Symptoms of hyperglycaemia

William Aldridge is a 42-year-old Indigenous Australian from Dubbo, New South Wales. S: William presents to the hospital emergency department (ED) with symptoms of hyperglycaemia, sudden onset of chest pain radiating down his left arm, and diaphoresis. B: William has a history of Type 1 Diabetes Mellitus (T1DM), diagnosed at the age of 14 years. William lives with his large extended family and is from the Tubbagah People of the Wiradjuri Nation. William was a well-known footballer and is an important role-model for young men in his community. William’s father, whom he loved very much and considered his idol, passed away 6 months ago, from a myocardial infarct Since his father died, William has not been managing his T1DM and has started smoking and drinking. This has had a negative impact on his physical engagement with football and his community. He also lacks interest in any other positive aspects of life. William is an Insulin dependent diabetic. He stopped recording his blood glucose levels about 3 months ago.

William’s T1DM is managed with Glargine (Lantus) insulin 12 units nocte and NovoRapid 4 units with meals. A: William observations on presentation to the ED were: Temperature: 37.C Pulse: 110 bpm Respirations: 22 Oz Sats: 92% BP: 145/90 BGL: 16.8 mmol Ketone level: 0.7mmol Height: 183 cm Weight: 89 kg BMI: 26.6 UA: SG 1030 PH 5 o Glucose large Ketones moderate R: The doctor has requested that you complete a physical examination, an electrocardiogram (ECG), urinalysis, QID BGLs and vital signs on William. He also requires blood tests to assess his blood glucose levels and cardiac enzymes and a chest X-ray. In your own words, discuss the difference between Type 1, Type 2, and gestational diabetes. Question 16 Consider the pathophysiology and treatment of each type.

NS What specific population group does each type affect? Reference/s must be included Based on William’s situation, identify two (2) health goals that Question 17 S NS may improve his lifestyle for each of the following areas: regular monitoring of blood glucose levels healthy eating weight loss . . . smoking cessation foot and eye care Outline what the expected outcome is for each health goal. In your response consider: William’s specific lifestyle and circumstances o how to improve his overall health and decrease possible complications associated with his diabetes. See the example provided below for guidance. Example: Health Promotion Goals Expected Outcome Exercise William will attend football training, William will increase physical activity once a week and warm up with the to assist with decreasing his BGLs over team for 15 minutes. the next 6 months. William is complaining of feeling dizzy, nauseated and has a headache. On assessing William, you note that he is pale and clammy and is tachycardia. You check William’s blood glucose level (BGL) and note that it is 3.4 mmol/L. a. What do you think is happening? How will you manage this situation? Question 18 b. How would you manage this situation if William lost NS consciousness? In your response consider: your immediate treatment of William including who you would notify and how how you would document the event and outcomes.

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