Hesi Case study Gerontology:
Age-Related Risks
Meet the Client: Carl RogersCarl Rogers is a sixty seven-year-old African American male
with a history of type 2 diabetes mellitus. Mr. Rogers schedules a go to with the healthcare
company (HPC) due to the fact he develops a nonhealing ulcer on his right heel. After
several weeks of domestic remedies, he makes a decision he needs to look the HCP. Upon
arrival at the health center, Mr. Rogers' critical signs and symptoms are taken and a physical
assessment finished.Vital Signs:The HCP discusses the diagnoses with Mr. Rogers and
explains that it's far essential to confess him to the inpatient scientific-surgical unit at once to
treat the heel ulcer.Diagnoses:
Mr. Rogers changed into diagnosed remaining yr with kind 2 diabetes mellitus. He explains
that he's skilled with self-management of insulin injections three instances in keeping with
day. Mr. Rogers states that his ingesting conduct are not first-rate, but he in no way misses
his insulin injections. He lives on my own and does not want to consume by himself, -
ANSThe level II non-recuperation ulcer on the purchaser's proper heel may want to require
amputation.
Extra protein is needed for healing wounds and restoring losses. Extensive tissue
destruction, including that which happens with burns, stress sores, and diabetic ulcers
requires a huge protein growth for the recuperation and grafting techniques. Older adults
with diabetes mellitus II (DM) additionally exhibit bad wound recuperation.
The development of hypoglycemia will be lifestyles-threatening.
This is a situation to the nurse.
Dehydration exacerbated by means of loss of vitamins.
Approximately 19% of overall water consumption comes from meals. Uncontrolled diabetes
mellitus causes an extra loss of water thru urine because of excessive blood glucose levels.
In such cases, the substitute of misplaced water and electrolytes is crucial to prevent
dehydration.
Lack of urge for food and no longer wanting to devour on my own may want to lead to
malnutrition.
Many of the health problems of older adults end result from popular growing old and states
of malnutrition due to terrible food conduct, together with a lack of urge for food, or
loneliness and now not wanting to consume on my own.
,The nurse performs a targeted assessment, exams Mr. Rogers' blood glucose with a
glucometer, then administers the prescribed dose of insulin at some point of morning
medication administration rounds.
Which data about the purchaser is of most concern to the nurse?
C
Blood glucose rises from 120 mg/dL to one hundred twenty five mg/dL in 8 hours.
Washes fingers with cleaning soap and water and allows alcohol swab wipe to dry earlier
than appearing chemstick.
Reports a new onset of blurry vision.
Depends on handwritten notes to recollect his ultimate blood glucose analyzing. -
ANSReports a brand new onset of blurry imaginative and prescient.
Blurry imaginative and prescient can imply cataracts, glaucoma, optic nerve damage or
diabetic retinopathy.
The nurse reports Mr. Rogers' blurry imaginative and prescient to his HCP, who then
evaluates and treats Mr. Rogers for worsening diabetic retinopathy.
Select all that observe
Which different signs must the nurse count on to discover in a client with a prognosis of
diabetic retinopathy?
Reports of floaters.
Loss of vision.
Jaundice of the sclera.
Difficulty with colour perception.
Pupil fixation. - ANSReports of floaters.
Small micro aneurysms protrude from the vessel walls, inflicting the purchaser to look pink
and black spots or lines described as floaters
Loss of vision.
Micro aneurysms and edema can cause increased intraocular strain, retinal detachment and
glaucoma, that may all cause loss of vision.
Difficulty with coloration perception.
, Macular edema associated with diabetic retinopathy can purpose impaired hue
discrimination ensuing in impaired shade belief.
During Mr. Rogers' hospital stay, the HCP prescribes an insulin pen to replace Mr. Rogers'
insulin syringes and insulin vials. Mr. Rogers is taught by way of the nurse to dial the pen to
the prescribed amount and to apply a magnifying glass to make sure that the amount of
insulin is correct with every injection. The nurse ensures that the 2 insulin pens are sincerely
marked as glargine (Lantus) or lispro (Humalog) so Mr. Rogers can discover them without
difficulty.
The nurse is aware that which information is accurate regarding the prescribed insulin?
Glargine (Lantus) is rapid-appearing insulin generally administered 15 mins before meals.
Lispro (Humalog) is intermediate-appearing insulin that peaks in four to 10 hours.
Glargine (Lantus) does not have a height c language.
Lispro (Humalog) is typically given at bedtime on an empty belly. - ANSGlargine (Lantus)
does not have a peak c language.
Glargine (Lantus), lengthy-appearing insulin, has an onset of one to 2 hours, has no reported
height, and has a period of 24+ hours.
The nurse making rounds finds Mr. Rogers unresponsive. His crucial signs are BP ninety
two/60 mmHg, apical pulse a hundred thirty five beats/min, T 100.Four° F (38.0° C). His
chemstick reading is excessive.
What situations, apart from hyperglycemia, would possibly Mr. Rogers have?
Hypernatremia.
Hypervolemia.
Ketonuria.
Osmotic diuresis.
Glycosuria. - ANSKetonuria.
The loss of glucose in cells results in fats breakdown through the liver, and ketonuria effects
from the excretion of ketones in the urine.
Osmotic diuresis.
Glucose is an osmotically energetic particle, and lack of glucose results in mobile
dehydration.
Age-Related Risks
Meet the Client: Carl RogersCarl Rogers is a sixty seven-year-old African American male
with a history of type 2 diabetes mellitus. Mr. Rogers schedules a go to with the healthcare
company (HPC) due to the fact he develops a nonhealing ulcer on his right heel. After
several weeks of domestic remedies, he makes a decision he needs to look the HCP. Upon
arrival at the health center, Mr. Rogers' critical signs and symptoms are taken and a physical
assessment finished.Vital Signs:The HCP discusses the diagnoses with Mr. Rogers and
explains that it's far essential to confess him to the inpatient scientific-surgical unit at once to
treat the heel ulcer.Diagnoses:
Mr. Rogers changed into diagnosed remaining yr with kind 2 diabetes mellitus. He explains
that he's skilled with self-management of insulin injections three instances in keeping with
day. Mr. Rogers states that his ingesting conduct are not first-rate, but he in no way misses
his insulin injections. He lives on my own and does not want to consume by himself, -
ANSThe level II non-recuperation ulcer on the purchaser's proper heel may want to require
amputation.
Extra protein is needed for healing wounds and restoring losses. Extensive tissue
destruction, including that which happens with burns, stress sores, and diabetic ulcers
requires a huge protein growth for the recuperation and grafting techniques. Older adults
with diabetes mellitus II (DM) additionally exhibit bad wound recuperation.
The development of hypoglycemia will be lifestyles-threatening.
This is a situation to the nurse.
Dehydration exacerbated by means of loss of vitamins.
Approximately 19% of overall water consumption comes from meals. Uncontrolled diabetes
mellitus causes an extra loss of water thru urine because of excessive blood glucose levels.
In such cases, the substitute of misplaced water and electrolytes is crucial to prevent
dehydration.
Lack of urge for food and no longer wanting to devour on my own may want to lead to
malnutrition.
Many of the health problems of older adults end result from popular growing old and states
of malnutrition due to terrible food conduct, together with a lack of urge for food, or
loneliness and now not wanting to consume on my own.
,The nurse performs a targeted assessment, exams Mr. Rogers' blood glucose with a
glucometer, then administers the prescribed dose of insulin at some point of morning
medication administration rounds.
Which data about the purchaser is of most concern to the nurse?
C
Blood glucose rises from 120 mg/dL to one hundred twenty five mg/dL in 8 hours.
Washes fingers with cleaning soap and water and allows alcohol swab wipe to dry earlier
than appearing chemstick.
Reports a new onset of blurry vision.
Depends on handwritten notes to recollect his ultimate blood glucose analyzing. -
ANSReports a brand new onset of blurry imaginative and prescient.
Blurry imaginative and prescient can imply cataracts, glaucoma, optic nerve damage or
diabetic retinopathy.
The nurse reports Mr. Rogers' blurry imaginative and prescient to his HCP, who then
evaluates and treats Mr. Rogers for worsening diabetic retinopathy.
Select all that observe
Which different signs must the nurse count on to discover in a client with a prognosis of
diabetic retinopathy?
Reports of floaters.
Loss of vision.
Jaundice of the sclera.
Difficulty with colour perception.
Pupil fixation. - ANSReports of floaters.
Small micro aneurysms protrude from the vessel walls, inflicting the purchaser to look pink
and black spots or lines described as floaters
Loss of vision.
Micro aneurysms and edema can cause increased intraocular strain, retinal detachment and
glaucoma, that may all cause loss of vision.
Difficulty with coloration perception.
, Macular edema associated with diabetic retinopathy can purpose impaired hue
discrimination ensuing in impaired shade belief.
During Mr. Rogers' hospital stay, the HCP prescribes an insulin pen to replace Mr. Rogers'
insulin syringes and insulin vials. Mr. Rogers is taught by way of the nurse to dial the pen to
the prescribed amount and to apply a magnifying glass to make sure that the amount of
insulin is correct with every injection. The nurse ensures that the 2 insulin pens are sincerely
marked as glargine (Lantus) or lispro (Humalog) so Mr. Rogers can discover them without
difficulty.
The nurse is aware that which information is accurate regarding the prescribed insulin?
Glargine (Lantus) is rapid-appearing insulin generally administered 15 mins before meals.
Lispro (Humalog) is intermediate-appearing insulin that peaks in four to 10 hours.
Glargine (Lantus) does not have a height c language.
Lispro (Humalog) is typically given at bedtime on an empty belly. - ANSGlargine (Lantus)
does not have a peak c language.
Glargine (Lantus), lengthy-appearing insulin, has an onset of one to 2 hours, has no reported
height, and has a period of 24+ hours.
The nurse making rounds finds Mr. Rogers unresponsive. His crucial signs are BP ninety
two/60 mmHg, apical pulse a hundred thirty five beats/min, T 100.Four° F (38.0° C). His
chemstick reading is excessive.
What situations, apart from hyperglycemia, would possibly Mr. Rogers have?
Hypernatremia.
Hypervolemia.
Ketonuria.
Osmotic diuresis.
Glycosuria. - ANSKetonuria.
The loss of glucose in cells results in fats breakdown through the liver, and ketonuria effects
from the excretion of ketones in the urine.
Osmotic diuresis.
Glucose is an osmotically energetic particle, and lack of glucose results in mobile
dehydration.
