VSIM Skylar Hansen post-quiz
This is Skyler Hansen. He is an 18-year-old male, just arrived in the Emergency
Department accompanied by his friend, who said he started acting 'weird' while
they were playing basketball. Skyler told him he was light-headed and was going
to lie down on the cement court. His friend became nervous and decided to bring
him to the hospital.Background:Skyler lives at home with his parents and
siblings. He was diagnosed with type 1 diabetes 6 months ago.Assessment:The
patient has not eaten anything for at least 5 hours. He is diaphoretic and drowsy;
wakes with stimulus, acting irrationally; and has slurred
speech.Recommendation:An initial assessment and vital signs are needed. He
has not been seen by the provider.
.........
The nurse knows that the early warning signs of hypoglycemia include
Palpitations d/t epinephrine release
Rationale:At the onset of hypoglycemia, the parasympathetic system is activated,
causing hunger. This is followed by activation of the sympathetic nervous system,
resulting in a surge of epinephrine and norepinephrine. This causes symptoms
such as diaphoresis, tremor, tachycardia, palpitation, anxiety, and hunger. Double
vision, drowsiness, and emotional changes are later signs of hypoglycemia, due
to lack of glucose needed for function of brain cells.
Mr. Hansen is showing signs of moderate to severe hypoglycemia, which include
headache d/t impaired brain function
Rationale:In moderate hypoglycemia, the fall in blood glucose level deprives the
brain cells of needed fuel for functioning. Signs of impaired function of the CNS
may include inability to concentrate, headache, lightheadedness, confusion,
memory lapses, numbness of the lips and tongue, slurred speech, impaired
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