Case Summary The school RN sees an 8-year-old male coming into the nursing office by his Phys Ed teaching with


Case Summary

The school RN sees an 8-year-old male coming into the nursing office by his Phys Ed teaching with complaints of profuse sweating and confusion. The patient is currently afebrile.

Objectives. (
More or less are possible)

1. Recognizing signs of hypoglycemia

2. Differentiate between hypo- and hyperglycemia

3. Initiates treatment plan for abnormal blood sugars

4. Evaluating effectiveness of treatment plan

Description of Client

Age:

8 years

Gender

male

Medical diagnosis or chief concern

Abnormal blood sugars

Care Setting
(More than one are possible)

|_| Emergency Department

|_| Medical-Surgical Unit

|_| Pediatric Unit

|_| Maternity Unit

|_| Behavioral Health Unit

|_| Intensive care unit

|_| Post-anesthesia Care Unit

|_| Skilled-care Facility

|_| Home

|_| Outpatient Clinic

|X| Other setting: school

|_| Others present:

History of chief concern/current condition/problem

Symptom: sweating and confusion

Onset: 30 minutes ago

Treatments tried (if applicable): drank water and sat down

Other history as indicated

Allergies: NKA

Weight/BMI (If applicable): 23 kg

Medical diagnosis/surgeries/psychosocial: Type I DM diagnosed 1 year ago, no further past medical history, no surgical history

Medications: Novolog

Diagnostic tests: blood glucose POC, vital signs

Assessments

Important, abnormal, or relevant assessments

Normal or irrelevant assessments

Confusion

Sweating

Recent illness with “up and down” sugars

PMHx DM Type I

Afebrile

Solutions

Priority to address

Desired outcome

Confusion

Sweating

DM I history

Alert and oriented x3

Normal blood sugars

Actions/order indicated

Actions/order not indicated/contraindicated

Obtain blood sugar

Obtain full set of vital signs

Send back to gym class immediately

Increase insulin dose

Information Sources

|_| Phase Sheet

|X| Nurses’ Notes

|_| History and Physical

|_| Admission Notes

|_| Vital Signs

|_| Medications

|_| Orders

|_| Intake and Output

|_| Laboratory Report

|_| Flowsheet

|_| Progress Notes

|_| Diagnostic Report

|_| Other:

1.) What is most concerning finding? (10 points)

2.) What factors best explain client’s symptoms? Use specific pathophysiology. (15 points)

3.) What condition would most likely be expected? (10 points)

4.) What will happen if this condition is not treated? (10 points)

5.) What actions should the nurse take? (15 points)

6.) Which actions are contraindicated? (10 points)

7.) How should the nurse provide the glucose and why? (10 points)

8.) When should the RN re-check the blood glucose? (10 points)

9.) Under which circumstances would EMS be activated? (5 points)

10.) Who should the nurse notify? (5 points)

CJCST Version 2.0 designed by Desirée Hensel, 2022. Permission granted to use and modify template for educational purposes.

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