Brett Howard Flashcards
What is Bretts Medical History
T1DM
What did Brett present to the ED with?
Has had a fall. Most likely due to drinking and not taking his insulin. Brett fractured his arm. Brett has a high BGL and ketones present.
Suggested fall from DKA.
What is diabetic ketoacidosis
When the body doesn’t produce or have enough insulin, it starts to break down fat as a result. When fat is broken down, it creates a bi-product ketone which causes your blood to become more acidic.
What are Inter-costal catheter (ICC) and Underwater Seal Drainage (UWSD) used for
pneumothorax
hemothorax
Difference between type 1 and type 2 diabetes
Type 1 diabetes is an autoimmune disease, which means it results from the immune system mistakenly attacking parts of the body. In the case of type 1 diabetes, the immune system incorrectly targets insulin-producing beta cells in the pancreas.
Type 2 diabetes is characterised by the body losing its ability to respond to insulin. This is known as insulin resistance. The body compensates for the ineffectiveness of its insulin by producing more, but it can’t always produce enough. Over time, the strain placed on the beta cells by this level of insulin production can destroy them, diminishing insulin production.
What is Heparin - actions and use
Used for prophylaxis and treatment of thromboembolic disorders.
Is a direct anticoagulant that potentiates the naturally occurring inhibitors of coagulation, antifactor Xa and anti -thrombin 3, which then slows the conversion of prothrombin to thrombin and fibrinogen to fibrin.
What are the nursing responsibilities of Heparin
- 8 rights
- Allergy check
- Do not rub site of injection
- Rotate sites regularly
- Look for signs of overdose by looking for bruising or blood in urine
What is Ondansetron - actions and use
Used for post operative Nausea and vomiting
Works as a serotonin antagonist highly selective against 5-ht3 receptors.
What are the nursing responsibilities for ondansetron
- 8 rights
- Allergy check
- Place wafer under tongue
What is Ducosate sodium/Sennoside - action and use
Laxative
They work by keeping water in the intestines, which helps to cause movement of the intestines.
What is Actrapid - use and action
Short acting insulin.
Actrapid lowers blood glucose levels by binding to insulin receptors to increase glucose uptake and inhibit hepatic glucose output.
Nursing responsibilities for Actrapid
- 8 rights
- Allergy check
- Ensure pt education correct
- Hypoglycaemia likely if BGL under 3 mmol/L
- Cloudy solutions discarded
How would you evaluate care, actions and ongoing care for Brett?
- Educate on medication use and importance of understanding
- Education on DKA
- Refer to diabetes nurse
- Include family/wife in education to ensure they know signs of hypo/hyperglycaemia and DKA
- Create SMART goals
- Referral to physio
Where can the ICC be placed?
2nd intercostal space for pneumothorax
8th or 9th intercostal space for haemothorax
What should you have beside the beside for with an ICC and why?
- Sterile water incase the UWSD breaks and you need to keep negative pressure whilst getting it fixed.
- Gauze to cover are incase drain removes
