The Client Is A 76 Year Old Man Who Lives With His Wife. He Has History Of Diabetes, Hypertension An

The client is a 76 year old man who lives with his wife. he has history of diabetes, hypertension and peripheral vascular disease. he takes insulin and a diuretic daily. he has treated a sore toenail for two weeks by soaking it in epsom salts twice a day. he was active and eating normally until two days age when he felt ill with flu-like symptoms. he had several episodes of diarrhea during the night. his wife is uncertain whether he took his insulin yesterday. his wife called their physician’s office this morning because her husband is very weak and confused. the physician advised her to take her husband to the emergency room of the hospital. the couple’s daughter and son are with their parents in the emergency room. the nurse performs a physical assessment and obtains a nursing history from the family members present. the client’s vital signs are tpr 38.2c, 98, 28 and bp 112/56. skin warm and slightly flushed. he arouses to his name but appears drowsy. he can state his name but does answer questions about where he is or the date. his lung sounds are clear and his breath are full and regular. his oral mucous membrane are dry. the dorsalis pedis pulses are 2+palpable. his great toe on the right foot is reddened and swollen. the client moves his foot away when the toe is examined but does not respond to questions to describe his pain. blood work is drawn and shows that the client has mild renal insufficiency and hyperglycemia ( blood glucose 352) electrolyte and arterial blood gas show these results; arterial blood gases ph: 7.31 po2: 91 pco2: 32 hco3:18 base excess: -5 electrolytes na 147 k 5.6 cl 108 hco3 18

 

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