospital admission.

Meghan had no family history of diabetes with the exception of one sister who had been diagnosed with gestational diabetes. Her medical history was significant for Crohn’s disease diagnosed in 2018 with no reoccurrence. Her pre-pregnancy weight was usually in between 114–120 lb. She had gained 25 lb during this pregnancy and lost 23 lb just before diagnosis.

Meghan’s blood glucose monitoring indicated that values were ranging from 200–300 mg/dl range. A repeat HbA1c was 8.7%.
TASKS: Complete the following activities to provide high quality, individualized care for the patient.

Comprehensive Assessment (15 mins) – Collect, organize and document information about the patient. Data will be used to:
1. Complete the client’s health record.
2. Perform a quick and comprehensive assessment of the client’s hospital admission.
3. Implement the relevant and appropriate assessment methods.
Implementing Care (20 minutes)
Obtain the CBG and urine specimen for Meghan.
Prepare, administer, and document the ordered medications. (Recall correct procedure in medication administration.)
Ongoing Care (15 minutes) - document the care that has been provided as follows:
Using the FDAR format – so that this is communicated with the healthcare team.
Discharge instructions (METHODS)

MEDICATION: dose, route, frequency_
TIME
SUN
MON TUES
WED THURS
FRI
SAT

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