Joyce Workman Swift River

Question: joyce workman is newly diagnosed with type 2 diabetes. list her acuities

Answer: education - increasedfall - normalhealth change - increasedneurological - normalpain - normalpsychological - normalsensorium - normal

Question: list her nursing concerns

Answer: enhanced readiness for learningineffective health maintenanceimbalanced nutritionrisk for injury

Question: Mrs. Workman presented to the diabetes clinic and provided a 24- hour food recall. She was then sent to the lab for ordered lab tests. She is to notify the nurse upon return to the clinic from the lab. Patient has requested more information on her diabetes and states she does not understand why she "should be concerned" with blood glucose control in both the short and long term.

Answer: 1Ask Mrs. Workman to explain what she knows about diabetes.2Explain in layman terms what Diabetes is and how it can adversely affect the body if left untreated.3Discuss lifestyle choices that can lead to type II diabetes.4Discuss lifestyle changes that can be beneficial in the management of type II diabetes.5Document teaching and understanding of teaching using teach back process.

Question: The nurse is providing information on nutrition to assist Mrs. Workman in managing her diabetes.

Answer: 1Assess Mrs. Workman's knowledge of nutrition and preferred foods.2Ask Mrs. Workman for a 24- hour diet recall.3Educate Mrs. Workman on healthier options based on the 24-hour diet recall.4Provide Mrs. Workman with a Mediterranean style diet plan.5Ask Mrs. Workman to demonstrate understanding using the teach back method.

Question: Mrs. Workman presented to the Diabetes Clinic for further evaluation of her diabetes, and lifestyle changes. She is planning on attending several of the classes that are being offered. Patient is requesting information on appropriate exercise programs. She has attended the Diabetic meal prep class, but still struggles with her diagnosis of diabetes.

Answer: 1Assess the patient's preferred exercise regimen.2Ensure the patient does not have pre-existing conditions that would limit exercise routines.3Provide an exercise routine that has been developed in conjunction with Mrs. Workman.4Review with Mrs. Workman safety measures related to blood glucose levels when exercising.5Use teach back method and document education provided.

Question: Day 3 of hospitalization at 12:30, Mrs. Workman calls the nurse and complains of cool clammy skin, anxious, weak, hungry but nauseous, and slightly confused. April 10, 1245, Blood Glucose level: 40 mg/dL Healthcare Provider has ordered: 1. Hypoglycemia protocol for BG level < 60 mg/dL 2. Regular insulin SQ 20 units for BG level > 160 mg/dL 3. Monitor BG levels q 4 hours and PRN 4. IV fluids D5 0.45% NS at 125 mL/hour via peripheral line 5. 1800 calorie ADA diet and teach the patient about diet changes.

Answer: 1Assess patient's blood glucose level.The patient is presenting with signs of hypoglycemia. 2Provide a 20 -gram carbohydrate liquid for consumption.3Provide another 20-gram carbohydrate liquid for consumption in 15 minutes for unresolved symptoms.4Reassess the blood glucose level in 15 minutes.5Provide additional teaching to the patient regarding prevention strategies for hypoglycemia.

Question: 3 months later, Mrs. Workman has returned to the Diabetes Clinic having lost 20 pounds and is requesting to stop taking the Metformin (Glucophage). HbA1C is 7.5 %. She is also complaining of new onset diarrhea.

Answer: 1Assess Mrs. Workman' s understanding of her medication, diet, and exercise regimen.2Explain to Mrs. Workman about carbohydrate foods causing GI upset.3Explore new ways of cooking for diabetes management.4Provide information to Mrs. Workman on support groups for diabetes.5Document education provided.