Type 2 diabetes

Red is an 80-year-old farmer and war veteran who lives by himself, 20 miles from the nearest city. He has been a widower for 10 years but his son and daughter-in-law, Jon and Judy, live nearby. He was diagnosed with type 2 diabetes about six months ago and recently began taking insulin. We (nurses from the home health agency) have been asked to see him to evaluate a wound caused by wearing shoes that were too tight. The toe was injured about three weeks ago. Red has been treating it by soaking his foot in water. His daughter-in-law, Judy, expressed concerns about his ability to manage diabetes self-care, and he has agreed that she can be present for the conversation. We know he is very independent, alert, and oriented. He drives himself into town at least once a week and spends a lot of time on his computer.

Patient Details

Patient Data: Male- Age: 80 years. Weight: 109 kg (240 lbs). Height: 183 cm (72 in).

Allergies: No known

Past Medical History: Diabetes type 2, diagnosed six months ago. Initially treated with oral antidiabetics, but a few weeks ago shifted to insulin.

History of Present Illness: The patient developed an ulcer on his big toe three weeks ago. He has been soaking his foot to heal the wound. Recently, he revealed the wound to his family, who called Dr. Baker.

Social History: Widower, his son Jon and daughter-in-law Judy live nearby.

Primary Medical Diagnosis: Pressure ulcer, right great toe. Type 2 diabetes.

Surgeries/Procedures & Dates: L4-5 laminectomy 25 years ago, transurethral resection of the prostate six years ago.

Questions

Pathophysiology review. Review the pathophysiology that is the focus of the vSim. Be brief using bullet points to highlight main points of pathophysiology.

Describe 5 statements re this health problem here

Medications review: Complete the table for each of the medications listed as preparation for the simulation following the example provided. Add rows as needed.

Lab Tests (blood, urine, sputum, cultures, etc): Please complete the table for laboratory tests listed in the preparation for vSim. Add rows as needed.

PROCEDURES and DIAGNOSTIC TESTS (oxygen, O2 Sat level, radiography, etc.). Please complete the table for procedures listed in the preparation for vSim. Add rows as needed.

GERO ASSESSMENT TOOLS.

Describe the purpose of each assessment tool and what the scoring means for care planning.

1.

2.

Based on your review of pathophysiology, medications, procedures and assessment tools, list at least two problems (apply 3 step process:  problem, R/T, AEB) (Nursing Process)

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2.