The Aboriginal Medical Service

Introduction
Christine (but she calls herself Chris) Saunders is a 36-year-old human resources manager for a state government department. She has been brought in by her younger brother and his partner. She unexpectedly arrived at their flat. She apologized “for being late” complaining angrily “the stupid taxi driver argued with me about the directions”. Sitting with the couple in their flat, she had trouble keeping up with the conversation and she remains uncharacteristically agitated.

With help from her brother, you establish she was diagnosed with diabetes “about eleven years ago”.She sees an endocrinologist at monthly visits to the Aboriginal Medical Service (AMS). As well as diabetes she has “high blood pressure”. In passing she mentions that her diabetes is getting better as she hasn’t had to go to the toilet so often recently. Before today she had just taken “a couple of sickies because I was feeling very nauseous” and “just plain tired”.
She needed help from her brother and his partner walking into the hospital. Her skin has a waxy appearance and she complains of “being very itchy”. Also, she is out of breath from the walk from the taxi rank to A&E. The veins on her neck veins are distended.
Vital Signs
Blood pressure: 160/95 mm Hg
Heart rate: 110 bpm
Respiratory rate: 26 breaths per minute
SaO2 94%
Finger prick glucometer reading(fasting): 9 mmol/L

Following this case study answer the following questions:

1. Presentation: What aspects of this case will you wish to focus upon?

2. Pathophysiology: Make an assessment that explains the patient’s presentation. What is their diagnosis?

3. Tests and Interventions: What are your tasks in the immediate period after the presentation? What are important tests that should be undertaken? Provide 5 examples

4. Nursing/nurse practitioner responsibilities and tasks: What will you do for them for whatever period the person will be under your care? Provide 5 examples