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avoid foods such as avacados, broccoli, dairy products, dried fruit, cantaloupe, and bananas. I would contact the nutrionist
Remember what type of medication on.
what is diabetes

wear identification bracelet, take prescribed dose of medication at the correct time, check blood glucose as ordered, maintain proper personal hygiene and diet. (Nekita)
If Mr. Torres is stable and ready for discharge I would begin instruction on nutrition for a diabetic. Proper bandage change for his wound. I would instruct him to use proper hygiene (Hand Washing) since diabetics are prone to infection(Bacteria thrive on glucose), Review instruction on Oral Agents and insulin injections and proper technique of injection (Maintaining Sterility). Encourage Mr. Torres to establish an excercise routine only if his blood glucose is within normal range. The importance of personal hygiene should be stressed. Also to obtain a hemoglobin A1C test every 3-6 months. Instruct patient to have anual eye examinations.(Adria)
What is diabetes

Brandi Burns=Red
Mr Jones is an 86 y/o male admitted to the hospital two days ago with dehydration, malnutrition and dementia. You are coming on shift and making rounds. You assess his skin and note redness on his sacrum and heels. He is incontinent of both urine and feces and cannot move himself around in bed. His v/s are T 98.7 P 88 R 22 BP 106/55.
1. What are contributing factors to the development of pressure ulcers?
immobility, impaired circulation, incontinence, age, anemia, contractures, diabetes, fever, low diastolic blood pressure, mental disorder, neurological disorder, obesity, pain, surgery, and vascular disease. Bed/ wheelchair-bound, / recovering from spinal cord injuries.
2. What are Mr. Jone`s risk factors in developing pressure ulcers?
Older age, dehydration ( poor skin turgor), malnutrition ( inadequacy of tissue repairing/healing), incontinence, and immobility.
The amt of pressure (intensity), the length of time the pressure is exerted on the skin (duration) and the ability of the MR. jones' tissue to tolerate the externally applied pressure. Also Shearing force, friction, and excessive moisture contribute to pressure ulcer formation since the pt cannot move himself around in bed. .
3. What stage pressure ulcer does Mr Jones have? What are the different stages of pressure ulcers? Describe the characteristics of each stage?
Stage 1 - non-blanchable intact skin. Persistent redness in lightly pigmented skin. skin indicators: warmth/ coolness skin temperature, firm/ boggy feel, / pain / itching.
Stage 2 - partial thickness injury into epidermis, dermis or both. The ulcer is superficial and present clinically as an abrasion, blister, / shallow crater.
Stage 3 - damage into SubQ tissue, but not through underlying fascia. the ulcer present a deep crater with / w/out undermining of adjacent tissue.
Stage 4 - Full thickness damage into muscle or bone, tissue necrosis/ supporting structures (tendons, joint capsule).
Unstageable - the actual depth of tissue losss is obscured by slough (yellow, tan, gray, / brown) and/ eschar (tan, brown, / black).
4. What nursing interventions can you do to help prevent the advancement of the pressure ulcer?
turning positioning q 2hr, encourage adequate nutrition and hydration, use appropriate dressing ( deuderm, ect ), encourage ambulation, keep skin clean, dry, and moisturized. Prevention for pressure ulcers: devices such as alternating pressure matresses, foam matresses w adequate stiffness and thickness, wheelchair cuschions, boots (foam, air), and lift sheets are useful in reducing pressure abd shearing force.
MrMr Jones continues this mean? it means that there is an erosion under the wound edge and a sinus that in indicate the extent of wound damage into surrounding deep tissue.
.
5. What are clinical signs of pressure ulcer infection?
hyperemia - increased blood flow to area, heat, redness, pain, swelling, loss of function, increased WBC count, malaise, nausea, anorexia, increased pulse and resp. rate.
Mr Jones is diagnosed with osteomyelitis as the result of the pressure ulcer on his coccyx. He is placed on antibiotics and is scheduled for a debridement. Why is a debridement needed?
Osteomyelitis is is a bone infection. A debridement is used to remove dead (necrotic) or infected tissue and sequestrum to improve and promote healing.
As the nurse assessing Mr Jones, you understand that a thorough skin assessment is critical for early detection and treatment.
6. What kind of lighting should you use when assessing the skin? How often should you assess his skin? What is the Braden Scale?
A room with exposure to daylight is preferred. A general assessment of the skin should occur at initial contact and continue throughout the assessment and hospital visit, espically if the patient is at risk for impaired skin integrity. The Braden Scale is used to assess patients at risk for skin breakdown/pressure ulcers. It assess areas related to: sensory perception, moisture, activity, mobility, nutrition, friction and shearing.
7.7. What is his skin? It is best assessed by using the backs of the hands
8. After assessing his heels, you note that they feel boggy. What does this mean? What can you do to help decrease this finding?
9. What is the required caloric intake for Mr Jones who weighs 65 kg? How many grams of protein should he being taking in daily?

side effects of Omeprazole
UPPER GI BLEED CASE STUDY
NUR 154

Assess respiratory status, and maintain open airway (aspiration oof blood)
All vital signs should be taken every 15 min until stable
monitor hourly urine
(Adria)
Upon assessment Mr Ulcer complains of pain in his abdomen. Upon assessment, his abd is rigid and tense. He has absent bowel sounds.
Take a coated caplet to avoid gastric irritation.
Notify provider if the following symptoms occur : black, bloody, or tarry stools, and coughing up blood or vomit that looks like coffee grounds.
stomach bleed. (Adria)
Mr Ulcer is discharge and controls his gastric secretions with no further episodes of bleeding.

Mr Ulcer is placed on ASA due to his newly diagnosed CAD and risk for clot formation.
What are you going to tell him in relation to taking the ASA?
with food or milk to prevent GI upset. pt should report any symptoms of gastricavoid irritation such as epigastric painof the GI tract.
Take a coated caplet to healthcare provider. (Nekitaavoid gastric irritation.
Notify provider if the following symptoms occur : black, bloody, or tarry stools, and Adria)coughing up blood or vomit that looks like coffee grounds.
Ty to avoid drinking Alcohol which increases the risk of stomach bleed.
Mr Ulcer is discharge and controls his gastric secretions with no further episodes of bleeding.

pt should avoid foods that cause epigastric distress such as spicy food, black pepper, and acidic foods. eating small frequent meals is better than large ones.
pt should not take any OTC medications without consulting with physician.
pt should otnot interchange antacids
pt should take all medication as prescribed. failure to do so may result in relapse.
encouragept should report any nausea, vomiting, epigastric pain, bloody vomit, or tarry stools.
encourage pt and chronic illness (Nekita)
Mr Ulcer is placed on ASA due to his newly diagnosed CAD and risk for clot formation.
What are you going to tell him in relation to taking the ASA?
as epigastric [painpain to healthcare providerprovider. (Nekita and Adria)
Mr Ulcer is discharge and controls his gastric secretions with no further episodes of bleeding.

Mr Ulcer is placed on ASA due to his newly diagnosed CAD and risk for clot formation.
What are you going to tell him in relation to taking the ASA?
Take ASA with food or milk to prevent GI upset. pt should report any symptoms of gastric irritation such as epigastric [pain to healthcare provider
Mr Ulcer is discharge and controls his gastric secretions with no further episodes of bleeding.

Mr Ulcer is placed on ASA due to his newly diagnosed CAD and risk for clot formation.
What are you going to tell him in relation to taking the ASA?
Take ASA as prescribed. Take ASA
Mr Ulcer is discharge and controls his gastric secretions with no further episodes of bleeding.