Sara Walton
7/10/2014
Pathophysiology of IDDM-
In type 1 diabetes, the pancreas does not produce insulin. Insulin is a hormone that is involved in regulating how the body converts sugar (glucose) into energy. People with type 1 diabetes need to take daily insulin shots and carefully monitor their blood glucose levels.
Signs and symptoms
Increased thirst frequent urination
Extreme hunger
Weight loss
Fatigue
Blurred vision
Clinical Manifestation- Renal function lab results are decreased, Edema, HIgh accu check (250)

Nursing Diagnosis-
Ineffective health maintance related to demonstration of uncontrolled diabetes and reporting lack of education about diabetes as evidence by high blood sugar
Intervention: Monitor input and output. Note urine specific gravity.
Rational : Provides ongoing estimate of volume replacement needs, kidney function, and effectiveness of therapy.
Intervention: Monitor temperature, skin color and moisture.
Rational : Fever, chills, and diaphoresis are common with infectious process; fever with flushed, dry skin may reflect dehydration.
Goal -would be met if the client’s blood glucose levels are between or below the targeted levels. A goal that is not successfully met would be shown by glucose levels being above the targeted levels.

Nursing Diagnosis imbalanced nutrition: less than body requirements related to inability to ingest food because of presence of cleft palate as evidenced by low hgb and hct and inadequate formation of rbc. monitor laboratory values, and report significant changes to physician. (rationale: laboratory values provide objective data regarding nutritional status) keep strict documentation of intake, output calorie count rationale: this information is necessary to make an accurate nutritional assessment.
Goal: Meet the needs of adequate nutrition

Medcation-
Humalog R – per sliding scale treating IDDM
Tums 1 tab TID treating
Aranesp 25 mcg sub q monthly
Aspirin 325 mg po daily treats CAD
Pepcid 40 mg po TID treats malignaat ascites
Ferrous sulfate 325 mg BID treats anemia
Lasix 80 mg po 1 tab daily treating CHF
Linsinopril 10 mg po 1 tab daily treats CHF
Methylphenidate 2.5 mg daily treats Narcolepsy
Nifedipine 60 mg po 1 tab daily treats Angina
Renavite po 1 tab daily (vitamin B) treats Chronic Renal Failure
Vitamin D 50,000 U 1 tab every week Treats Osteoperoisis

Lab

Na: 138 - Normal 137-147mmol/L Altered levels reveal imbalance of electrolytes and low values are most often seen in cases of cardio or pulmonary diseases

K: 4.9 Normal 3.4-5.3 mmol/L This test to monitor serum potassium levels, an electrolyte that’s vital to various metabolic processes

Cl: 105 Normal 99-108mmol/L This test is ordered to monitor serum chloride levels, an electrolyte that’s vital to various metabolic processes

C02: 27 Normal
BUN: 50 Normal 5-20mg/dL Elevated BUN: Related to dehydration et CHF- Renal blood flow is dimished. This is one lab test done to diagnose dehydration(increase in BUN).

Cr: 3.3 Normal 0.2-1.0mg/dL Used to measure the