Case Study

Working patient scenarios or cases help improve diagnostic reasoning and understanding of pharmacologic management in acute care.

In this assignment, you will be given a case with all required information to develop an appropriate diagnosis (there is only 1 correct diagnosis). You will answer questions and include your rationale and utilize EBP in your management of the patient presented. Read the questions carefully as many have multiple components.

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You should complete the Unit 3 learning activity to assist you in your knowledge of this diagnosis and answering some of the questions.

Danny Jameson Case Study

DJ, who was diagnosed with type I diabetes mellitus when he was 13 years old, is now a new NP. Danny’s diabetes remained in control throughout middle and high school, college, and throughout graduate school. However, when Danny started his NP residency program, his regular schedule of meals and insulin injections was completely disrupted. One morning, after a very late night in trauma surgery, Danny completely forgot to take his insulin! At 5 a.m., before rounds, he drank orange juice and ate two doughnuts. At 7 a.m., he drank more juice because he was very thirsty. He mentioned to the student next to him that he felt “strange” and that his heart was racing. At 9 a.m. he excused himself from the operating room because he thought he was going to faint. Later that morning, he was found unconscious in the call room. He was transferred immediately to the emergency department, where the following information was obtained:

BP

90/40

Pulse

130/min

RR

32/min, deep and rapid

Glucose

560mg/dL

Na+

132mEq/L

K+

5.8mEq/L

Cl-

96mEq/L

HCO3-

8mEq/L

Ketones

+++

ABG

pO2

112 mm Hg

pC02

20 mm Hg

pH

7.22

Questions:

What is your final working diagnosis for this patient, how did you determine it, and what is its etiology?
Explain in detail the cause and effect of Danny’s symptoms using resources in EBP.
What factors contributed to Danny’s hyperkalemia? Is his total body K+ low, normal, or high?
What measures will you take to correct his electrolyte imbalance?
How will you medically manage this patient? Write a set of admission orders for Danny, including all scheduled and prn medications with indications. (Ex: Zofran 4mg IV q 6hrs prn nausea, Insulin 5 units ac meals for basal coverage).
Assignment Requirements:

Before finalizing your work, you should:

be sure to read the assignment description carefully(as displayed above);
consult the Grading Rubric(under Course Resources) to make sure you have included everything necessary; and
utilize spellingand grammar check to minimize errors.
Your writing assignment should:

follow the conventions of Standard English(correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style,and mechanics; and
use APA 7th edition
How to Submit:

Submit your assignment to the Unit 3 Assignment Dropbox before midnight on the last day of the unit. Save a copy of your work.

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