Case Summary
| The school RN sees an 8-year-old male coming into the nursing office by his Phys Ed teaching with complaints of profuse sweating and confusion. The patient is currently afebrile. |
Objectives. (More or less are possible)
| 1. Recognizing signs of hypoglycemia
2. Differentiate between hypo- and hyperglycemia 3. Initiates treatment plan for abnormal blood sugars 4. Evaluating effectiveness of treatment plan |
Description of Client
| Age: | 8 years | Gender | male |
| Medical diagnosis or chief concern | Abnormal blood sugars | ||
Care Setting (More than one are possible)
| Emergency Department
Medical-Surgical Unit Pediatric Unit Maternity Unit Behavioral Health Unit Intensive care unit |
Post-anesthesia Care Unit
Skilled-care Facility Home Outpatient Clinic Other setting: school Others present: |
History of chief concern/current condition/problem
| Symptom: sweating and confusion
Onset: 30 minutes ago Treatments tried (if applicable): drank water and sat down |
Other history as indicated
| Allergies: NKA
Weight/BMI (If applicable): 23 kg Medical diagnosis/surgeries/psychosocial: Type I DM diagnosed 1 year ago, no further past medical history, no surgical history Medications: Novolog Diagnostic tests: blood glucose POC, vital signs |
Assessments
| Important, abnormal, or relevant assessments | Normal or irrelevant assessments |
| Confusion
Sweating Recent illness with “up and down” sugars PMHx DM Type I |
Afebrile
|
Solutions
| Priority to address | Desired outcome |
| Confusion
Sweating DM I history |
Alert and oriented x3
Normal blood sugars |
| Actions/order indicated | Actions/order not indicated/contraindicated |
| Obtain blood sugar
Obtain full set of vital signs |
Send back to gym class immediately
Increase insulin dose |
Information Sources
| Phase Sheet
Nurses’ Notes History and Physical Admission Notes Vital Signs Medications Orders |
Intake and Output
Laboratory Report Flowsheet Progress Notes Diagnostic Report Other: |
- What is most concerning finding? (10 points)
- What factors best explain client’s symptoms? Use specific pathophysiology. (15 points)
- What condition would most likely be expected? (10 points)
- What will happen if this condition is not treated? (10 points)
- What actions should the nurse take? (15 points)
- Which actions are contraindicated? (10 points)
- How should the nurse provide the glucose and why? (10 points)
- When should the RN re-check the blood glucose? (10 points)
- Under which circumstances would EMS be activated? (5 points)
- Who should the nurse notify? (5 points)
