vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)/vSim: Juan Carlos (J.C.)
NURS 501: Pathophysiological and Pharmacological Bases for Nursing Practice
April 25, 2022
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vSim: Juan Carlos (J.C.)
J.C. is a 52-year-old Hispanic male admitted for surgical debridement of a diabetic foot
ulcer on his right big toe. J.C. has a history of hypertension, hyperlipidemia, and type II diabetes.
Current medications include lovastatin, insulin detemir, glyburide, metformin XR, cephalexin
and lisinopril. Patient was aware of his medical history, his medications, and whether the
medications were taken. J.C. stated that there was a pain and a throbbing within the right big toe
and rated the pain 3/10.
Given J.C.’s medical history, monitoring his blood glucose reading and maintaining the
glucose levels would be the top priority in his care. If his glucose levels were to go above the
normal range (hyperglycemia), J.C. may experience vomiting, excessive hunger and thirst, and
tachycardia (Cleveland Clinic, n.d.). If the opposite were to occur and his glucose levels were to
go below the normal range (hypoglycemia), J.C. may experience sweating, shakiness, and
irritability (Mayo Foundation for Medical Education and Research, 2020). The other priority
would be monitoring the status of the diabetic toe ulcer. If it worsens, it could result in
neuropathy, deformity, or even peripheral arterial occlusive disease (PAD) that could result in
amputation (Oliver and Mutluoglu, 2021). J.C. does present with other comorbidities, but they do
not call for immediate intervention. The priorities did not change during the care as these issues
required more immediate attention. J. C’s vitals did not show any immediate concern for
alternative interventions to control the blood pressure, oxygen saturation, or heart rate.
While J.C. was able to recall his medical history and medications, he also presents to the
hospital with a foot ulcer which is indicative that he was not monitoring his glucose levels well.
His blood glucose readings were extremely high and required a few intervention options to bring
the glucose levels back within normal range. His medical history includes a sliding scale for his
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