NurseThink® Time
1. She will have poor skin turgor due to
dehydration, which is a result of her high
blood sugar (Harding et al., 2020).
2. She will have an increased thirst drive also
as a result of her hyperglycemia (Harding et
al., 2020).
3. An eye assessment should be done to
determine if she has visual disturbances.
Due to her other signs of advancing
diabetes (sore on her foot she couldn’t feel
and vaginal infections), it is likely her vision
may be altered as well (Harding et al.,
2020).
1. Hemoglobin A1C is a priority lab test that
was done for this patient. A normal A1C
finding is below 5.7% and a level above 6.5%
indicates diabetes. This patient’s A1C was
abnormal at 12% which indicates she has
diabetes (Harding et al., 2020).
2. Blood glucose is a priority lab for this
patient. Her blood glucose level was 210
mg/dL which indicates diabetes since it is
over 200 mg/dL (Harding et al., 2020).
3. Urine should be checked for ketones for this
patient. A normal level is below 0.5 mmol/L.
This patient’s ketone level was +4 which is
high (Harding et al., 2020).
1. Check facilities insulin sliding scale to
determine how much insulin she needs
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administered. Using the one from class, she
would need 2 units of insulin to be given
(Harding et al., 2020).
2. Her foot wound will need to be cleaned and
dressed, most likely with a wet-to-dry
dressing (Harding et al., 2020).
3. It will be imperative to connect her with
social work in order to ensure she has
access to her full dose of medications
(Harding et al., 2020).
1. Diabetic ketoacidosis is a potential
complication if this patient’s blood sugar
remains uncontrolled. This can cause
serious issues, such as a coma (Harding et
al., 2020).
2. Sepsis can result from her wound if it isn’t
cleaned and cared for properly (Harding et
al., 2020).
3. Permanent kidney damage (nephropathy)
leading to kidney failure can result due to
damage done to the vessels of the kidney
caused by the high amounts of sugar in the
blood (Harding et al., 2020).
1. The nurse should administer priority
medications and monitor the patient’s
blood glucose for effectiveness of the
dosage. In general, glucose should be
monitored regularly (Harding et al., 2020).
2. The nurse should monitor meal intake and
schedule a meeting with the dietician to talk
with the patient about nutrition planning
(Harding et al., 2020).
NurseThink® Time
3. The nurse should check the patient’s legs,
feet, and heels for additional sores that may
be present due to peripheral neuropathy.
Taking proper care of any sores will reduce
the risk of infection and amputation
(Harding et al., 2020).
1. Rapid-acting insulin, such as lispro, is
indicated to lower her blood sugar back into
the therapeutic range for a type 2 diabetic.
This range is 80-130 mg/dL before a meal
and less than 180 mg/dL two hours after the
beginning of a meal (Harding et al., 2020).
2. Metformin has been prescribed for her to
lower the amount of glucose her body
absorbs in her intestines. This medication
also aids in the reduction of glucagon
production by the liver (Harding et al.,
2020).
3. She has also been prescribed glyburide
which stimulates the pancreas to produce
insulin and helps the body to effectively use
insulin (Harding et al., 2020).
1. A key discharge issue is her accessibility to
her medication. Referring her to social work
will enable her to receive her appropriate
dosage of medication (Harding et al., 2020).
2. She would benefit from education on the
importance of yearly physical assessments,
especially kidney function (Harding et al.,
2020).
3. She would also benefit from A1C education,
which should be checked every three
months to determine the efficacy of her
treatment regimen (Harding et al., 2020).
©2021 NurseTim, Inc., All rights reserved.
Harding, M. Kwong, J., Roberts, D., Hagler, D., &
Reinisch, C. (2020). Lewis’s medical-surgical
nursing: Assessment and management of
clinical problems (11th ed.). Elsevier, Inc.
 Read each question carefully and provide a
detailed answer. Each answer should be at
least 2-3 complete sentences. Please
proofread your answers by watching for
spelling, and grammatical errors.
 Provide a rationale for your answers by
citing your Med-Surg Textbook, Giddens,
and/or NANDA book for nursing diagnosis
or nursing interventions. Journal articles or
websites are not acceptable sources. List
your Med-Surg Textbook and/or NANDA
book at the end of the document in APA
format. If you need assistance with APA
format, there are references available in
Blackboard. You do not need to provide a
detailed answer for fill in the blank,
multiple choice, or matching questions and
you do not need to cite references for these
types of questions.
 Your answers should appear in a different
color font then the question.
 Refer to the course syllabus for guidelines on
submitting Learning Assessments.
 Type the name of each group member and
Group number at the top of the first page of
the Learning Assessment.