Care of a Group of Patients

Care of a Group of Patients

Care of a Group

Bluegrass Community and Technical College

Critical Criteria #1: Assessment and Prioritizing Patient Care
Client # 1 is a 71 year old female who was hospitalized on 1/23/13 with an admitting diagnosis of hyperglycemia, weakness and dehydration.   This client has history of underlying lung cancer with metastasis to bone and was recently diagnosed with metastasis to the brain. Other history includes Hypertension, Hypothyroidism, Mitral Valve regurgitation and COPD. Chemotherapy has been put on hold and she is currently getting radiation to the head. Client’s family reports her being more dependent over the last two weeks. She was found with acute kidney/injury (dehydration) and severe degree of hyperglycemia which is new news to her.   She was admitted for IV fluids, control of new onset diabetes, and other preexisting complications.   She was placed on Thickened liquids due to complication swallowing. Client recently has almost no appetite. Insulin was started for new diabetes problem.   Her vitals were stable (T: 97.5, P:93, BP:161/74, RR: 20, O2: 93%per 2L NC).   She is allergic to Codeine and Aspirin.  
Upon assessment of this client, I found her sleeping in bed.   Client aroused easily to verbal stimuli and oriented X3. Family was at bedside. PERRLA. Mucous membranes pink and moist, no JVD noted. Her nasal cannula was in place and set at appropriate level of 2L/min. Respirations even and unlabored. Wheezes noted throughout bilateral lungs, patient reports she is a smoker. I.S. at bedside, patient reports she has not been using it.   Teaching performed and patient correctly used the apparatus. Client has a dry chronic cough. Double lumen PICC noted to right upper chest.   Dressing is dry and intact. Site is without redness and edema.   1/2NS is infusing at 125 ml/hr.   Abdomen is soft and distended. Bowel sounds positive in all four quadrants. Skin- pink, cool and dry. Skin tear noted to right upper forearm. Client turned q2 hours. No other skin...

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