Dm Uncontrolled, Ptb Iiv Female 57 Y/o Diagnosis Decreased Blood

DM uncontrolled, PTB IIV Female 57 y/o DIAGNOSIS

ANALYSIS

GOAL

Decreased blood sugar level Imbalanced nutrition, less than body requirements

Hypoglycemia is a condition in which the amount of blood glucose (sugar) in the blood is lower than normal. Babies born to diabetic mothers may develop hypoglycemia after delivery when the source of glucose (the mother's blood) is gone and the baby's insulin production metabolizes the existing glucose

After 30 mins. Of – nursing intervention the patient’s glucose level will be normalized.

O: The patient is lying restlessly on her bed.

With decreased level of consciousness

The client has slow deep respirations.

NURSING INTERVENTIONS

RATIONALE

EVALUATION

Observe for signs of hypoglycaemia,. Eg. Changes in level of consciousness, cool clammy skin, rapid pulse, anxiety, irritability, shakiness.

–

Once carbohydrate metabolism resumes (blood glucose reduced) and as insulin is being given, hypoglycaemia can occur.

The client’s glucose level has been normalized as evidence by a repeat RBS of 120 mg/dl

–

Perform fingerstick glucose testing

–

Bedside analysis of serum glucose is more accurate (displays current levels) than monitoring urine sugar, which is not sensitive enough to monitor fluctuations.

–

Administer regular insulin by intermittent or continuous IV method

–

Regular insulin has rapid onset and thus quickly helps move glucose into the cells. The IV route is the initial route of choice because

The patient appears to be pale.

The patient has cold clammy skin.

S: The patient complains of difficulty of breathing.

The SO verbalized “wala nga siyang ganang kumain, kapag pinapakain siya susubo lang ng kaunti tapos ayaw na.”

absorption from subcutaneous tissues may be erratic

– M:

–

Glucose solution may be added sfter insulin and fluids have brought the blood glucose to approximately 400 mg/dl. As carbohydrate metabolism approaches normal, care must be taken to avoid hypoglycaemia.

–

May be useful in treating symptoms related to autonomic neuropathis affect GI tract, thus enhancing oral intake and absorption.

Administer Glucose solution

BP 80/40 RR 17 PR 57 Temp 35.4 RBS 60

–

Administer other medications as indicated: metoclopramide

Drug Name

Dosage

Classification

Indication

Contraindication

Side Effects

Nursing Responsibilities

Ceftriaxone

1g

Bactericidal:

Perioperative Prophylaxis

Contraindicated with allergy to

CNS: head ache,dizziness,

>Perform skin test before administering to detect if the

Inhibits

IV q12

synthesis of Bacterial cell wall, causing cell death

cephalosporin or penicillins or penicillins

lethargy,parestesia

patient is allergic to the drug

GI: nausea, vomiting, abdominal pain, flatulence, liver toxicity

>Assess for patient’s history of liver and renal depression, lactation and pregnancy

GU: nephrotoxicity

>Have vitamin K available in case hperprothombinemia occurs

Hematologic: bone marrow depression

>Discontinue if hypersensitivity occurs

Hypersensitivity: ranging from rash, fever to anaphylaxis

>Inform the patient about the side effects

Local: pain, inflammation at IV site

Tramadol

100mg q8 IVP

Analgesic

Used to treat moderate to moderately severe pain and most types of neuralgia, including trigeminal neuralgia. It has been suggested that tramadol could be effective for alleviating symptoms of depression, anxiety, and phobias.

Health professionals have not yet fully endorsed of its use on a large scale for these disorders, although it may be used when other treatments have failed (under the supervision of a psychiatrist).

CNS: sedation, dizziness or vertigo, head ache, confusion, dreaming , sweating, anxiety and seizures CV: Hypotension, tachycardia, bradycardia

>Instruct patient to avoid alcohol while taking the drug and for 3 days because severe reactions often occur

Should the check the patients name, the correct route, dosage, and frequency of the medicine that should be given