Admitted to the hospital is an 86-year-old female with COPD, CHF, DM, & hypertension. Her BMI is 32.
Home medications include an oral antidiabetic, corticosteroids, a beta-blocker, and aspirin.
She lives with her son in his home. She is in the upstairs portion of the home requiring steps to the living areas.
The son does not like to cook, and care manager has the patient set up on Meals-on-Wheels; her daily diet lacks adequate amounts of vegetables and fruit.
The patient states that in the last 6 months she has noticed some loss of vision in spots of his visual field as well as dryness of his eyes. Occasionally, she sees black dots and continue to run into things as she turns corners. Soft wheezing is heard throughout anterior and posterior lung fields with slightly diminished breath sounds in the bases. Slight Edema noted in lower legs. Vital signs are blood pressure 180/80 mm Hg; heart rate 75/min, sinus rhythm; respirations 28/min; temperature 98.6° ; and pulse oximeter reading 93% at rest on room air. With activity pulse ox is 88% with no oxygen. Blood glucose is 175 mg/dL.
Document a nursing note on the patient for each of these problems: (a) Potential for falling/injury · (b) Vision impairment · (c) Inadequate nutrition. Include any additional notes that may be important.
What impact could this patient’s nutritional state have on her eyes and vision? How does this effect nursing assessment and patient teaching?
Describe how diabetes mellitus impacts this patient?
Review the patient’s home medications. Describe how the patient’s home medication may be impacting her current blood glucose levels.
