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
|X| 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
|X| Nurses’ Notes
|_| History and Physical
|_| Admission Notes
|_| Vital Signs
|_| Medications
|_| Orders
|_| Intake and Output
|_| Laboratory Report
|_| Flowsheet
|_| Progress Notes
|_| Diagnostic Report
|_| Other:
1.) What is most concerning finding? (10 points)
2.) What factors best explain client’s symptoms? Use specific pathophysiology. (15 points)
3.) What condition would most likely be expected? (10 points)
4.) What will happen if this condition is not treated? (10 points)
5.) What actions should the nurse take? (15 points)
6.) Which actions are contraindicated? (10 points)
7.) How should the nurse provide the glucose and why? (10 points)
8.) When should the RN re-check the blood glucose? (10 points)
9.) Under which circumstances would EMS be activated? (5 points)
10.) Who should the nurse notify? (5 points)
CJCST Version 2.0 designed by Desirée Hensel, 2022. Permission granted to use and modify template for educational purposes.
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