Hello there! Want a discount? Grab 5% OFFon your first order!
originalresearchpapers.com logo
Hello there! Want a discount? Grab 5% OFF on your first order!
originalresearchpapers.com logo

Nursing Note: Client was playing basketball, injured his right ankle, “I made this great jump shot, and when I

Nursing Note: Client was playing basketball, injured his right ankle, “I made this great jump shot, and when I landed, I felt something pop in my right ankle.” Right ankle with slight swelling, no obvious deformity, toes warm with capillary refill less than 3 seconds. +active ROM in toes and denies increased numbness or change in tingling. Has had numbness and tingling in both feet for the past year. Reports doing daily capillary blood glucose monitoring but does not always follow a diet plan. “It’s hard, I don’t want my friends to think of me as sick, so I eat what they eat. I take about the same amount of insulin every day.” 

4/3 1015

Neuro/Cognitive: Alert and oriented x 4, pupils 4 mm and PERRLA. Grips equal and strong. Right lower extremity, non-weight-bearing, toes wiggle, full weight-bearing with left leg. Bilateral foot numbness and tingling x 1 year.

Cardiovascular: S1/S2, regular rhythm.

Respiratory: Lungs clear, no cough noted or reported.

Gastrointestinal: Abdomen soft with active bowel sounds x 4 quadrants. Last bowel movement was today.

Integumentary: Skin appears intact. +blue bruising, +swelling to right lateral ankle.

4/3 1145

Nursing Note: Client inquiring about snacks, “I haven’t eaten today, and I feel dizzy. I get like this if I don’t eat.” Blood glucose: 82. Client took NPH insulin at approximately 0800, did not eat. Client unsure how much insulin he took, “I was in a hurry, but took about the same number on the syringe as I usually do.” Snack of turkey sandwich and milk, client, ate 100%.

4/3 1415

Nursing Note: Client reports seeing a provider on the other side of town for diabetes management every six months. Has not had blood drawn in the past year, “I couldn’t get to the lab.” Completes capillary blood glucose checks about once a day, time varies, sometimes before he eats and sometimes after. “I didn’t know that it mattered; my mom never did that. Maybe that is why I sometimes feel so weak and dizzy.” Denies ever having diabetic education as a teen or an adult, saying it was never offered and he didn’t know he needed it. Provider informed of client conversation.

4/3 1500

Nursing Note: Client return demonstrates safe crutch walking and elastic bandage application. Discharge instructions reviewed with the client. Client verbalized understanding of discharge instructions and will make appointments with clinic dietitian and diabetic educator. Blood glucose 135 on discharge.

Jake Abbott 28-years-old

CJSim Overview: Young adult with an ankle injury.

Share This Post

Email
WhatsApp
Facebook
Twitter
LinkedIn
Pinterest
Reddit

Order a Similar Paper and get 15% Discount on your First Order

Related Questions

Help responding to collegues Please respond to the following colleaguesAS Angela

Help responding to collegues  Please respond to the following colleagues AS Angela Stapleton-Burley Jun 25 10:56pm Manage Discussion by Angela Stapleton-Burley Reply from Angela Stapleton-Burley   Hi Everoyne, One significant benefit of incorporating big data into clinical systems is the enhancement of predictive analytics, which allows providers to proactively identify

Purpose: The purpose of this assignment is to assess your ability to conduct a systematic and comprehensive head-to-toe physical assessment. This will

Purpose: The purpose of this assignment is to assess your ability to conduct a systematic and comprehensive head-to-toe physical assessment. This will help reinforce critical thinking, clinical reasoning, and documentation skills essential for nursing practice. By completing this assignment, you will demonstrate proficiency in assessing various body systems, identifying normal

COMPLETE USING DOCUMENT POSTED WITH ASSIGNMENTThumbnails/thumbnail.pngDetermining Anesthesia Service Payments and Modifiers As a new medical

COMPLETE USING DOCUMENT POSTED WITH ASSIGNMENT Thumbnails/thumbnail.png Determining Anesthesia Service Payments and Modifiers As a new medical coder for an Anesthesiologist group, it is important that you practice calculating service payments by assigning the appropriate anesthesia code(s) and modifier(s), as well as determining the base and time unit values, any

COMPLETE ALL QUESTIONSThumbnails/thumbnail.png1) The ICD-10-CM Official Guidelines for Coding and Reporting are approved by the FILL IN

COMPLETE ALL QUESTIONS Thumbnails/thumbnail.png 1) The ICD-10-CM Official Guidelines for Coding and Reporting are approved by the FILL IN BLANK  parties for ICD-10-CM to accompany and complement the official conventions and instructions provided within ICD-10-CM. 2) Official coding guidelines use the term FILL IN BLANK  when referring to face-to-face contact between patients and health

  Questions Discussion Board: Instructions Purpose: The purpose of this assignment is to familiarize you the complexity of quantitative statistical

  Questions Discussion Board: Instructions Purpose: The purpose of this assignment is to familiarize you the complexity of quantitative statistical analysis. Instructions: For this discussion, please complete the following: Review the assigned chapters in Polit and Beck (2017): i.e., chapters 18-20. Identify five different facts or pieces of information that

You deserve a bonus!

Subscribe and get regular bonuses and discounts.