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Nausea and vomiting
Mr. jenaro is a 61 year old Spanish speaking man who presents to the emergency room with his wife Dolores. Mrs. Jenaro is also Spanish speaking, but understands some English. Mr. Jenaro complained of nausea and vomiting for two days and symptoms of confusion. His blood glucose is 796mg/ml. intravenous regular insulin ( Novolin R) is prescribed and he is admitted for further evaluation. He will request teaching regarding his newly diagnosed diabetes.
Case Study
Mr. Jenaro is newly diagnosed with diabetes. His hemoglobin A1C is 10.3%. Mr. Jenaro is slightly overweight. He is 5ft 10 inches tall and weighs 174 pounds ( 79Kg). He reports no form of regular exercise. He does not follow diet at home. He states, I eat whatever Dolores put s in front of me. She is a good cook. For past few months, Mrs. Jenaro has noticed that her husband has been very thirsty and been up and down to the bathroom a hundred times a day. Neither can recall how long it has been since there changes in Mr. Jenaro began. Dolores states, It been quite a while now. It just seem to be getting worse and worse.
Question
1. The nurse doses not speak Spanish. Discuss what the nurse should keep in mind to facilitate effective communication using an interpreter. What is the difference between the role of a medical interpreter and that of a medical translator?
2. Describes the following serum glucose tests used to help confirm the diagnosis of diabetes mellitus. Casual, fasting, postprandial and oral glucose tolerance test?
3. When evaluating Mr. Jenaro ‘s postprandial result, what is important to consider regarding his age and tobacco use?
4. Explained what a hemoglobin A1c (HbA1C) lab test tells the health care provider?
5. How might the nurse briefly explained what diabetes is diabetes is in lay terms to Mr. and Mrs. Jenaro ?
6. Explained the difference between type 1 diabetes and type 2 diabetes and who is at increased risk for developing each type. Base on this understanding, which type of diabetes dose Mr. Jenaro have?
7. Discuss the prevalence of diabetes and the potential long –term complication of diabetes?
8. List five nursing diagnose appropriate to consider for Mr. Jenaro?
9. Discuss Mr. and Mrs. Jenaro ‘s learning needs. Consider the communication preferences of Mexican Americans?
10. Discuss the dietary recommendations for a diabetes based on the Food Pyramid?
11. Discuss how culture may influence Mr. Jenaro ‘s diabetes management in terms of food choices, diet and exercise, and use of alternative health care provider?
12. Discuss the information the nurse and /or diabetes educator should include when teaching Mr. Jenaro about proper foot care.
13. Discuss the lifestyle considerations the nurse and/or diabetes educator should discuss with Mr. Jenaro and his wife
14. Discuss what Mr. Jenaro should be taught about how to manage his diabetes on days that he is ill ( e.g, if he were to have a stomach virus
15. Mr. Jenaro meets his friend at a local bar once a week for a beer or two. What impact dose alcohol have on a diabetes? Should he discontinue this social activity?