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ANSWER EACH WITH 2-3 SENTENCES

 Patient Profile: C. S., a 60-year-old truck driver, has been diabetic and has required insulin therapy for the past 12 years. Diabetic neuropathy has led to several complications, including end-stage renal disease, which he developed two years ago. He now receives hemodialysis three times a week and has an AV fistula in his left forearm. Yesterday, C. S. presented in the ED with a respiratory infection and was hospitalized with pneumonia, hypertension, and fluid overload. He will receive dialysis while on your nursing unit.

Critical Thinking Questions: Answer each question completely and thoroughly.

1) Is it appropriate to administer an aminoglycoside antibiotic for his respiratory infection? Why or why not?

2) What changes would you expect to see in this patient’s blood glucose levels during and after hemodialysis? What nursing care would you provide during and after hemodialysis?

3) C. S. missed his dialysis treatment on the day of admission. How might this be evidenced in his respiratory status? What care would you expect to provide next and why?

4) His wife comments on the fruity odor of his breath. What complication would cause this sign? What should you do next and why?

5) C.S. complains of dry, itching skin. How would you explain this symptom to him? What nursing measures for skin care would you provide and why?

 

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