University : AAAR Institute of Business and Technology UniLearnO is not sponsored or endorsed by this college or university.
Subject Code : NURS8730
Country : Australia
Assignment Task:

Case Study 1

Mr GM.  58 years old.  Diagnosed inn 2015 with T2DM during acute hospital admission following an unconscious collapse.  Staff where he lives reported a 10-day period of being off his food and was reporting polydipsia, polyuria and increasing weakness. He also experienced episodes of vomiting and diarrhoea resulting in significant dehydration. 

Lives in a Supported Residential Care facility (SRF) with minimal support. 

Medical history: 

Paranoid Schizophrenia with a history of apathy, listlessness and indifference

Chronic Obstructive Pulmonary Disease (COPD). Recent exacerbation with current maintenance dose of glucocorticoid 5mg.

Morbid Obesity BMI 45.1 kg/m2 

Two BGL’s of 6.3mmol/L and 6.9mmol/L (relation to food unknown) taken in 2014 during hospitalisation but not followed up. 

Routine Medications:

Quetiapine

Sodium Valproate

Findings at diagnosis:

HbA1c 12% (108mmol/mol)

Blood osmolality 352mOs/kg

Ketones 4.6mmol/L

Antibodies for Type 1 diabetes negative

Urine microbiology – positive for urinary tract infection

Serial troponin levels normal

Treated initially with fluids and rapid acting insulin.

Discharged on Gliclazide MR 120mg daily, Metformin 1g twice daily and Lantus 100 units nocte

Referrals made to dietitian, diabetes educator and podiatrist with liaison with SRF manager. He declined a mental health worker. 

Ongoing care was in the hands of his GP.



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  • Posted on : July 29th, 2018
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