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vSim: Juan Carlos (J.C.)

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vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)

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vSim: Juan Carlos (J.C.)


University of Maryland: School of Nursing

NURS 501: Pathophysiological and Pharmacological Bases for Nursing Practice

April 25, 2022

, 2


vSim: Juan Carlos (J.C.)

J.C. is a 52-year-old Hispanic male admitted for surgical debridement of a diabetic foot

ulcer on his right big toe. J.C. has a history of hypertension, hyperlipidemia, and type II diabetes.

Current medications include lovastatin, insulin detemir, glyburide, metformin XR, cephalexin

and lisinopril. Patient was aware of his medical history, his medications, and whether the

medications were taken. J.C. stated that there was a pain and a throbbing within the right big toe

and rated the pain 3/10.

Given J.C.’s medical history, monitoring his blood glucose reading and maintaining the

glucose levels would be the top priority in his care. If his glucose levels were to go above the

normal range (hyperglycemia), J.C. may experience vomiting, excessive hunger and thirst, and

tachycardia (Cleveland Clinic, n.d.). If the opposite were to occur and his glucose levels were to

go below the normal range (hypoglycemia), J.C. may experience sweating, shakiness, and

irritability (Mayo Foundation for Medical Education and Research, 2020). The other priority

would be monitoring the status of the diabetic toe ulcer. If it worsens, it could result in

neuropathy, deformity, or even peripheral arterial occlusive disease (PAD) that could result in

amputation (Oliver and Mutluoglu, 2021). J.C. does present with other comorbidities, but they do

not call for immediate intervention. The priorities did not change during the care as these issues

required more immediate attention. J. C’s vitals did not show any immediate concern for

alternative interventions to control the blood pressure, oxygen saturation, or heart rate.

While J.C. was able to recall his medical history and medications, he also presents to the

hospital with a foot ulcer which is indicative that he was not monitoring his glucose levels well.

His blood glucose readings were extremely high and required a few intervention options to bring

the glucose levels back within normal range. His medical history includes a sliding scale for his

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