Name: Section: Date: Grade /40 (15% WT) Kaiden Watchell is a 65… Name:              

Name: Section: Date: Grade /40 (15% WT) Kaiden Watchell is a 65… Name:                         Section:                                   Date:                             Grade               /40 (15% WT) Kaiden Watchell is a 65 year old single male who has a 20 year history of type 2 diabetes. Both of his parents also had type 2 diabetes. He had a myocardial infarction at age 57 and states that he was told his cholesterol is high. He smokes 15 cigarettes per day for the past 40 years. WT 220 lbs HT 5 feet 8 inches. He has been in hospital for three days due to diabetes complications and poorly controlled blood glucose levels. His blood glucose on admission was 33 mmol/L. He reported blurred vision, polyuria, and severe polydipsia. Skin was warm and dry and temperature was 38.3 C. He was very lethargic.He reports numbness on the soles of both feet and a small, round, well-demarcated ulcer was noted on the ball of his left foot. He notes that he has not taken his anti-hypertensive medication or anti-diabetic medications for the past few days as he is recently unemployed and is trying to ration his medication and he has been sick in bed with a cold.  Assessment Findings this morning (day 3).Fasting blood glucose 9.9 mmol/L Reports fatigueAlert and oriented x 3 Productive cough with thin yellow phlegmSkin is warm and dry Urine is clear and concentrated with U/O 150 cc overnightUrine tests negative for ketones He reports that his usual BP is 160/80 and HR is 84, though he rarely checks this. Explain the rationale for each of the VS findings from his initial admission.  T 38.3 CHR 135/bpmBP 108/70O2 sat 92% RR 30/min             What are the risk factors for diabetes complications for this client?     a. What specific complication is this client presenting with when first admitted to hospital?  What findings support this? What put him at risk for this complication?     His Hb A1c is 8.5 and he cannot remember it ever being lower than that. Explain the significance of this finding.   The client reports that he has never experienced angina and did not experience pain with his myocardial infarction. What pathophysiology explains why this may occur?      Explain the significance of each of the diagnostic test findings from admission. (10 marks total) Lab test Findings Normal Findings Marks Arterial Blood Gases (ABGs)pH 7.35 PaCO2 35 PaO2 84    HCO3- 24pH 7.35-7.45  PaCO2 35-45 mmHg PaO2 80-100 mmHg    HCO3- 21-28  mmol/L  Random Blood glucose 33 mmol/L5.0-10 mmol/L Hematocrit (Hct) 0.500.37-0.47     Sodium (Na+ )150135-145 mmol/L Potassium (K+)3.3 3.5-5.0 Meq/l Creatinine12061.9-114.9 mmol/L                                  Ketones (urine)NegativeNegative       Explain the pathophysiology associated with the clinical manifestations related to the client’s feet.   Health Science Science Nursing NURSING PNP300 Share QuestionEmailCopy link Comments (0)

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