Assignment task:
Raymond is a 16-year-old student who attends the GP surgery at 9am to see the diabetic nurse accompanied by his mother Alice.
Raymond has type-one diabetes which was diagnosed when he was three and this has been poorly controlled recently.
Raymond is studying A-Levels at a local college and is keen to go on to university and study engineering.
He likes socialising with friends and finds the restrictions imposed by his condition very difficult.
Alice is worried because Raymond's college work has been deteriorating and she is worried that he will not get the grades he needs to go on to further study.
Raymond appears quite drowsy and is complaining of thirst and keeps asking for a cup of water. Alice tells you that he never seems to be out of the loo.
OBSERVATIONS TAKEN IN CLINIC
AIRWAY: Raymond can talk in full sentences.
BREATHING: RR 30 breathing appears deep and laboured and his breath carried a slight smell of nail polish remover. SpO2 95% on air.
CIRCULATION: HR 100bpm, BP 98/50mmHg.
DISABILITY: AVPU: Alert but drowsy and rather distressed. Blood glucose just reads as HIGH on the Practice Monitor.
EXPOSURE: Temperature 36.2C, no wounds visible, no IV access, Raymond appears quite drawn and has reduced tissue turgor.
Question 1: Using the A-E approach identify the nursing priorities for Raymond's care whilst he is in the clinic.
- Consider both his current presentation and the potential for any further deterioration and how this could be managed.
- Treat Raymond as a whole person, considering everything we know about him and not just his presenting condition.