Introduction
Christine (but she calls herself Chris) Saunders is a 36-year-old human resources
manager for a state government department. She has been brought in by her younger
brother and his partner. She unexpectedly arrived at their flat. She apologised “for
being late” complaining angrily “the stupid taxi driver argued with me about the
directions”. Sitting with the couple in their flat, she had trouble keeping up with the
conversation and she remains uncharacteristically agitated.
With help from her brother you establish she was diagnosed with diabetes “about
eleven years ago”. She sees an endocrinologist at monthly visits at the Aboriginal
Medical Service (AMS). As well as diabetes she has “high blood pressure”. In passing
she mentions that her diabetes is getting better as she hasn’t had to go to the toilet so
often recently. Before today she had just taken “a couple of sickies because I was
feeling very nauseous” and “just plain tired”.
She needed help from her brother and his partner walking into the hospital. Her skin
has a waxy appearance and she complains of “being very itchy”. Also, she is out of
breath from the walk from the taxi rank to A&E. The veins on her neck veins are
distended.
Vital Signs
Blood pressure: 160/95 mm Hg
Heart rate: 110 bpm
Respiratory rate: 26 breaths per minute
SaO2 94%
Finger prick glucometer reading(fasting): 9 mmol/L

Following this case study answer the following questions:

1. Presentation: What aspects of this case will you wish to focus upon?

2. Pathophysiology: Make an assessment that explains the patient’s presentation. What is their diagnosis?

3. Tests and Interventions: What are your tasks in the immediate period after the presentation? What are important tests that should be undertaken? Provide 5 examples

4. Nursing/nurse practitioner responsibilities and tasks: What will you do for them for whatever period the person will be under your care? Provide 5 examples